1. Melanie McNeil, Esq. State Long-Term Care Ombudsman Office of the State Long-Term Care Ombudsman 404-657-5327 Melanie.McNeil@dhs.ga.gov www.georgiaombudsman.org 3/10/20161

2. Overview Who we are What we do Who we serve How we serve 3/10/20162

3. Who we are Office of the State Long-Term Care Ombudsman: Independent office of Dept. of Human Services Program expenditures approximately $2.7 M federal, state and local funds Six state office staff, approximately 45 local agency staff State Long-Term Care Ombudsman oversees the program Office of the State Long-Term Care Ombudsman provides: technical assistance to local representatives, information and assistance to residents, families and the public training for staff representatives collects, analyzes and reports data 3/10/20163

4. What we do “ As mandated by the Older Americans Act, the mission of the Long-Term Care Ombudsman Program is to seek resolution of problems and advocate for the rights of residents of long-term care facilities with the goal of enhancing the quality of life and care of residents.” National Association of State LTC Ombudsman Programs, 2006 3/10/20164

5. Unique Characteristics of LTCO Federal confidentiality requirements mean no sharing of client- specific information without consent (including sharing with other agencies; LTCO representatives are not “mandated reporters”) Complaint investigation focus: –less on “did it happen?” (as opposed to preparing for potential legal action, for example) –more on “how can we assist in resolving the issue for this resident?” (regardless of whether sufficient evidence for legal or regulatory action) Resolution based on whether resident satisfied with the outcome Individual complaint work as well as systemic advocacy work 3/10/20165

6. Who we serve Residents of Facilities Nursing Homes Personal Care Homes Assisted Living Communities Community Living Arrangements Intermediate Care Facilities for Individuals with Intellectual Disabilities Money Follows the Person Participants 3/10/20166

7. How we serve Investigate and work to resolve residents’ problems Advocate for what the resident wants Routinely visit facilities to: provide residents with access to LTCO and monitor conditions Provide consumers with information about long-term care Educate facility staff about residents’ rights 3/10/20167

8. How we do the work Restructure under way: Currently, contract with Area Agencies on Aging in 12 regions that subcontract with 13 providers. July 1, 2016 - Direct contracts with non-profit providers; reduce regions to six (6) Services: Certified Long-Term Care Ombudsman (LTCO) representatives and Volunteers make quarterly visits to residents of Nursing Homes, Personal Care Home and Assisted Living Communities for monitoring conditions and resolving complaints Monthly contacts with Money Follows the Person participants Respond to complaints for Community Living Arrangements and Intermediate Care Facility residents 3/10/20168

9. Types of Complaints to LTCO Related to Nursing Homes Discharge, eviction - planning, notice Dignity, respect, staff attitudes Personal hygiene Cleanliness, presence of pests Failure to respond to requests for assistance Symptoms unattended, pain not managed Equipment – disrepair, hazard, poor lighting, fire safety Accidents / unknown injuries, falls, improper handling Care plan / resident assessment Medications – administration, organization 3/10/20169

10. Collaborations Ga. Dept. of Human Services – Adult Protective Services, Forensic Special Initiatives Unit, Public Guardianship Office, Aging and Disability Resource Connection, Community Care Services Program Ga. Dept. of Community Health – Healthcare Facility Regulation Division US Dept. of Health and Human Services – Administration for Community Living, Centers for Medicare and Medicaid Services US Attorney – Skilled Nursing Facility workgroup US Bankruptcy Trustee – Patient Care Ombudsman Ga. Attorney General – Medicaid Fraud Control Unit Georgia Bureau of Investigation workgroup Colleges and Universities –Georgia State University: College of Law, Gerontology Institute –Georgia Tech –Clayton State –Kennesaw State University 3/10/201610

11. Memberships Georgia Gerontology Society American Society on Aging National Association of State Long-Term Care Ombudsman Programs Georgia Commission on Family Violence 3/10/201611

12. Reputation Other Offices of State Long-Term Care Ombudsman look to Georgia for examples Frequently requested to participate on workgroups – national and state Invited by policy makers to participate 3/10/201612

13. Contact Information Melanie s. McNeil, Esq. Office of State Long-Term Care Ombudsman Department of Human Services 2 Peachtree St., NW, 33rd Floor Atlanta, GA 30303-3142 404-657-5327 866-552-4464 www.georgiaombudsman.org 3/10/201613