Inside The Senior Alliance: Long-Term Care Ombudsman (Ep. 1.8)
Michelle Danou of the Michigan Long-Term Care Ombudsman Program shares with Jason about the role of an ombudsman in advocating for those in long-term care facilities, such as a nursing home. She also details the work of an ombudsman when it comes to transitioning people out of a long-term care facility back into their community.
Jason Maciejewski (00:00):
Welcome to episode eight of inside The Senior Alliance, a podcast exploring resources in the field of aging. I’m Jason Maciejewski, chief advocacy and planning officer with The Senior Alliance, the area agency on aging, serving Western and Southern Wayne County. Today I’m joined by Michelle Danou from the Michigan Long-Term Care Ombudsman program. Michelle, welcome to inside The Senior Alliance.
Michelle Danou (00:19):
Hi Jason. Thank you so much for having me today.
Jason Maciejewski (00:22):
It’s great to have you join us. And while The Senior Alliance hired you for the Long-Term Care Ombudsman position, it’s actually a state-level program. The Michigan Long-Term Care Ombudsman Program and that program has the final say on whether an ombudsman is certified to do the work in the field. Could you tell us about the relationship between the state-level program and The Senior Alliance?
Michelle Danou (00:45):
Each area on agency directly or through a subcontract provides Long-Term Care Ombudsman services for a specific service area. As ombudsman, we are employees of our respective area agency on aging and programming oversight as an ombudsman is through the ombudsman program. To fulfill the roles of an ombudsman, a new hire completes intensive training and mentoring through the ombudsman program to achieve ombudsman designation. Once this process has been completed, the newly hired ombudsman can begin to provide advocacy of free services to residents in long-term care settings.
Jason Maciejewski (01:17):
So as the Long-Term Care Ombudsman for Southern Western Wayne County, which is our service area, what does your job entail on a day-to-day basis?
Michelle Danou (01:26):
Jason, this is a great question. Each day is different. My role is a resident advocate for licensed long-term care settings in our service area is derived by the concerns of residents, and if a resident offers consent to advocate on their behalf. Oftentimes I am a sound board for a resident or loved one, and we may discuss options for advocacy, so they may resolve concerns on their own. We promote self-advocacy. I also provide education, and in an area such as what is long-term care. What does that look like for my loved one? I can provide such licensed long-term care settings in our service area and the surrounding service areas. Family members may have questions, in reference to how can I research how a long-term care provider performs? I will explain the different websites through licensing and regulatory affairs and can send links if they wish. Family members and residents will also reach out if they have questions of how to submit a state complaint with licensing and regulatory affairs, also referred to as LARA. We’ll discuss the complaint process and direct them on the three different options to submit a complaint with licensing and regulatory affairs. If a resident is interested in transferring to the community, we’ll discuss possible options and local agencies that can provide services such as community transition programs. I can assist with consent from the resident to request a referral, to be submitted to the agency that the resident has identified. Hot topics have been residents and family members reaching out and inquiring about information concerning COVID-19 vaccinations, visitation guidance, and residential care facilities, and COVID-19 isolation in quarantining of residents.
Jason Maciejewski (03:00):
So when I’m out in the community, one of the questions I get is about nursing home inspections. So does the Long-Term Care Ombudsman conduct inspections of nursing facilities?
Michelle Danou (03:09):
The Michigan Long-Term Care Ombudsman program is not a regulatory agency and we do not have authority in long-term care settings. We do advocate for residents and part of this advocacy is responding to concerns or complaints from multiple sources. We will work to investigate complaints and bring about at the direction of the resident to resolve the issue. Nursing home inspections are conducted by the Michigan department of licensing and regulatory affairs. Nursing home inspection reports can be found online at medicare.gov.
Jason Maciejewski (03:38):
When you visit a nursing facility, what do you look for as the ombudsman?
Michelle Danou (03:42):
When we visit a nursing home, we’re there to visit with the residents, as we are their advocate. I’ll ask the residents, how are they doing? If the resident has any thoughts about what’s going good in their home, do they have any concerns? If a resident has concerns, we’ll discuss the concerns, possible ways they can advocate for themselves, or with the support of loved ones. If a resident offers consent to discuss their concerns with the long-term care provider, we’ll discuss possible options for advocacy and resolution. Depending on the concerns the resident has reported and the direction the resident has given me, I will then proceed and discuss the concerns with the appropriate department. We will discuss the concerns and develop a plan to resolve the concerns. I will continue to follow the resident, and if for example, resolution has not been agreed upon and or met, brought change for the resident, we will continue to advocate with resident consent.
Jason Maciejewski (04:29):
One of the topics that comes up when people think about nursing homes, unfortunately is fraud and abuse. So how is the Long-Term Care Ombudsman involved in investigating that?
Michelle Danou (04:41):
As an ombudsman, our role is to advocate for residents with resident consent. If a resident discusses alleged abuse, neglect, or exploitation, I proceed at the wishes of the resident, reporting abuse, neglect and exploitation per resident consent. I can offer resident resources, such as adult protective services APS, or the elder abuse task force hotline number. If a resident requests and gives consent, I can report on their behalf of their concerns of abuse, neglect, or exploitation.
Jason Maciejewski (05:09):
And one of your roles is to assist people who are transitioning out of a nursing facility. You recently played a part in moving two different people back into the community, actually moving to the UP in fact. What role do you play for people making a move back into the community?
Michelle Danou (05:25):
Residents have the right to live in the least restrictive environment possible. Often I’m in communication with a resident who would like to move back into the community, but needs assistance. The assistance needed can be looking for housing, or they may have housing, but are seeking assistance in the home. Connecting residents with resources is only a small sliver of what ombudsman can do. During COVID-19 has been increasingly challenging to assist residents who would like to transition the community due to reasons such as housing shortages or home care company staff shortages. I worked with a resident who attempted to move into the community, into their own home. And we had to reach out to several agencies before an agency can be identified to have the resources to provide the resident services in the home. After several months of advocacy, the resident transitioned back into the community, back to their own home.
Michelle Danou (06:11):
As ombudsman, we cannot stop if there’s a barrier. We have to continue to advocate to be the voice of the resident. Another example, a resident may have been transferred to a nursing home away from their home area or their loved ones for various reasons. I worked with the ombudsman who provided advocacy services in the upper peninsula. And it was a group effort. The ombudsman in the upper peninsula was able to precure funding so the resident could be transferred to a nursing home in the upper peninsula, back to their hometown to be with family. As ombudsmen, we work within our specific service area, but we often work with others, residents’ needs and wishes they’re not always in our service area. Also, as ombudsmen, we have an idea of the services that are available in our service area, but we did not know what services are available in other areas of Michigan. Working in collaboration is key, especially for assisting residents who wish to transfer to their home area.
Jason Maciejewski (07:03):
That’s a good example of how important family members are to a process like transitioning out of a nursing facility. You work with family members of nursing facility residents through family councils. How did those get started? And what did those councils do?
Michelle Danou (07:17):
Family members who have loved ones in a nursing home can organize a family council, meet on a regular basis, discuss resident concerns and can plan activities for residents. Family councils are independent from the nursing home and is organized by the family members of residents. Family councils aim to give family members a voice to improve the quality of life in the home and give families a voice in decisions that affect residents in nursing homes. Nursing homes are required to listen and implement family council recommendations on resident care in life in the home. I’m often contacted by family members inquiring what does family council look like? Family councils are run by family members of the homes residents. They meet in a private area of the home on a regular basis, choose topics for discussion and establish a way to exchange information with nursing home staff. The home must assign a staff person to provide assistance to the council and respond to the family council written requests.
Michelle Danou (08:10):
There are many benefits for residents who are nursing homes with family councils. Some of the benefits are providing family members to support each other and share information and improving communication. So family members can know what is happening in the home. Family councils also help to identify problems and address concerns as a group and serves as a sounding board for new ideas. Family councils can also sponsor speakers or educational events for residents and family members. If a family member would like information about family councils in nursing homes, a fact sheet is available under the resource tab on our website at www.mltcop.org. Or you can reach out to your local ombudsman at +1 866-485-9393.
Jason Maciejewski (08:58):
Family councils are really important to the experience of people in a facility and for their caregivers. Thanks for sharing that. Could you share a success story with us about one of the people you’ve worked with, how the involvement of the ombudsman has made a difference in their life?
Michelle Danou (09:11):
COVID-19 has brought unprecedented and challenges in everyday life, especially in the life of a resident. I recently worked with a resident and a family member as a nursing home is not facilitating in-person visits for residents who are receiving hospice services. On behalf of the resident and family, I reached out to the nursing home and acquired why in-person hospital visits were not being facilitated as they are permitted per visitation guidance for residential care facilities. After reaching out to the nursing home, the family was contacted to offer in-person visits. During the first in-person visit, the family had the opportunity to see the advanced decline of the resident and the resident wanted to go home. Advocating for the in-person visits gave the family the opportunity to advocate and fulfill the resident’s wishes – to go home with hospice services, where the resident passed away in their home with family. Advocating for the resident brought awareness to the nursing home and what their responsibility is for in-person visits, which hopefully assisted other residents and family members to have the same opportunity to see each other.
Michelle Danou (10:10):
Another example, too often, residents’ personal belongings are missing, stolen, or do not follow them when they’re transferred to another long-term care setting. I was contacted by the upper peninsula ombudsman as a resident who was in my service area transferred back to their nursing home in the upper peninsula but was transferred without their motorized wheelchair. Once again, in collaboration with upper peninsula ombudsman, we were successful in locating the motorized wheelchair at the nursing home they were in, in my service area. We were able to advocate for the discharging nursing home and accepting nursing home to work together and a motorized wheelchair was delivered to the resident.
Jason Maciejewski (10:45):
Thanks for sharing that impactful story. If a nursing facility, resident or a caregiver wants to talk with the Long-Term Care Ombudsman program, how should they reach out?
Michelle Danou (10:54):
Any resident, family member, community member can reach out to the Michigan Long-Term Care Ombudsman program via website at www.mltcop.org, or by calling +1 866-485-9393. Our contact numbers are a geo routed number and will connect the caller to their local ombudsman.
Jason Maciejewski (11:17):
Great. Thanks for that information, Michelle, is there anything you’d like to add?
Michelle Danou (11:21):
Do the ever-evolving coronavirus COVID-19 pandemic outbreak, the Michigan Long-Term Care Ombudsman program recognizes the challenges and importance of informing family and friends of the ever-changing guidelines. To address and assist in educating families and friends, the ombudsman program host sessions, the first and third, Wednesday of each month at 6:30, which covers COVID-19 topics such as guidelines for visitation, testing, and quarantine. You can find this Zoom invite on our website at www.mltcop.org. Also, I’d like to take this opportunity if any resident family member has any questions, we can be reached at our website and through our phone number at +1 866-485-9393.
Jason Maciejewski (12:08):
Michelle, thanks for joining me today on the podcast.
Michelle Danou (12:10):
Thank you, Jason. Thank you for your time to discuss the Michigan Long-Term Care Ombudsman program.
Jason Maciejewski (12:14):
If anyone has questions about services or programs The Senior Alliance offers, you can call us at +1 800-815-1112, or email us at firstname.lastname@example.org. Information about our agency or the programs and services we offer can be found on our website at www.thesenioralliance.org. On Facebook, we can be located by searching for The Senior Alliance. And finally, our Twitter handle is @AAA1C.
I’m, Jason Maciejewski. Thank you for listening to this episode of Inside The Senior Alliance
Inside The Senior Alliance is a production of The Senior Alliance and Blazing Kiss Media.