The Maine Long-Term Care Ombudsman Program Makes a Difference

Facility closures
When three nursing facilities closed, Ombudsman Program staff worked with residents, family members, and staff to identify each resident's complex care needs and determine where the resident would like to move. The Ombudsman Program provided residents with information on other options for placement and assisted their families in the search and placement process. The residents were all able to find another facility and moved successfully.

Helping a consumer appeal their MED assessment
The Ombudsman Program was contacted by a consumer’s family requesting assistance with an appeal of a MED assessment. The assessor did not find the consumer nursing home eligible which decreased her home care hours; the family disagreed with the assessment outcome. LTCOP met with the consumer and her family to help them prepare for the hearing. The consumer and her family won the hearing which resulted in a new MED assessment. LTCOP discussed what to expect at the assessment and attended the assessment as a support. The consumer was found Nursing Home Eligible and her home care hours were doubled from the prior assessment.

Concerns about over-medicating
The Ombudsman program was contacted by a family member who shared concerns that a doctor had prescribed too many medications for a resident. The family member was asking for medications to be reviewed and changed but this request was being refused. The Ombudsman Program worked with the family member, nursing home staff and the doctor and the medications were changed which gave the resident a better quality of life.

Cost of care issue
The Ombudsman Program was contacted by a consumer who normally had no cost of care for MaineCare but suddenly was told he needed to pay hundreds of dollars a month. The Ombudsman program worked with MaineCare at identifying medical expenses that could lower the cost of care if the consumer sent in documentation of these expenses. The consumer was not aware he needed to send in documentation and with the help of The Ombudsman Program was able to collect and send in the appropriate information. The consumers cost of care was then adjusted back to $0.

Transitioning back into the community
The Ombudsman Program was contacted by a resident who wanted to go home but was faced with many barriers preventing her from doing so. The consumer was told by her doctors that going home would be impossible due to her physical limitations. The Ombudsman Program went out to meet the resident and, upon determining her eligibility, enrolled in her in the Homeward Bound program. With the help of the Homeward Bound team, the resident was able to safely transition into the community and lives independently in her own accessible apartment. The resident was able to get in-home care, remote monitoring, and the assistive technology she needed to thrive on her own.

Helping a resident change facilities
The Ombudsman Program was contacted by a resident who wanted to move from one nursing home to another to be closer to family. The resident’s MaineCare was not in effect at the current nursing home and needed to be corrected before another nursing home would be willing to accept the resident. The Ombudsman Program worked with the Office of Family Independence advocating for the MaineCare to be approved so the current nursing home could be paid for the services already provided and the new nursing home would be paid after the move. This was resolved allowing the resident to move to the nursing home closer to the family.

 

 

"All long-term care consumers have the right to be treated with dignity and respect."