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Volunteer ombudsmen look out for the elderly

By Susan Latham Carr
Staff Writer
Published: Monday, December 19, 2011 at 5:50 p.m.

Lisa Pierce did not know the Florida's Long-Term Care Ombudsman Program existed until an ombudsman stopped by earlier this month while she was visiting her mother at the Palm Garden of Ocala nursing home in Ocala.

"I am so glad it's there," Pierce said about the program. "They can act as liaison for those who don't have a voice."

The volunteer ombudsmen work to protect the rights and dignity of people who live in nursing homes, assisted living facilities and adult family care homes, which are private homes with five or fewer residents. Ombudsmen do yearly assessments of each facility and investigate complaints.

Ombudsmen were giving Palm Garden its yearly assessment when they stopped to talk to Pierce about the care her mother was receiving. Pierce assured the ombudsmen that her mother was being treated well.

"We ask them about any problems or concerns they have while living in the home," said Charlotte Poss, an ombudsman who is assigned to monitor six Marion County facilities. "When a resident goes into a facility, the only thing that changes is their address because that's their home now."

The Ombudsman program, which has existed since 1975, is mandated by the federal and state governments. In Florida, it operates under the auspices of the state Department of Elder Affairs.

"When we get a complaint, we go in and investigate first," said Helen Anderson, the Withlacoochee District ombudsman manager, which serves five counties, including Marion. "Our job is to resolve the problem."

Those who move into long-term care facilities maintain all their rights as citizens and actually gain a few more rights under the law. Those rights must be posted in each facility in an area where residents can see them. For instance, it is illegal to have anyone restrained, either physically or mentally. And residents must be treated with dignity and their privacy must be honored, Poss said. The facility also has to make its annual survey available for review.

Anyone can file a complaint, whether a resident, a family member, a staff member or visitor. Complaints may be filed in writing, by phone, online or in person.

"We take anonymous complaints," Poss said.

A complaint can be as simple as a resident not getting a salad but, to that person, that is important, Poss said.

But ombudsmen do not accept complaints made by a resident about another resident.

Ombudsmen can go into a facility as many times as they desire and they go in unannounced, so the facility cannot prepare for a visit. However, Ombudsmen cannot see a resident's medical chart without consent from the resident.

When a complaint is filed, an ombudsman is assigned to investigate, Anderson said. An ombudsman will go to the facility and talk to various residents, including the resident the complaint concerns, and determine if the complaint is valid. All cases are confidential.

Ombudsmen cannot recommend a facility but their assessments of facilities are available to the public.

"If someone wanted to know what our last assessment was, we can share that with them," Anderson said.

There are nine nursing homes, 31 assisted living facilities and 13 adult care homes in Marion County. All are reviewed once a year and many are visited more than once a year.

Since she was certified in 2006, Poss, who visits more than the six facilities she is assigned to in Marion County, has handled 191 cases, completed 95 assessments, traveled 17,218 miles and volunteered 1,882 hours to ensure that seniors are getting proper care. She said she visits facilities as often as she can.

Poss said sometimes people are afraid to complain for fear of retaliation.

"If residents see you, they recognize you, they feel comfortable talking to you," Poss said. "They are not afraid to talk about their problems."

She said that today's facilities are changing their cultures to be more like home than institutions.

"The majority of facilities I go into are good facilities," Poss said. "Every facility is going to have something of a problem. Usually, it's correctable."

If a complaint cannot be resolved, it is referred to the Agency for Health Care Administration, which regulates and licenses the facilities. The Department of Children and Families' Adult Protection Unit would be called in on abuse cases. Medicaid fraud is reported to the state Attorney General's office. And officials from all these organizations can form a team, that also might include the Health Department and/or Fire Department, to investigate problems. Two teams were formed this year in the Withlacoochee District, Anderson said.

"We are mandated reporters when we go out," Anderson said. "If we see anything we need to report, we will."

Most complaints are about food. Medications — not receiving them on time or receiving an overdose — also generate a large number of complaints, Anderson said.

When Poss and Anderson were at Palm Garden this month, besides talking to residents and staff, they checked if there was adequate staff, if the bathrooms and spas were clean, if employees called out and knocked on residents' doors before entering a room and if call lights were answered promptly. They checked to see if meals were hot and if the residents were eating in the dining room, not just in bed, if residents had sufficient water, and whether there were any smells of urine or overwhelming disinfectant odors, which might indicate a problem.

They also checked to see that the posted menus listed what actually was being served and that the posted activities were being offered.

Poss said one of her biggest successes was getting a competent resident, who did not have Alzheimer's disease, out of a secured unit where the resident had been placed by a guardian.

But there is a shortage of ombudsmen.

In Anderson's district — Marion, Citrus, Sumter, Levy and Citrus counties — there are a total of 191 long-term care facilities and only 34 ombudsmen.

"We don't have enough people," Anderson said. "We purely rely on volunteers to do the work. We always need volunteers."

Ideally, Anderson would like to have one volunteer per facility. She said they are supposed to visit facilities quarterly but she does not have enough volunteers to do that

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