Program to Solve Problems Understaffed by Half

07/16/01

DAVE PARKS
News staff writer

Alabama has a program to help nursing home residents resolve problems without going to court, but it is vastly understaffed. The state has less than half the ombudsmen needed to provide minimum service to more than 30,000 residents of nursing homes, assisted living facilities and boarding homes, according to a study last year by the Institute of Medicine, an independent health and science research group. 

The institute recommended one ombudsman for every 2,000 long-term care beds, according to Marie Tomlin, head of the state's Long Term Care Ombudsman program. Alabama has one ombudsman for every 5,000 long-term care beds. To cover the state, the program relies on part-time workers and volunteers, she said.

Ombudsmen act as intermediaries for the residents. Most often last year, Alabama ombudsmen handled complaints about involuntary evictions, beds not being held while residents were hospitalized, mishandling of medications and nutritional issues. The shortage of ombudsmen is more critical in some areas, such as Jefferson County, Ms. Tomlin said. Amy McAfee, who recently resigned her position as the county's sole ombudsman, had responsibility for 9,000 beds.

"It's impossible," Ms. Tomlin said. She said an ombudsman program benefits nursing homes and residents by resolving problems without lawsuits. Nursing home residents and their families often are afraid to complain to nursing home administrators about problems, or they are discouraged from doing so, Ms. Tomlin said. "They're told: 'If you don't like it here, you've got to get out.'" If conditions persist or deteriorate, people become angry and file lawsuits, an expensive trend plaguing the nursing home industry.

"We've got to learn as a nation to deal with our problems in a better way," Ms. Tomlin said. "People need to feel secure in having problems resolved." But it's difficult to keep up with the need while understaffed, she said.

The program now operates on $511,000 a year, which is mostly federal funds. The Alabama Association of Area Agencies on Aging proposed a $500,000 increase to the state Legislature, but it wasn't approved. D. Lee Guyton Jr., president of the Alabama Nursing Home Association, said that at his two nursing homes, he's found ombudsmen useful as objective third parties.

"The ombudsman program, if it is used correctly, is an excellent tool," Guyton said. Bruce Thevenot, executive director of the Alabama Nursing Home Association, agreed that ombudsmen may be helpful in deterring litigation. "We're for resolving as many problems as possible right there in the facility," he said.