Montana Long-Term Care Ombudsman: Filing Complaints and Protecting Resident Rights

When a nursing home suddenly tells your parent they must leave within 30 days, when medication errors keep happening and the administrator brushes off your concerns, or when you suspect your parent's care is slipping but you cannot pinpoint why — the Long-Term Care Ombudsman is the independent advocate who investigates on the resident's behalf.

Montana's Long-Term Care Ombudsman Program (LTCOP) operates under the federal Older Americans Act and Title 50, Chapter 5 of the Montana Code Annotated. It is free, confidential, and independent from both the facilities it oversees and the state agencies that regulate them.

What the Ombudsman Does

The Ombudsman investigates complaints, mediates disputes, and advocates for residents in nursing homes and assisted living facilities. Common issues include:

• Care quality concerns — medication errors, delayed response to call lights, inadequate nutrition, poor hygiene
• Involuntary discharge or transfer notices — facilities attempting to remove residents without proper notice or valid cause
• Billing disputes — unexpected charges, unexplained rate increases, or charges for services not delivered
• Resident rights violations — restrictions on visitors, confiscation of personal property, lack of privacy
• Abuse or neglect patterns — recurring incidents that suggest systemic problems rather than isolated events

The Ombudsman does not have enforcement authority to shut down facilities or impose fines. That power belongs to the DPHHS Quality Assurance Division. But Ombudsman investigations frequently lead to corrective action plans, and their involvement signals to a facility that a family is not going to quietly accept substandard care.

How to File a Complaint

Statewide toll-free line: 1-800-332-2272

You can also reach the program through regional offices embedded within Montana's Area Agencies on Aging. This decentralized model means local ombudsmen understand the specific facilities and communities they serve.

When filing a complaint, provide:

• The resident's name and facility location
• A specific description of the problem (dates, times, names of staff involved if known)
• Any documentation you have — photos, medical records, billing statements
• What outcome you are seeking

Complaints are confidential. The Ombudsman will not disclose the source of a complaint to the facility without the complainant's written permission, which protects family members from retaliation.

Fighting an Involuntary Discharge

Under Montana law, a long-term care facility must provide a 30-day written notice before executing an involuntary discharge. The notice must include:

• The specific reason for discharge
• The effective date
• The resident's right to appeal
• Contact information for the Long-Term Care Ombudsman

Valid reasons for involuntary discharge are limited: the facility cannot meet the resident's care needs, the resident's health has improved enough that facility care is no longer necessary, the resident endangers other residents' safety, the resident has not paid after receiving proper notice, or the facility is closing.

A facility cannot discharge a resident simply because their care needs have increased and become more expensive. If a resident transitions from needing Category A to Category B level care and the facility only holds a Category A license, the facility must assist with a planned, orderly transfer — not a sudden ejection.

Contact the Ombudsman immediately if you receive a discharge notice. The Ombudsman can:

• Review whether the notice complies with legal requirements
• Investigate whether the stated reason is legitimate
• Mediate between the family and the facility
• Help the family request a fair hearing to challenge the discharge
• Assist in identifying alternative placements if the transfer is warranted

Appealing a Nursing Home Transfer

When a nursing home issues a transfer notice — often after a Medicare-covered stay ends and the facility wants to free the bed — residents have the right to remain in the facility while an appeal is pending, provided they request a hearing before the transfer date.

The appeal goes to the DPHHS Office of Administrative Hearings. The Ombudsman can help families prepare for the hearing and may attend as an advocate, though they do not serve as legal counsel.

When to Contact APS Instead

The Ombudsman handles facility-level care quality and rights issues. If you suspect criminal behavior — physical assault, sexual abuse, theft, or deliberate financial exploitation — contact Montana Adult Protective Services at 1-844-277-9300 in addition to the Ombudsman. APS handles investigations that may result in criminal referrals to law enforcement.

For cases that involve both care quality concerns and suspected abuse, contacting both agencies simultaneously ensures the issue is addressed from both the regulatory and protective services angles.

The Montana Care Decision Guide covers the complaint and appeal process in detail, including what documentation to gather, how to escalate unresolved issues, and when to involve the DPHHS Quality Assurance Division directly.

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