Missoula Aging Services explains long‑term care types and ombudsman role

On the public‑access program Senior Connections, host Mike McCracken and two certified local ombudsmen from Missoula Aging Services discussed local long‑term care options, how families can evaluate facilities and the ombudsman program that advocates for residents.

The discussion matters because Missoula’s aging population means more families will be choosing between adult foster care, personal care homes and nursing homes — decisions that have different services, licensing limits and payment rules.

Maggie, an information and assistance specialist and certified local ombudsman with Missoula Aging Services, summarized facility types: "Basically, there's 3 types of long term care facilities. 1 is an 1 is the adult foster care facility, another 1 is the personal care home facility, and the third 1 is the nursing home facilities." She said adult foster care homes are "smaller home like settings" licensed for up to four residents and provide only personal‑care services such as help with bathing, dressing and meals. Personal care homes, she said, can range from small houses to much larger facilities that may house more than 100 residents and also provide personal‑care services and medication reminders.

Maggie explained that some personal care homes use two levels of care. "A levels, the residents must be self ambulatory. ... In a level, also, they cannot be totally incontinent," she said. "Also in the b level, you have to have a third party health care provider perform an assessment on the resident. They need to develop a care plan, and these residents do not have to be ambulatory. They can be incontinent, and there's also no nursing services available there either." She described nursing homes as providing "24 hour care, 24 hour nursing services," and said they are "under a doctor's care while at the facility."

Angela, also an information and assistance specialist and certified local ombudsman, walked through practical steps families can take. She advised consulting the person's primary physician to determine care needs and making a written list of required supports — for example, help with transferring, bathing or cooking — to match a resident’s needs to a facility’s services. She noted payment limits: "Medicaid will help pay for a nursing home, but they don't pay for personal care homes or adult foster care homes. There is a program called Medicaid waiver which can provide limited service ... to a limited number of people in the community." Angela said Missoula Aging Services has a case manager to explain waiver options.

Both ombudsmen encouraged callers to obtain facility inspection (survey) results. Angela said state surveys occur about every 15 months and that "nursing homes should have those results on‑site"; she added that survey reports can also be accessed at Medicare.gov, though online postings sometimes lag by a few months. For personal care homes and adult foster care, she said, copies may not always be on‑site and can be obtained from the Long Term Care Quality Assurance Division in Helena; Missoula Aging Services staff can provide the contact numbers.

The program also described local capacity and contact points. The guests told viewers there are four nursing homes, 16 personal care homes and roughly 10 adult foster care homes in Missoula County and urged people to call Missoula Aging Services for checklists, facility lists and other materials. The number given repeatedly during the program for Missoula Aging Services was 728‑7682. The show also cited the Citizens Advocate office and provided the number as +1 803322272 for callers seeking statewide ombudsman assistance.

Regarding the ombudsman program itself, Angela said the role is federally required: "The long term care ombudsman are advocates for residents in long term care facilities ... The program was incorporated into federal law in 1978 through the amendments of the Older Americans Act. ... In Montana, there are 2 state ombudsman who are in Helena, and they oversee the program. And there are approximately 43 local ombudsman." She described the local ombudsman duties as advocating for residents who feel vulnerable, mediating disputes between residents/families and facility administration, conducting investigations when rights are suspected to be violated and providing education on residents' rights.

Maggie gave examples of common complaints that trigger ombudsman investigations: unanswered call lights, food or cleanliness complaints, lost items, use of bed rails without a physician’s order and inappropriate discharges. She said all long‑term care facilities are mandated to post an ombudsman poster with contact information, and callers from out of county can be referred to the appropriate local ombudsman in the facility’s area.

The program closed with practical information for families: Missoula Aging Services maintains lists of long‑term care facilities in Missoula County, offers written checklists and safety check items for facility visits, and can mail or hold materials for pickup. The guests also noted that Missoula Aging Services recently moved to a new facility on Stevens, and viewers were invited to call or drop in for assistance.

Contact information and programs referenced during the program: Missoula Aging Services, 728‑7682; Citizens Advocate office (number given on air) +1 803322272; Medicare.gov for inspection reports; Older Americans Act (federal law authorizing ombudsman programs); Montana Long Term Care Quality Assurance Division for survey records.

For families assessing options, the advisers emphasized documenting needs, reviewing state surveys, asking facility administrators for policies and safety features, and contacting Missoula Aging Services or the local ombudsman when rights or care quality are in question.