Complaints & Concerns about Programs & Services
Life in a nursing or rest home is not always easy. Many residents are alone, and feeling powerless. A Long Term Care Ombudsman is an advocate for residents living in long term care facilities. Ombudsmen offer a way for residents and their loved ones to voice their complaints and have their concerns addressed so that residents can live their lives with dignity and respect.
The Executive Office of Elder Affairs, through 24 Local Program Areas, administers the Massachusetts Long Term Care Ombudsman Program. Ombudsmen work within the system to improve the quality of life and care of residents. Ombudsmen volunteers and staff are certified by the State Ombudsman and visit nursing and rest homes on a regular basis. Other key activities of Ombudsmen include:
- Receive, investigate and work to resolve concerns of residents.
- Educate residents, families and providers about resident rights.
- Refer individuals to other appropriate agencies for assistance when resolution of a concern is not possible through the Ombudsman Program.
- Advocate for positive change to the long term care system in Massachusetts.
- Provide information and assist consumers in selecting a long term care facility.
- Keep the identities of residents and complainants confidential unless the person making the complaint consents to having such information released, or abuse or neglect are involved.
Community Care Ombudsman
The purpose of the Community Care Ombudsman Program is to assist elders and their families in the community by investigating and resolving their complaints. Covered community care programs include: programs of medical, functional, or social support services that are provided to an individual living in their home, apartment, in a day care program, or a managed care demonstration program under the Social Security Act. Also covered is home health services, community based Medicaid programs, the state home care funded program and federally funded an private pay elder care programs specified.
The Community Care Ombudsman responds to inquiries from elders and their families, educates consumers about their rights and responsibilities, counsels consumers about concerns with their services, refers consumers to appropriate sources for help, and investigates and resolves complaints through mediation.
Protective Services Program
The Executive Office of Elder Affairs is required by law to administer a statewide system for receiving and investigating reports of elder abuse, and for providing needed protective services to abused elders when warranted. To fulfill this responsibility, Elder Affairs has established 22 designated Protective Services (PS) agencies throughout the Commonwealth to respond to reports of elder abuse. Elder abuse includes physical, emotional and sexual abuse, neglect by a caregiver, self-neglect and financial exploitation. The goal of the Protective Services Program is to prevent, remedy or eliminate the effects of abuse on the elder. The primary focus is on ending or alleviating the abuse. However, other critical program goals include: freedom, safety, least disruption of lifestyle and the least restrictive care component. An elder’s right to self determination must be respected to the fullest extent possible, and the least restrictive appropriate service alternatives should be used to meet the needs of the elder.
Developed as a short term crisis intervention program, Protective Services are services designed to eliminate or alleviate the abuse of an elder. Caseworkers work with the elder, family and community agencies to provide medical, mental health, legal and social services.
Protective Services casework may include services such as:
- Safety planning;
- Substance abuse treatment;
- Mental health services;
- Family intervention;
- Homemaker/health aide services;
- Emergency food or fuel;
- Legal assistance;
- Financial assistance;
- Medical services and therapies;
Reporting Elder Abuse
Elder abuse reports may be made to the appropriate designated PS agency or the statewide Elder Abuse Hotline (1-800-922-2275), which operates on a seven days a week, 24 hours a day basis. Typically, elder abuse reports are made to PS agencies by calling 1-800-243-4636 (or calling their local agency directly) during normal business hours and to the Hotline during after-hours periods, on weekends and holidays. While certain professionals are required by law to report suspicions of abuse, anyone with concerns for an elder can file a report.
When it is determined that a filed report meets the definition of a reportable condition, a trained PS caseworker is assigned to investigate the allegations. If abuse is confirmed, the elder is offered a choice of services to address the situation. In cases of serious abuse, the PS agency must make a report to the District Attorney for possible prosecution.
An elder who has the capacity to make informed decisions has the right to refuse an investigation, services, or other particular course of action. However, court ordered services must be sought on behalf of abused elders who are unable to make informed decisions, and are at risk of serious harm. In addition, protective services must be provided in the least restrictive and appropriate manner possible. This means that in-home and community based services are given preference over institutional placement.
Money Management Program
The Massachusetts Money Management Program is a free service that assists low-income elders who might be at risk of losing their independence due to their inability to pay basic rent, food and utility bills on time. Oftentimes, these elders are homebound, disabled, visually impaired, or confused, and without family nearby to help them. Trained, insured, supervised volunteers assist their clients by writing checks, balancing their checkbooks and ensuring that bills are paid on time.
How to Know When Someone Needs Help
- The elder is unclear about the bank accounts s/he has and where accounts are located.
- Unpaid bills are scattered around the elder’s home.
- Utilities have been shut off in the last 12 months.
- The person complains about not having enough money to make ends meet.
The Money Management Program uses volunteers to provide this service in the elder’s home. An insured, supervised volunteer is matched with each elder. The volunteer visits the elder at least monthly to help keep track of income and expenses, and to make sure that bills are paid on time.
The Money Management Program is available to Massachusetts residents age 60 and over who are:
- Homebound, visually impaired, disabled or confused;
- At risk of losing independence due to their inability to pay bills on time;
- Without family or friends to help; and who,
- Meet income and asset guidelines.
Seeking to prolong independent living in the community, the Money Management Program provides two levels of assistance. The Bill Payer Service assists elders develop a budget and balance their checkbooks. The elder makes all the decisions and retains check-signing capacity. When it is determined that an elder is incapable of managing his/her finances, the Social Security Administration may appoint a Representative Payee. The volunteers are given legal authority to write and sign checks through a special checking account.
While Protective Services seeks the least restrictive option possible to resolve the situation, certain situations require more restrictive actions to ensure an elder’s safety. If a court appointed decision maker is required, Protective Services would petition for the appointment of a guardian or conservator through the court system. To assist in this process, Elder Affairs contracts with five not-for-profit agencies across the state to provide conservator and guardianship services to PS clients who are unable to make informed decisions and are at risk of serious harm. A conservator is appointed by the court to manage the finances of another person, while a guardian is responsible for managing both the financial and personal care needs of his/her ward.