Aging in Style with Lori Williams
Aging in Style with Lori Williams

Episode · 1 year ago

036. The Role of the Ombudsman in Advocating for Seniors' Care


If you’re a senior or family of a senior with questions or concerns about your nursing home or assisted living facility, a great resource to use is an ombudsman. 

This is a mediator position that help residents free of charge in nursing homes and assisted living throughout the U.S. They protect residents’ safety, welfare, and health and make sure facilities are following regulations and held accountable. 

As you might guess, this is a huge relief for families of residents!Yuri Martinez is an ombudsman in Tarrant County, Texas, and has advocated for senior residents for 12 years. She explains the ins and outs of her job, what the most common calls are for her service, and how they help seniors. Plus, she details how to become a volunteer if this speaks to your heart.

Topics discussed:
- What is an ombudsman
- Settling disputes for seniors
- Acting as an intermediary between facilities and seniors
- How to become an ombudsman
-The Older Americans Act
- Nursing homes / assisted living facilities

Takeaways from this episode:

- Rather than fixing problems, an ombudsman coordinates conflicts and holds all parties involved accountable - that they’re following standards and ensuring that the resident is getting proper care and services.
- They observe conditions in senior environments, searching for signs of lack of care, neglect, fall risks, and more.
- An ombudsman receives calls mostly about involuntary discharges or no longer being allowed in a senior living facility. This would then involve helping all parties understand proper procedures, reversing the discharge or starting appeals.
- Anyone in the U.S. can find an ombudsman by going online and searching by county. Facilities are also required to provide that information in an open, accessible area.
- To become an ombudsman, you must have a genuine interest in helping residents, be 18 or older, have reliable transportation, pass a background check, and complete 36-hour training.

Resources mentioned in this episode:

Tarrant County LTC Ombudsman Program: 
United Way of Tarrant County
1500 N Main, Suite 200, Fort Worth, TX 76164
Office: (817) 258-8104
National Ombudsman Resource Center:
Yuri Martinez, MSSW:

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Welcome to aging in style with me, Laurie Williams. I'm an optimist by nature and I believe you can follow your dreams at any age. My grandmother's journey with dementia ignited a passion and need to work with seniors. I've spent the past thirteen years learning about seniors and aging. In my mid S, I followed my own dream and found it my company, where I use my expertise to help seniors locate housing and resources. On this podcast, we cover all aspects of aging. Joanna's each week to meet senior living experts and inspirational seniors who are following their dreams. The fact is, we're all aging, so why not do it in style? Hi, welcome back to another episode of aging in style with Laurie Williams. One of the things that I really love about doing the podcast, and there are many, one of my favorite things is learning, and I don't know you. I worked in senior living over fourteen years, but I don't know everything, and so I felt like today's topic was going to be a really good one for everyone, including myself, to learn more about. So when you are in an assistant living or a skill nursing sometimes things go wrong or sometimes there's, you know, complaints or questions you have, and that's why there is a program called the onbudsman program and that's what we're going to talk about today and really learn about the program, how it works. And so the perfect person to tell us about it is Uri Martinez, and we talked a couple of weeks ago and she explained to me how the onbudsman program worked and I just thought, let's let's share this with everyone, because everyone needs to know about this. So let me tell you about Yuri. She has a bachelor's and a master's degree in social work from the University of Texas at Arlington and she has worked as a long term care on Budsman for over twelve years in terrent county, helping to promote quality of care for residents in nursing homes and assistant living facilities. She's involved in various community organizations and task forces to advocate for older people your he's also the proud mother of a fun living nine year old girl and a wife of fourteen years. So welcome Yuri. Thank you, Lori. I'm happy to be here and share this information with everyone listening. Oh you're welcome. I'm so glad that you're on the show. I think this is such important information for people to know about. So I always like to ask guess, how are you drawn to working with seniors? I've always had a passion for helping others and for social justice. So for me it was and I believe will always be, an important life pursuit to work in a row where I can make a positive impact on people's lives and help them overcome hurdles throughout their journey. With that being said, I honestly didn't find this field, it found me. I was working at the Mental Health Association at the time when the manager of the Terran County on budsman program asked if I wanted to be a volunteer and I accepted and I've been working as an unbudsman, like you mentioned, for almost thirteen years now. I'm a beat thirteen years in June,...

...and also as volunteer coordinator. So I just fell in love. Yeah, I can found your passion, which is so important in life. It makes makes it not like a job. Right, when you're doing what you love, right exactly, it's not a job, it's more of a passion. And a calling. MMM, absolutely so. Tell us what is the Ombudsman Program? Tell us all about that, how it works and you know, just share that. Absolutely. I'm always excited to tell everyone about the Ombudsman program. So the Ombudsman Program provides advocacy services at no cost to residents living in nursing homes and assisted living communities, not only in the area, in the county, but throughout the United States. The ambudsman program is a federally mandated program through the older American sect and hence why it is a nationwide program. Batsman listen to residents and family members when they have concerns or issues. They take residents about their rights. We protect residents health, safety welfare and we hope families to learn about nursing homes and the various funding options as well, and we work to resolve problems on behalf of residents and to ensure that the regulations are protecting the residents as well. Say, someone's in an assistant living and a daughter has her mom and as sister living will say, what would be an example of a reason why she would contact you? Yes, so, not long ago this situation actually came up. A daughter of a resident in an assistant living community called and she had gotten my information from another family. She was unaware of the program and this other family member said, hey, it sounds like you may need the services of the abutsman. So she did and she was spot on. We were the right people to call. As you know, throughout the covid nineteen pandemic there have been lots of questions and changing guidelines and such, and she was unaware of the guidelines related to visitation. So her dilemma was that she was not being allowed to visit her mom and her mom was in hospice and actively dying. So we were able to sift through the guidelines and educate the facility about these guidelines and help the family to be able to visit the mom during this difficult time. So that would be one one of many examples. Okay, what would be like? I guess what is the most common call that you get when it relates to maybe a skilled nursing facility? So one of the most common calls we get, unfortunately, are related to involuntary discharges, meaning that residents are no longer allowed to live in this build nursing facility for a number it could... a number of reasons. Sometimes the facility says that they no longer can meet the needs of the resident. Sometimes it's because the resident has no funding. It could be a number of different reasons. In veribly, many times the reason is in justifiable and that's where we become involved to help the resident and the family and the facility to understand the proper procedures. Most of the Times our role is to try to stop the involuntary discharge or sometimes even reverse it once it's happened, through an appeal process. Okay, so that's good to know. So is that like if someone's on maybe Medicaid and they're trying to discharge them or it could be any any reason. It could be anyone, whether they are on Medicaid or not. Whatever the funding source is is not an issue when it comes to US helping the residents with something like that. It could be a privately funded resident or a Medicaid resident. Okay, so kind of the beauty of what you do, is it? You're like an intermediary, correct, like you come in and work between the facility and with the family. Yes, we are kind of like an intermediary and that's often how we explain our role to many of our residents and families is that when a resident comes to us, we often are not the person who is actually fixing the problem, but rather the Messenger or the mediator, the person that is coordinating and holding everyone together and holding people accountable so that all the parties involved are doing what they're supposed to to ensure that the resident is getting proper care and proper services. Excellent. So sometimes I see, especially here with Covid, I've seen a lot of people on social media posting things and also they've contacted me, but it's typically about nursing homes and they have concerns over the care being received in nursing homes. How do you address those kind of questions? And I'm sure you've been getting a lot of those two I'm guessing a lot of complaints or concerns we have. We have, you know, it's been it's been a year today, and so we have received many questions. So the way that we address those concerns is by making sure that we're looking at the guidelines, which, I believe I mentioned earlier, are changing constantly. So we just didn't sure that we're following the guidelines that are put out by the proper authorities, so the Texas Health and Human Services Commission and this you know, the state regulations in the federal regulations for nursing facilities, that we're following those and if we have questions, we also can reach out to the regulatory department to ask for clarity or assistance with interpretation of any questions that we receive. So we do also work together with other groups to ensure that we're relaying the correct information to residents and families and staff. Okay,...

Great. So if you are working with the family and you're not able to come to a resolution with say it's an assistant living in a family and they have a concerner complaint, what happens next? If you can't resolve that, what's the next step? So the next step? It's going to vary on a case by case basis. Sometimes it's escalated immediately to regulatory services or sometimes we work with the corporation. If the if there is a corporation involved, they may have a department that dedicates themselves to resolving resident concerns and hence we can escalated to that department and try to get it resolved that way, or we can refer it to other outside agencies for assistance with resolution, such as, like I said, Texas Health and Human Services, regulatory or other outside agencies if it's appropriate. Okay, and I know you mentioned this is co completely free to families and they should know that. But how would someone contact you? And I know we're in Texas, but this podcast goes out to the entire country. So how do people find their local on Budsman? Absolutely so, in order to find their local onbutsman, so in text has anyone can call? I'll give you that information. First, in Texas, anyone can call the state long Term Care Onwn budsman office at one eight hundred two, five two two and forty one two, and they are happy to assist with finding the onbutsman in your particular area. People around the nation can go online and just do a search for the county and the long term care on budsman program if you happen to have a loved one in a facility, there's another option for finding who your own budsman is. You should be able to ask your facility and they should be able to provide you that information. Also, another requirement that facilities have is that they should have the phone number and the name of the Ombudsman posted in an area of the nursing home where it's easily accessible to everyone, so not in a lounge, not an unemployee break room, but in an area where it's prominently visible. So there are several ways to find out who your own budsman is in your area. Okay, and, as we mentioned, this is for assistant living and skill nursing facilities. Does it also cover like a residential care home? So I know those have become pretty popular and in Texas we have unlicensed and license care homes. But how does the UNBUDSMAN program do you work with the care homes as well? So let me let me clarify something. The residential care homes, as you mentioned, can be unlicensed or licensed. We only have jurisdiction or authority or permission to enter those that are licensed. So there are small what we call small assisted living, or they may be medium assisted living. They have to be licensed. So it can be a home, you know,...

...with for five, six, seven, eight people and as long as they have an assisted living license to the state of Texas, then and ambutsman will be assigned to that home. If they are unlicensed, then we don't have permission to enter those. Okay. So how it works for you then, to clarify it as an ombudsman, you have a certain area or certain communities that are assigned to you, certain skill nursing and certain assistant livings and care homes. Yes, yes, that is correct. So throughout the State of Texas there are twenty eight on butsman programs. Some cover one county and some cover multiple counties, thereby covering the entire number of counties throughout the state. The structure of each program varies by area. So, for example, in Taran County we have seven people on staff and we also have volunteer on Butsman who helped to advocate for residents as well. So the county we have over two hundred facilities, and so we divide the county amongst the seven of us and we are each assigned to multiple facilities in an area. Okay, and and the volunteers awesome. Yeah, what I was going to ask you to clarify a little more about the volunteer program how does that work? And if someone wanted to volunteer, what kind of qualifications would they need to have? Absolutely, utely, absolutely. I'm always happy to talk about our volunteer program it is one of the most rewarding programs that there is, and I'll tell you I actually started out as a volunteer, as I mentioned earlier, and so it's a great program it is a a commitment. It's not a onetime event. It is an ongoing process. So anyone can call the onbutsman program and enquire about information and how to become an ambudsman. Some the qualifications include having a true interest, having a genuine interest in advocating for residents, being compassionate, having compassion and empathy and wanting to help others. So a true desire to help the people living in our nursing homes and our assisted livings. The person must be eighteen years or older must have reliable transportation, because we normally make visits to the facility so that we can make observation in the facility and observe the residents and their environment and such. So as it stands right now, we are not doing very many visits and that's because of, you know, the issues with the CO at nineteen pandemic. However, you know, we are slowly getting back into doing things in a more normal way, and so it's important for people out there to understand that that is also one of the requirements and filling out an application package, passing a criminal history check. Those are the main qualifiers and, like I said, you can reach...

...out to locally. You can call eight hundred and seven two five, eight, eight hundred and two four, and I'm always happy to provide information. I usually call and then email the the information, the training schedule and application package. The training varies as far as the timings and the dates by area, so it's going to be different for everybody throughout the nation. It's some our weekends, some are weekdays, you know, during the day, evenings go on and so forth. Okay, that is a thirty six hour training. HMM. That was my next question for you. So you got there before me. So how it's thirty six hours of training and it's in person training? Currently it is virtual. So it is virtual? Okay, yeah, because a covid everything's virtual. What kind of things are covered in the training? Oh, it is. It includes a lot of information. So some of the some of the things that are included in the training are the physical aging process. There is an entire chapter on abuse, neglect, on exploitation, we talk about residents rights and regulations and, of course, we train on the problem solving process, which is a lot of the work that we do, and also reporting. We give a little bit of history. So there's there's a little bit of everything and it is a training manual that is quite involved, and so people will just receive all the skills and tools that they need in order to do their work as an unbudsman. I love it. That's that's such great information, especially if someone has an interest in working with seniors. What a great way to learn more and do something very positive as a volunteer. Absolutely, absolutely. We all any and all inquiries about becoming volunteers. Volunteers are the heart of our program we couldn't do what we do without our volunteers and I'm very grateful for them. That's wonderful. So I know, like you said, things are different due to covid. You haven't been able to go in and visit the different facilities when it's not covid. How often are you going out and going into like, say, an assistant living community, and what does do they know you're coming and kind of how does that work? Sure? So normally we would visit nursing homes on a monthly basis and the assistant living visits vary by type and size. So smaller facility or alert versus a larger facility may be visited with a different frequency. And to answer your question about whether the facilities know that a nonbudsman is going to visit, know, we typically don't announce our visits. That's just in the role. We don't. We don't do that. So so they usually don't know. Now, during the pandemic there have been a few times when we have been allowed to coordinate visits prior to visiting, only because...

...of the safety factor for the most importantly for the residents, for all involved, but most importantly for the residents, to make sure that things are okay, that we're not exposing or putting anyone at risk. So that coordination has been something that was new to us. And when you go in to visit, what kind of things are you looking for? Oh, there are many things. So we are looking at the residents themselves, so their person. We're making observation about the person. So things like are the residents well groomed? Are they dressed appropriately? You know, making sure it's not four o'clock in the evening and they're still in their pajamas. Not, you know, not that some residents may want to be in their pajamas, you know, and that's their choice and that's okay, but just things that would kind of be out of the norm in the environment. We're observing things that are unsafe, perhaps any fall risks, any odors that may be indicators of lack of care. We are observing the staff and how they are engaging with the residents. Are they engaging appropriately with residents? And we're observing sometimes records if we have permission to observe records and need to get information based on a residence concern or families concern, and always with consent of the residents. That's incredible and I think that I mean to me. I think it gives peace of mind because you're another, another pair of eyes going in and taking a look in these communities and you know, you know what you're looking for. So I think that's that's wonderful and should give families a little more peace of mind. We hope it does. They really do. And yes, like you said, we are second set of eyes and you know, in working with the facilities as well. We try to keep a good working relationship and that's one of the things that I often share with my facilities is that, you know, administration can't be in every corner of the building and so many times they're grateful for the fact that we're bringing things to the tension of the management that perhaps they hadn't seen or weren't aware that it was an issue, and it helps the collaboration between the two wonderful. I'm so happy to know more about this program because, like when we talked a couple of weeks ago, like I said, I really I knew about the program but I didn't know a lot of detail and it's so much more detailed than I understood and I'm so glad to know about this and glad to be able to share this with our listeners. I always like to ask this question of everyone who's on, but is there an inspirational senior in your life or you know, could be someone still living or someone who has passed on, and I'm sure working with seniors, like all of us, we have lots of lots of stories and lots of people who are inspirations to us, but is there one that stands out for you yes, yes, so you're right. Like you said, working...

...with so many seniors always provides me with many people who I'm inspired by, but I actually have two seniors in my personal life who have been great inspirations for me, and that is my mother and her mother, which is my maternal grandmother, who just turned a one hundred less summer in July, a proud one hundred. Yes, yes, so both have been great role models for me. They've been loving, respectful, patient and overall supportive, and they're both exceptionally selfless and willing to help others. That's wonderful. Thank you for sharing that. And you know, I find a lot of people that I talk to you, pretty much everyone. We're all kind of drawn into working with seniors because of our experience with our own families, and I know for me that's the case. My Grandmother had dimension and she is my inspiration and I, you know, she grew up in the same house with me, or I grew up with her living with us, and I just think it's interesting to me how so many of us we have those strong bonds with our grandmothers and, you know, seniors in our family. Absolutely, yeah, we have so much to learn from we really do. We do, and I think it's such a blessing to be in a position, in a role where we're able to interact with seniors and I think you know, like you mentioned, the volunteer program. If anyone out there listening is really you know you have that passion to learn more about seniors and to do something for them and to be an advocate for them. Definitely check out the program in your area. Yes, and thank you for this opportunity, Lorie, to tell everyone about our program and to give everyone the opportunity to know more about it. It is a great opportunity, like you've said, to engage with seniors in our community who are in need and we are that voice for our seniors in our in our community, assist living in nursing homes, provide the voice that they sometimes don't have. Absolutely thank you so much for being on the show. I just appreciate you coming on and sharing you know about the program and about some of the stories some of the people you've been able to help. Absolutely it's been my pleasure, Lori thank you for having me on. Great Well, thank you all for listening and I'm going to share the information that Yuri has shared with us. So phone number for for the Ombudsman Program also information. I know she shared a phone number for the volunteer program but we'll put links and in the comment section so you'll be able to find all these different resources and services. So, as always, thank you for listening and we'll see you next week, but by.

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