Al Malley, center, an ombudsman with Florida’s Long-Term Care Ombudsman Program, talks with Palm City Nursing and Rehabilitation client Andrew V. Donnally, while he works in the physical therapy room at the facility. Malley is responsible for checking on the conditions of nursing homes and rehabilitation centers through surveys and quarterly visits.
May 28, 2010
By Kit Bradshaw
PALM CITY — What’s the No. 1 complaint in nursing homes or assisted-living facilities on the Treasure Coast?
Al Malley, 78, who has been a long-term care volunteer ombudsman for 12 years, says it is the practice of discharging residents early, then refusing to take the person back into the facility.
“We call this practice ‘dumping,’” Malley said. “The nursing home, for instance, will send someone who is too burdensome or disruptive, or they require too much care, to the emergency room, and when it is time for them to return to the facility, they won’t take them back. They dump them.
“Legally, you can’t put anyone out of a facility unless you give them an appropriate discharge. But they do it.”
Malley, of Palm City, and 19 other volunteers in the program work from the Fort Pierce office, which is under the direction of the Long-Term Care Ombudsman Program of the Florida Department of Elder Affairs.
They cover the 128 nursing homes, assisted-living and congregate care facilities in Martin, St. Lucie, Indian River and Okeechobee counties. They annually assess each facility, checking whether the facility is in good repair, the residents are clean and call lights are promptly answered.
They also check how the food is cooked and served, if the medical treatments are explained to the residents and if medications are dispensed correctly.
They respond to complaints from residents, family members and staff .
“Ombudsmen are first and foremost advocates,” said Elizabeth Davis, the ombudsman program spokeswoman.
“We focus on residents, their needs, desires and concerns, and if a resident needs someone to speak on his or her behalf, we’ll be there to do that. We want to help facilities improve the quality of care they offer.”
There are 400 volunteer ombudsmen in the state, Davis said, working with 3,800 long-term care facilities.
There are two or three paid individuals at each of the 17 local offices, but the majority of those involved with the program are volunteers like Malley. Davis said the program saves the state about $2 million in salaries alone, and the volunteers’ work helps avoid issues like bed sores, falls and neglect, which can cost the state millions in hospital feels.
The Florida program was founded in 1975 as a result of the federal Older Americans Act, which grants a special set of residents’ rights to individuals living in long-term care facilities. It operates under federal and state law.
Malley said that by law, an ombudsman never announces that he or she is coming into the facility, and they can go into the nursing home or assisted living facility at any time.
Malley said that once he finds a problem, he will sit down with the administrator and work out a plan to correct it. He’ll return in about two weeks to make sure the problem is remedied.
“The relationship isn’t adversarial,” said Sue Riddell, administrator of Palm City Nursing and Rehabilitation Center. “The biggest thing that an ombudsman does is make sure that the residents rights are respected and we have that job too, of protecting our residents’ rights.
“If they have an issue, they’ll make a recommendation to make sure every thing is going well. Anything of a serious nature needs to go to the respective agency.”
Malley said, “We have a lot of clout. If they don’t follow through, then I’ll bring someone from the Agency for Health Care Administration with me, and this agency can declare a moratorium on new patients or fine the facility.”
FLORIDA'S LONG-TERM OMBUDSMAN PROGRAM
Founded in 1975 as a result of the federal Older Americans Act and operating under the Florida Department of Elder Affairs, the program has 400 volunteers statewide who help residents in 3,800 long-term care facilities in the state.
Ombudsman requirements: 21 or older; pass a Level 2 (national) background screening; be interviewed; once accepted, be in training until he or she completes three facility assessments and three complaint investigations in the company of a trainer or mentor.
Prior experience: Volunteers can be retired or working, can be a professional or nonprofessional in a related field. Those with special skills, such as volunteer recruitment experience, may be asked to use those skills.
Time requirements: Ombudsmen commit to working 20 hours per week, conducting annual assessments, responding to complaints, offering “in-service training” to facility staffs, or attending continuing education courses.
Local office: Fort Pierce, covering Martin, St. Lucie, Indian River and Okeechobee counties
Contact: (772) 595-1385