What Is a Healthcare Ombudsman? Colorado Guide for Facilities

Since the 1970s, the U.S. has been making significant strides to improve conditions at nursing homes and other long-term care settings. One notable, federal initiative is the Long-Term Care (LTC) Ombudsman Program, which requires each state to investigate and address residents’ concerns using a trained long-term care ombudsman. Colorado’s program is designed to not only protect the rights of residents, but also ensure facilities are complying with all relevant state and federal regulations.

If you’re an LTC facility leader in Colorado, it’s important to approach ombudsmen as partners, not adversaries. Understanding how to work with your local ombudsman can help improve the quality of your care delivery. We’ll provide an overview of what an ombudsman does and what to expect before interacting with one.

What Is the Colorado Ombudsman Program?

The primary mission of Colorado’s Long-Term Care Ombudsman Program is to protect the health, welfare, and safety of all residents receiving LTC services. The program is overseen by the state’s Department of Health and Human Services (HHS) and authorized by both the Older Americans Act and the Older Coloradans’ Act.

Networks of local offices are spread across the state, which each recruit and manage teams of staff and volunteers who serve as certified ombudsmen. These individuals are trained to visit various LTC facilities to ensure that the rights of residents are being upheld.

What Does an Ombudsman Do?

The general definition of an ombudsman is someone who objectively investigates and settles complaints made by individuals against organizations. Within the context of long-term care, this typically involves the complaints about a facility from residents, friends, family, or staff. However, there are many other services provided by a medical ombudsman. Colorado staff and volunteers are also trained to:

• Advocate for the rights of residents living in a long-term care facility
• Resolve issues about residents’ quality of life or quality of care received
• Work with residents, family, friends, or facility staff to meet regulatory requirements
• Provide resident education on self-advocacy and LTC service options

Who Does an Ombudsman Work With?

Whether you’re a resident, family member, friend, staff member, or member of the population of Colorado, your ombudsman is here to help you with any LTC-related concerns. More specifically, Colorado’s program is designed to aid the following groups or individuals:

• Residents of skilled nursing homes and licensed assisted living residences
• Family and friends of residents in licensed LTC facilities
• Administrators and employees of licensed LTC facilities
• Any groups or individuals concerned about the rights of LTC residents
• Anyone residing in Colorado

Groups or individuals seeking to file a formal complaint can use Colorado’s online submission system. For all other general questions or inquiries, you can find your local ombudsman’s contact information on the office’s webpage.

What Types of Issues Does an Ombudsman Resolve?

There are a variety of issues that an ombudsman is equipped to resolve. For residents, an ombudsman works to address any cases of mistreatment in LTC settings. For facility staff and leaders, the ombudsman will also help answer questions or provide guidance about local and federal laws. Examples of specific issues overseen by Colorado’s office include:

• Violations of rights. This covers issues relating to lack of privacy, loss of dignity, negative staff attitudes, and emotional or verbal abuse.
• Transfers and discharges. This would include sudden discharges, undisclosed service fees, readmission refusals, and unexplainable Medicaid billing charges.
• Inadequate care quality. This would relate to care issues like unanswered call lights, untimely medication administration, and poor hygiene practices.
• Regulatory compliance issues. An ombudsman can assist with any confusion around new laws or amendments impacting older adults, and help with education on resident rights.

Tips for Facilities Working With an Ombudsman

If a complaint is filed about your facility, you may need to undergo an investigation by your local ombudsman. Colorado’s program works collaboratively with facility leaders to help resolve potential issues, so it’s important to remember that this is an opportunity to improve your operations. Follow these tips to help your ombudsman resolve any issues as quickly and effectively as possible:

• Cooperate. Work alongside your ombudsman by providing any information that they ask for. Communicating and cooperating effectively can help to resolve problems in an efficient manner.
• Act. If an issue is found, make the necessary changes advised by your ombudsman. This will help prevent any future issues and improve the safety and quality of care that you’re delivering to residents.
• Follow-Up. Even if a particular issue is resolved, you can always follow-up with your ombudsman for more help. They will guide you through any and all regulatory questions you have so that you can continue striving for excellence in your care services.

Improve Regulatory Compliance at Your LTC Facility

Ready to take further action after receiving advice from your ombudsman? Colorado facility leaders can start here. Don’t miss out on IntelyCare’s other free guides on regulatory compliance, delivered straight to your inbox.