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The Local Ombudsman and Filing Complaints

Two different systems: the free, independent long-term care ombudsman, and the state health department complaint line. Here is when to use each.

HomeState RulesThe Local Ombudsman and Filing Complaints

The local long-term care ombudsman

TODO — Your region's Long-Term Care Ombudsman office. This page needs real, primary-sourced content specific to your state and metro. Do not copy another site's content here. Research and write:
  • Which ombudsman region/office covers each county you serve, and its phone number and address.
  • That the ombudsman is free, independent, and acts only with resident consent.
  • Whether your coverage area spans more than one ombudsman region (common when a metro straddles a state's administrative boundaries).

Reporting abuse or neglect

TODO — Your state's Adult Protective Services structure. This page needs real, primary-sourced content specific to your state and metro. Do not copy another site's content here. Research and write:
  • Whether APS is a single statewide hotline or county-administered (structure varies a lot by state).
  • The specific phone number(s) for each county you cover, plus any statewide fallback line.
  • The state health department's facility complaint line (separate from APS).

Which one to call

The long-term care ombudsman and the state health regulator do different jobs, and using one does not preclude the other. The ombudsman advocates for a resident and can attend a care conference with you, but does not license, inspect or fine a facility. The state regulator investigates regulatory complaints and can take enforcement action, but is not an advocate for an individual resident's preferences the way an ombudsman is.

The consent rule

An ombudsman acts only with the consent of the resident or their legal representative. This surprises adult children. If a parent has capacity and does not want a complaint pursued, that decision stands, even where family disagrees with it.

Questions families ask

What is Managed Long Term Care (MLTC), and is it mandatory?

MLTC is New York's managed-care model bundling home care, personal care, adult day health care, and nursing home care through DOH-approved plans. It has been mandatory since 2012 for dual-eligible adults 21+ needing more than 120 days of community-based long-term care.

Did New York's 2014 Medicaid expansion change anything for senior long-term care eligibility?

No — New York's 2014 ACA Medicaid expansion (and its earlier 2001 Family Health Plus expansion) covers non-elderly low-income adults. Long-term-care Medicaid for seniors uses entirely separate aged/blind/disabled eligibility rules that were not changed by either expansion.

Does Medicaid ever try to recover money from a family after a senior on Medicaid passes away?

Yes — New York's Medicaid Estate Recovery Program can file a claim against a deceased recipient's estate to recover what Medicaid paid for long-term care, subject to spousal and other protections.

What does New York's Long Term Care Ombudsman actually do, and is it really free?

The Long Term Care Ombudsman Program investigates and helps resolve complaints for residents of nursing homes and assisted living/adult care facilities, and advocates for residents' rights. It is free, independent of any facility, and acts only with resident consent.

How do I report suspected abuse or neglect of an older adult in Erie County?

Call Erie County Department of Social Services Adult Protective Services at (716) 858-6877, or the statewide New York abuse-reporting line at 1-844-697-3505 (8:30am-8pm, NY only). Call 911 if someone is in immediate danger.

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