Page 43 - Ombudsman Participant Manual Optimized_Neat

Federal Final Rule Tip Sheet
Ombudsman

Reporting and Investigation
Abuse

Does the Rule prohibit ombudsmen from investigating abuse complaints? No. Both the Older Americans Act and the Rule

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“identify,
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require the Ombudsman Office to investigate, and resolve complaints that relate action, inaction
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decisions that may adversely affect the health, safety, welfare, or rights of the residents.” (OAA Section 712(a) (3) (A), (a)

(5) (B) (iii); 45 CFR 1327.13(a) (1), 1327.19(a) (1), (b)). Abuse, neglect and exploitation of residents are among the

complaints that fall within this purview.

However, ombudsmen are not appropriately the official substantiator (or, finder of fact) for abuse complaints on behalf of

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the state other governmental entity. Ombudsmen represent the interests f residents, rather than the interests the
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state other governmental entity. (See OAA Section 712(a) (3) (E), (a) (5) (B) (IV); 45 CFR 1327.13(a) (5), 1327.19(a) (4)).

While the complaint resolution function of the ombudsman requires “investigation,” an ombudsman investigation is not

for the same purposes as an investigation by protective services, licensing and regulatory agencies, law enforcement or

other entities that represent the state or other government entity in determining whether abuse occurred. In most states,

substantiation determinations are made by adult protective services and/or the state’s licensing a nd regulatory agency,

not y the Ombudsman Office.
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In contrast, when n ombudsman receives any complaint (including, but not limited abuse-related complaint),

investigates solely for the purpose of gathering necessary information to resolve the complaint to the resident’s

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satisfaction. does not investigate order to determine whether any law regulation has been violated for
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officially
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purposes taking official protective, regulatory, enforcement action. The goal f the investigation resolve the
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complaint the resident’s satisfaction, but not to whether the abuse or other allegation occurred.
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The ombudsman does not have duty collect sufficient evidence meet the higher legal standards proof that
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protective services, licensing or regulatory agencies, law enforcement may need meet n order fulfill their
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respective purposes. With appropriate consent, the ombudsman makes a referral to the appropriate protective service,

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regulatory, law enforcement entity investigate for respective purpose.
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dispute resolution
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With the Ombudsman Office fulfilling its and advocacy duties, the priorities and interests f the
individual resident can supported informal ways that often prevent the need for more formal regulatory legal
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action. the government entities charged with taking protective, regulatory, enforcement actions are not providing
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the outcomes that serve the health, safety, welfare or rights of residents, the Ombudsman Office is available to address

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these larger systemic problems. Therefore, critically important that each these entities able to fulfill
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distinctly
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their duties.
Office of the LTC Ombudsman
Office of the LTC Ombudsman
Version 1.0 September 2020
Version 1.0 September 2020
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