What is a Healthcare Ombudsman? South Carolina Guide for Facilities

In 1972, Congress took a pivotal step toward improving nursing home conditions by amending the Older Americans Act and establishing the national Long-Term Care (LTC) Ombudsman Program. This program requires each state to protect the rights of LTC residents using a medical ombudsman. South Carolina in particular has established a comprehensive program that serves anyone who has questions or concerns about the state’s LTC services.

If you are an LTC facility leader, you can work with your local ombudsman to improve the quality of your care services. To help you to get the most out of their guidance, we’ll walk you through what an LTC ombudsman in South Carolina does and how to prepare for potential interactions with one.

What Is the South Carolina Ombudsman Program?

Administered by the Department of Aging, the overarching purpose of South Carolina’s ombudsman program is to advocate for the rights of older adults living in LTC facilities. The South Carolina ombudsman office assists residents with a range of issues related to violation of rights, transfers and discharges, benefit assistance, respect, and abuse/neglect. Ombudsmen are spread throughout the state to help improve quality of care in the following settings:

• Nursing homes
• Assisted living facilities
• Community residential care facilities
• Department of disabilities and special needs facilities
• Department of mental health facilities

If you are an LTC facility leader, you’ll most likely be interacting with the LTC ombudsman office. However, South Carolina also has a separate ombudsman office that addresses general questions about government services. For more information about this office, you can visit the Department of Administration’s website.

What Does a South Carolina LTC Ombudsman Do?

An ombudsman is defined as an impartial party that investigates and resolves complaints made by individuals against organizations. In long-term care, this involves any complaints that residents, their friends or families, or other concerned parties make about a care facility.

For example, if a resident is concerned about the way they are being treated by staff, they can file a complaint with the South Carolina ombudsman for nursing home and LTC facilities. Their assigned ombudsman will keep the complaint anonymous as they conduct an investigation to confirm the issue. If the issue is confirmed, they will work with the resident and facility to help resolve the complaint.

Beyond investigating and addressing filed complaints, there are many other duties carried out by an ombudsman. South Carolina’s staff and volunteers are also trained to:

• Educate residents, family, staff, and the community on topics affecting LTC residents.
• Provide information and referrals for LTC programs and services.
• Advocate for improvements to state and federal regulations affecting LTC services.
• Serve as a liaison between facilities and residents/families.
• Empower residents to self-advocate for their rights and resolve issues.

Who Can Seek Help From a South Carolina Ombudsman?

While South Carolina’s ombudsmen are primarily trained to advocate for the rights of LTC residents, they’ll also help anyone in the community who is concerned about the welfare or safety of older adults. This includes LTC staff and facility leaders. Examples of people who may want to contact the ombudsman office include:

• Residents who have questions about how their Medicare benefits cover services.
• Residents or families who want to learn about LTC services in their area.
• LTC staff who are concerned about the way their LTC facility is overseen.
• Facility leaders seeking guidance on how to adhere to federal care guidelines.

Who Is Your Ombudsman? South Carolina Phone Number and Contact Information

South Carolina’s ombudsman offices are spread throughout the state. The ombudsman you should contact will depend on the county you or your facility is located in. However, you can reach out to the Department of Aging, which houses the main LTC ombudsman office, for guidance on how to reach your designated ombudsman. The contact information for the Department of Aging is provided below.

Tips for Facilities Undergoing Investigations

While your ombudsman is always available to guide you through any regulatory questions you may have, they’ll need to conduct a more formal investigation if they receive a complaint about your facility. This may feel stressful, but remember that your local ombudsman is trained to find a fair resolution for both you and your residents. Follow these tips to help the investigation go as smoothly as possible:

• Communicate: If your ombudsman asks you about the situation at hand, be as communicative as possible. Provide them with all the information they need to understand the potential issue and resolve the case fairly.

• Collaborate: Your ombudsman would rather work with you than against you. If your ombudsman invites you to discuss ways to improve your facility’s care services, engage with them to find a practical solution.

• Comply: If the ombudsman confirms that there is an issue at your facility, this is an opportunity to improve the quality of your services. Act on any advice from your ombudsman in a timely manner to ensure that the issue is addressed appropriately.

Keep Your Residents Safe and Healthy

Looking for ways to keep up with healthcare regulations after working with your ombudsman? South Carolina facility leaders can stay informed through IntelyCare’s free newsletter. We offer dozens of practical tips that will help you keep your residents safer, healthier, and happier.