Office of the State Long-Term Care Ombudsman

The Office of the State Long-Term Care Ombudsman (OSLTCO) is authorized by the federal Older Americans Act and the state Older Iowans Act. Operating as an independent entity within the Iowa Department of Health and Human Services, the role of the OSLTCO is:  

  • to protect the rights of individuals residing in long-term care facilities, including nursing facilities, assisted living programs, residential care facilities and elder group homes, by empowering them, investigating complaints, seeking resolution to problems, and providing individual and systemic advocacy, with the goal of enhancing quality of life and care, and 
  • to educate, empower and advocate for Medicaid managed care members living in a long-term care facility or enrolled in one or more of Iowa’s Home and Community-Based Services (HCBS) waiver programs including AIDS/HIV, Brain Injury, Children’s Mental Health, Elderly, Health and Disability, Intellectual Disability and Physical Disability. 

Volunteer Opportunities

Anyone interested in applying to become a volunteer ombudsman may reach out to the OSLTCO to receive an application or click the link below.  Volunteers are an important part of the work of the OSLTCO and may carry out visits, administrative tasks, or other special projects.

Volunteer Application

Managed Care Executive Summaries

OSLTCO Online Contact Form 

Please use this online form to submit your inquiry or concern to the Iowa Office of the State Long-Term Care Ombudsman (OSLTCO).  All information is confidential.  Please do not submit personal information such as Social Security number or a detailed medical history: if we need additional information, we will gather such when we respond to your inquiry. The OSLTCO may also be reached by calling 1-866-236-1430 (toll-free).

Note:  The OSLTCO is not an emergency response organization. In an emergency, or if someone is in immediate danger, dial 911.   

Local Long-Term Care Ombudsman Districts

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Involuntary Discharges

State and federal laws outline the rights of individuals who live in long-term care facilities.  Included in these rights is the right to appeal a decision if asked to involuntarily transfer or discharge from a facility.  For information about the rules, resident rights, or to request assistance, contact the Office of the State Long-Term Care Ombudsman (OSLTCO) at 1-866-236-1430, or email: sltco@hhs.iowa.gov   

Nursing Facility Involuntary Discharge: 

An involuntary discharge from a Nursing Facility occurs when the facility provides a 30-day written notice to a resident informing him/her of the need to move out of the facility. Under 42 Code of Federal Regulations (CFR) 483.15(c) and Iowa Administrative Code 481-58.40(1), a facility must permit residents to remain in a facility and not discharge them unless: 

  • There is a medical reason as determined and documented by the resident’s primary care provider, 
  • The resident's behavior poses a threat to themselves or to the well-being of other residents or staff;   
  • There is nonpayment for the resident’s stay; 
  • Due to action pursuant to Iowa code chapter 229; 
  • By reason of negative action by the Iowa Department of Health and Human Services; or 
  • By reason of negative action by the quality improvement organization (QIO). 

Residents have the right to appeal an involuntary discharge within seven (7) days of receiving the notice.   

Assisted Living Program Involuntary Transfer: 

A transfer from an Assisted Living Program may occur due to the following criteria as outlined within Iowa Administrative Code 481-69.23(1): 

A program may not knowingly admit or retain a tenant who: 

  • Is bed-bound; or 
  • Requires routine, two-person assistance with standing, transfer or evacuation; or 
  • Is dangerous to self or other tenants or staff, including but not limited to a tenant who: 
  • (1) Despite intervention chronically elopes, is sexually or physically aggressive or abusive, or displays unmanageable verbal abuse or aggression; or 
  • (2) Displays behavior that places another tenant at risk; or 
  • Is in an acute stage of alcoholism, drug addiction, or uncontrolled mental illness; or 
  • Is under the age of 18; or 
  • Requires more than part-time or intermittent health-related care; or 
  • Has unmanageable incontinence on a routine basis despite an individualized toileting program; 
  •  Is medically unstable; 
  • Requires maximal assistance with activities of daily living; or 
  • Despite intervention, chronically urinates or defecates in places that are not considered acceptable according to societal norms, such as on the floor or in a potted plant. 

Additional transfer criteria may be disclosed in the written occupancy agreement.  If an Assisted Living Program initiates the transfer process, the tenant or their legal representative shall be notified in accordance with the occupancy agreement.  The program is obligated to follow their internal appeal process if the tenant or their legal representative wish to appeal this decision. 

Residential Care Facility Involuntary Discharge: 

An involuntary discharge from a Residential Care Facility occurs when the facility provides a 30-day written notice to a resident informing him/her of the need to move out of the facility. Under Iowa Administrative Code 481-57.14(1), a facility must permit residents to remain in a facility and not discharge them unless: 

  • There is a medical reason as determined and documented by the resident’s primary care provider, 
  • The resident's behavior poses a threat to themselves or to the well-being of other residents or staff;   
  • There is a repeated refusal by the resident to participate in their service plan. 
  • There is nonpayment for the resident’s stay; or 
  • Due to action pursuant to Iowa Code chapter 229. 

Residents have the right to appeal an involuntary discharge within seven (7) days of receiving the notice. 

Monthly Facility Transfer/Discharge Notification: 

Federal regulation 42 CFR 483.15(c)(3) requires long-term care facilities to send a summary of all transfers/discharges from a facility to the OSLTCO.   

  • Facilities can submit this form on or before the 5th of each month for the preceding month: Facility Monthly Discharge Template   
  • Provide identifying information in the email subject line, i.e. Facility Name/Month of the Report, 
  • Email this form to sltco@hhs.iowa.gov If email is not an option, a hard copy can be mailed to the Office of the State Long-Term Care Ombudsman at: 321 E. 12th Street, Fourth Floor, Des Moines, IA 50319. 

Facility Closure

 Learning about a facility closure can be very stressful for everyone involved.  The OSLTCO is actively involved during facility closures and will offer support and advocacy to all residents throughout the closure process. By having discussions in advance with the facility and legal representatives and by being better informed about resident rights and facility responsibilities, transfer trauma may be able to be minimized, and residents may be better prepared for sudden or unexpected closures.    IDA_Ombudsman_Facility Closure Brochure_3.5x10 (3).pdf  

This short video highlights how to be better prepared when a facility is closing: Facility Closure  

This six-minute informational video provides in depth details to outline the specifics of how to self-advocate, how to prepare for a move and uphold resident rights during the closure process:  Facility Closure   

Resources

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