What Is a Healthcare Ombudsman? DC Guide for Facilities
In 1972, Congress amended the Older Americans Act and established the national Long-Term Care (LTC) Ombudsman Program to help improve conditions in long-term care facilities. Under this program, each state (and the District of Columbia) is required to uphold the rights of LTC residents by providing the services of an ombudsman. DC in particular provides ombudsman services for a number of other health-related areas in addition to long-term care.
If you’re an LTC facility leader, your ombudsman can help you comply with healthcare regulations and enhance the quality of your care. To prepare you for potential interactions with your ombudsman, we’ll walk you through what an LTC ombudsman in Washington, DC does and what you can expect when working with one.
What Is the DC Ombudsman Program?
While ombudsman programs are typically associated with long-term care, DC has three distinct ombudsman offices — each overseeing a different type of healthcare-related area in the state. These offices include:
- Long-Term Care Ombudsman: This program is part of Washington, DC’s Legal Counsel for the Elderly and aims to protect and advocate for the rights of older adults living in LTC facilities.
- Behavioral Health Ombudsman: This program is overseen by the state’s Department of Behavioral Health (DPH) and aims to address issues related to DPH-run programs and services.
- Healthcare Ombudsman: This program was legislated by the Council of DC and helps DC residents work through issues or questions regarding their healthcare coverage.
What Does an Ombudsman Do?
In more general terms, an ombudsman is defined as an impartial party that investigates and resolves complaints made by individuals against organizations. In healthcare, this involves any complaints that residents, their friends or families, or other concerned parties make about a facility or service.
In Washington, DC, complaints can be submitted directly to the DC ombudsman office that corresponds with the related service area or program in question. For example, families that have issues with their loved one’s nursing home should contact the LTC ombudsman. Conversely, individuals who have concerns about their child’s school-based mental health provider can contact the behavioral health ombudsman.
Beyond investigating and addressing filed complaints, there are many other duties carried out by an ombudsman. Washington, DC’s ombudsmen are also trained to:
- Educate individuals about their healthcare rights and available services.
- Identify, monitor, and address gaps in healthcare services and systems.
- Teach and empower individuals to self-advocate for their needs.
- Consult individuals who have healthcare service-related questions.
- Guide facility leaders and staff through regulatory questions and concerns.
Who Can Seek Help From a DC Ombudsman?
Anyone who has questions about LTC services, state-based behavioral health programs, or health insurance can contact one of the three respective ombudsman offices for guidance. Examples of individuals who may want to reach out to an ombudsman include:
- Families of residents who need help finding local LTC services.
- Residents who are experiencing low quality care at their LTC facility.
- Individuals who need help finding substance use disorder services for their loved ones.
- Individuals who are prescribed a medication that their insurance doesn’t want to cover.
- Facility leaders who have questions about federal regulations impacting their operations.
Who Is Your Ombudsman? DC Contact Information
The ombudsman you should contact will depend on the health or service-related area that you would like to inquire about. We’ve outlined all of the contact information for the long-term care, behavioral health, and healthcare ombudsman offices in the tables below.
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| Phone Number | (202) 434-2190 |
| Address | 601 E St. NW, Washington, DC 20049-0001 |
| DCOmbuds@aarp.org | |
| Website | https://www.aarp.org/legal-counsel-for-elderly/what-we-do/info-2017/dc-long-term-care-ombudsman.html |
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|---|---|
| Phone Number | (844) 698-2924 |
| Address | 64 New York Avenue, NE, Washington, DC 20002 |
| dbh.help@dc.gov | |
| Website | https://dbh.dc.gov/service/ombudsman-office |
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|---|---|
| Phone Number | (202) 724-7491 |
| Address | 441 4th Street, NW, Suite 250 North, Washington, DC 20001 |
| healthcareombudsman@dc.gov | |
| Website | https://healthcareombudsman.dc.gov/ |
Tips for Facilities Undergoing Investigations
When complaints are submitted to an ombudsman, DC facility leaders may need to undergo an investigation. While this may feel stressful, keep in mind that the ombudsman’s goal is to find a fair resolution for both you and your patients/residents. An ombudsman would rather work with you than against you, so it’s in your best interests to remain cooperative. Here are three tips to help the investigation go as quickly and smoothly as possible:
- Communicate: Provide all necessary information that your ombudsman asks for so that they can get clarity on the situation. Be as honest, transparent, and open as possible.
- Collaborate: Engage with your ombudsman in a respectful manner to discuss solutions for resolving the issue. This will also help you implement actions that are most feasible for your facility.
- Comply: If the ombudsman recommends ways to fix your operations, act on their advice accordingly. This is an opportunity to improve your care services and prevent similar issues from occurring in the future.
Stay Up-To-Date on Regulations Impacting Your Facility
Want to stay on top of regulations and avoid the need for investigations by your ombudsman? DC facility leaders can stay informed through IntelyCare’s free newsletter. Our expert team of writers offers valuable tips and insights on how to deliver safer and higher quality care.