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Tuesday, July 8, 2014

Ohio long-term care ombudsmen to assist consumers with problems and concerns related to MyCare Ohio

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Pro Seniors operates our region's Long-term Care Ombudsman program.

In Ohio, when consumers have concerns about their long-term care services - at home, in a nursing home, assisted living or other skilled care facility - they can turn to their local Long-term Care Ombudsman. With the launch of MyCare Ohio, the Ohio Department of Aging (ODA) received funding from the Centers for Medicare and Medicaid Services (CMS) to expand the ombudsman program to include MyCare Ohio consumers.

Generally speaking, ombudsmen field complaints about long-term care services and voice clients' needs and concerns to nursing homes, home health agencies, and other providers of long-term care. They work with consumers, their families or other representatives, and care providers to resolve problems and concerns related to services and care.

Ombudsmen:

  • link consumers with the services or agencies they need to live a more productive, fulfilling life, 
  • advise on selecting long-term care in Ohio, 
  • inform about the rights of consumers, and 
  • provide information and assistance with benefits and insurance.

With the launch of MyCare Ohio, Ohio's Ombudsmen are available to help consumers with questions or concerns related to any of their MyCare-covered services (transportation, physician services, behavioral health services, prescription issues, hospital issues, and more).

For MyCare Ohio consumers, the Ombudsman will:

  • Provide Ombudsman Core Services: information, advocacy and complaint investigation. 
  • Provide information regarding rights and benefits to members, families and providers within the MyCare Ohio service delivery system.
  • Investigate and resolve complaints regarding MyCare Ohio enrollment and service delivery.
  • Assist and represent MyCare members and families in administrative hearings and appeal situations in accordance with Ombudsman policy.
  • Conduct outreach, and serve on the MyCare Ohio managed care plans’ advisory councils. 

To reach the MyCare Ohio Ombudsman for Butler, Clermont, Clinton, Hamilton and Warren counties:

Pro Seniors Inc
Ms. LeVon Pressley
Lpressley@proseniors.org
Direct Dial: 513-458-5536
Toll Free: 800-488-6070

To speak with a local Ombudsman about issues NOT related to MyCare Ohio:

Pro Seniors Inc.
513-345-4160
Toll Free: 800-488-6070
To bypass the receptionist and reach the ombudsman intake desk, press #7##

If you live outside our area, you can locate the Long-Term Care Ombudsman Program serving your county in Ohio at the Office of the State LTC Ombudsman website.

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