HJBR Sep/Oct 2025

CARING TOGETHER 18 SEP / OCT 2025 I  HEALTHCARE JOURNAL OF BATON ROUGE   STATE REGULATIONS VARY While federal laws — such as those under the Older Americans Act and CMS regulations — apply nationwide, each state may have its own rules regarding licensing, services, and oversight of long-term care. Readers are encouraged to contact their state’s Department of Health or Long-Term Care Ombudsman Program to understand regulations that apply locally. CASE STUDY: “IT’S MY DECISION” Mr. Smith, age 93, was blind but fiercely independent. He had lived alone for years in a modest home with his three beloved cats. After a serious leg wound, he was hospital- ized. There, staff urged him to assign a power of attorney (POA). With few close relatives, he chose a niece he hadn’t seen in years. Following discharge, Mr. Smith entered a nursing facility for what he believed was temporary rehabilitation. Weeks turned into months. He was informed that his niece had signed paperwork enrolling him in long-term custodial care. He received no visits, no phone calls from her. When he asked when he could return home, a staff member explained that his niece, his POA, placed him there for long-term custodial care. Mr. Smith realized he wasn’t going home. Meanwhile, Mr. Smith’s neighbors had been car- ing for his cats and keeping up the house, waiting for his return. During a regular visit, the ombudsman met Mr. Smith and listened as he expressed his desire to go home and that he did not want his niece making his decisions. At his request, the ombudsman initiated support through the Ombudsman Legal Assistance Program (OLAP). An OLAP attorney met with Mr. Smith to ensure that he fully under- stood his rights and comprehended what he was doing by revoking the POA, and the possible consequences (family tension). Mr. Smith chose to revoke the POA. Then came the power of coordinated support: With Mr. Smith’s permission, he, the social worker, director of nursing, minimum data set (MDS) nurse, administrator, physi- cal therapist, and the ombudsman had a care plan meeting to discuss steps needed to help Mr. Smith safely discharge home. AMedicaid Home and Community-Based Services (HCBS) Waiver assessment was conducted of Mr. Smith’s home. A ramp was installed. Awalk-in shower and grab bars were added. His kitchen floor was repaired. In-home care was scheduled for a few hours, five days a week. Mr. Smith returned home, to his cats, his faith community, and the neighbors who never stopped rooting for him. He lived independently for two more years and passed away in the home he loved, with dignity, autonomy, and peace. When Medical Teams and Ombudsmen Collaborate, Everyone Wins At first glance, the missions of medical professionals and ombudsmen may seem distinct. But look more closely, and shared goals emerge: to reduce harm, honor dignity, and improve quality of life for every individual in care. Medical professionals are trained to diagnose, treat, and heal. Ombudsmen are trained to listen, advocate, and uphold the rights of the individual. When these two forces align, something pow- erful happens: Care becomes person-centered, not system-driven. Outcomes improve. Discharges go more smoothly. Lives are honored. The following case studies illustrate what this looks like, not in theory, but in practice. DID YOU KNOW? The Medicaid Home and Community-Based Services (HCBS) Waiver helps eligible individuals receive care at home through support such as personal aides, home modifications, meals, and transportation.