Ombudsman program a resource, advocate for nursing home residents

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If Maryland residents calls her phone number and needs help, Stevanne Ellis makes sure they get it.

Ellis has been a long-term care ombudsman at the local and then the state level for a combined 14 years, advocating on behalf of nursing home, residential care community and assisted living residents to improve their care and quality of life. She fields numerous calls per week from residents, their families and the occasional wrong number, making sure they get the information they need – whether that’s a list of the nursing homes in Maryland, or the correct phone number to the Maryland State Department of Assessments and Taxation.

“I have people that have called me for years, literally, because they know I’m somebody that they can trust,” Ellis said. “They know that we follow through on things, that we’re here for them. And that’s what it’s all about.”

The ombudsman program was created in 1971 in response to widespread reports of abuse and neglect in nursing homes across the country. The program was a part of a larger move to federally regulate standards of care in nursing homes. Today, every state – and D.C., Puerto Rico and Guam – is required to have a Long-Term Care Ombudsman Program, or LTCOP, per the Older Americans Act, which supports a variety of programs for seniors.

Over the past year and a half, ombudsman programs have been responding to complaints brought on or exacerbated by the coronavirus pandemic. Complicating their response were the restrictions on visitation in nursing homes and assisted living facilities, which made it difficult or impossible to conduct quality of care checks.

“Since visitation was restricted for so long, ombudsman programs are seeing serious quality of life and care issues due to the long-term isolation, understaffing, etc.,” wrote Amity Overall-Laib in an email. Overall-Laib is the director of the National Long-Term Care Ombudsman Resource Center.

Information discussed with an ombudsman is confidential, so the Administration for Community Living collects population-level information on ombudsman program activities each year and compiles them into an annual report to track national trends.

In the 2019 federal fiscal year, complaints about discharges or evictions were the most common across residents of nursing homes and residential care communities, respectively. Overall-Laib wrote that complaints about discharges in nursing homes have been the most common complaint for “nearly a decade.”

When an ombudsman receives a complaint, the first step he or she takes is to learn how the long-term care resident wants an issue resolved. Sometimes, residents may want to resolve issues on their own, so ombudsmen equip residents with as many resources as possible to help them in their efforts, including connecting them with other state agencies or legal organizations.

“LTCOPs strive to empower residents and provide resident-centered advocacy,” Overall-Laib wrote. “LTCOP advocacy is based on resident goals for complaint resolution.”

In Maryland, every county has a local ombudsman. They visit nursing home or assisted living residents to determine the necessary response to any complaint they receive. Maryland also has volunteer ombudsmen, who have the same authority as a local ombudsman and can help the county offices respond quickly to more complaints.

After a complaint is resolved, the local ombudsmen follow up with residents to make sure changes actually occurred to improve their quality of life.

At the state level, Ellis oversees the operations of the local ombudsman and their training.

Ellis has a background in social work, but ombudsmen come from a variety of different backgrounds, from lawyers to health care workers to government workers. Training is “rigorous,” said Ellis, and consists of a combination of classroom work, online modules, field work and an exam.

Because of the pandemic, the program has added an infection control component, to increase safety during facility visits.

Over the next year, Ellis hopes to expand outreach across the state so that the LTCOP can help even more long-term care residents.

“However long you live in a nursing home or an assisted living (facility), it’s your home,” Ellis said. “So the fact that we can pay play a small part in that when people need us, it’s quite an honor. And I really do mean that.”