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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 advocate for 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.
Local Long-Term Care Ombudsman Districts
The Long-Term Care Ombudsmen investigate complaints, seek resolution to problems, and provide individual and systemic advocacy with the goal of enhancing quality of life and care and upholding resident and member rights. All services are free and confidential.
The OSLTCO may be contacted:
- to ask for assistance resolving a concern or to learn about self-advocacy
- to inquire about resident and member rights
- to clarify state or federal regulations, facility policies and managed care organization processes
- to understand the role of substitute decision makers, such as power of attorney, guardian and/or conservator
- to obtain assistance with the involuntary discharge of a resident or the facility closure process
- to receive information about resident and family councils
- to learn about information available to choose a long-term care facility or Medicaid managed care organization
- to apply to become a volunteer ombudsman
Volunteer Opportunities
Long-Term Care Ombudsman Brochure
This video covers issues that the Long-Term Care Ombudsman can help address:
This video covers the rights that Long-Term Care residents have:
Volunteer Opportunities
Volunteers are an important part of the work of the OSLTCO and may carry out visits, administrative tasks, or other special projects. Some individuals living in long-term care facilities have little or no outside support from family or friends. A volunteer ombudsman who visits regularly can brighten a resident’s day and help ensure care is delivered in a respectful, dignified manner to meet an individual’s needs.
Anyone who is passionate about helping others, has a caring nature, and is eager to learn is encouraged to apply! Reach out to the OSLTCO at sltco@hhs.iowa.gov to receive an application or click the link below. We offer volunteers comprehensive training, resources, and continuous support.
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Annual Reports
Back to topTown Halls
Town hall meetings are public, recorded, and will be shared on our website. Please be cognizant of the public nature of these meetings in determining whether to share personal details or information. If there are specific concerns about the public nature of these meetings or information shared during these meetings, please reach out to the Office of the State Long-Term Care Ombudsman.
October 2024: Personal Needs Allowance
Personal Needs Allowance (PNA) is the amount of monthly income an individual on Medicaid who resides in a nursing facility can keep. This town hall discusses PNA in Iowa and a resident-led initiative to increase the amount, which was last increased to $50 in 2001.
November 2024: Family Council
Family councils are an organized, self-led group of families and resident representatives who meet regularly to help support and advocate for resident rights to improve quality of life and care and communicate suggestions and collective concerns to facility staff for the betterment of residents. This town hall talks all things family councils, offering ideas for a successful family council, with the goal of increasing the number of active family councils in our state.
December 2024: Visiting During the Holidays
Celebrating and being present with those who live in a long-term care facility is so important for overall well-being, during the holidays and every day of the year. This town hall includes a conversation regarding visitation, to include resident rights, how to involve residents and tenants during the holiday season, and how to help keep everyone healthy during a busy, joyful time of year.
Involuntary Discharges & Closures
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.
Involuntary Discharge Brochure
This video covers the actions that you can take when you are facing a discharge from the facility:
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.
- 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
This video highlights what qualifies as Elder Abuse and what steps you can take if you feel abuse is happening:
Useful Links
- Iowa Department of Inspections, Appeals and Licensing - Health Facilities Division
- Find Healthcare Providers: Compare Care Near You | Medicare - Click here to search for a list of nursing facilities.
- National Consumer Voice for Quality Long-Term Care:
- Disability Rights IOWA
- Iowa Legal Aid
- HHS Managed Care Organizations (MCOs)
- Iowa Area Agencies on Aging (AAA)
- Your guide to living in a nursing home (medicare.gov)