New Hampshire Long-Term Care Ombudsman: How to File Complaints and Protect Residents

When your parent's nursing home suddenly announces they are being discharged because their care needs have "exceeded what the facility can provide," you need an advocate who understands the rules — not a family member arguing from emotion. The Office of the Long-Term Care Ombudsman exists to be that advocate, and the service is free.

What the Ombudsman Does

The Office of the Long-Term Care Ombudsman (OLTCO) is an independent advocacy office within the Department of Health and Human Services, located at the Brown Building, 129 Pleasant Street, Concord, NH 03301. Staff and certified volunteer ombudsmen visit nursing homes and assisted living facilities, investigate resident complaints, and work to resolve conflicts directly with facility administrators.

The ombudsman is not a regulator — they cannot fine facilities or revoke licenses. Their power is in advocacy: they investigate complaints, mediate disputes, and connect families with the regulatory agencies that can take enforcement action when needed.

Contact the OLTCO:

• Phone: 603-271-4375 or toll-free 1-800-442-5640
• Email: [email protected]

When to Contact the Ombudsman

Involuntary discharge. If a nursing home (He-P 803) or supported residential facility (He-P 805) attempts to discharge your parent against their will, contact the ombudsman immediately. Facilities must follow specific discharge procedures with adequate notice, and residents have the right to appeal. The ombudsman can review whether the facility followed proper procedures and advocate for your parent to remain.

Care quality concerns. If you notice signs of inadequate care — pressure ulcers developing, medications being missed, your parent losing weight without medical explanation, unanswered call lights — the ombudsman can investigate and push for corrective action without you having to confront facility administration alone.

Rights violations. New Hampshire nursing home residents have legally protected rights, including the right to privacy, the right to participate in their own care plan, the right to communicate with visitors and advocates, and the right to voice grievances without retaliation. If any of these rights are being violated, the ombudsman is your first call.

Billing disputes. When facility charges do not match what the admission agreement specified, or when your parent's rate increases without proper notice, the ombudsman can review the contract terms and advocate for resolution.

How to File a Complaint

You do not need a formal process or documentation to contact the ombudsman. Call the toll-free number, describe your concern, and an ombudsman will follow up. Complaints can also be submitted by email.

For maximum effectiveness:

• Document specific incidents with dates, times, and the names of staff involved
• Take photos if appropriate (visible injuries, unsanitary conditions)
• Keep copies of all admission agreements and care plans
• Note any witnesses to the incidents

The ombudsman investigates complaints confidentially. Your parent's identity and your identity as the complainant are protected unless disclosure is necessary and authorized.

Filing Directly With Regulators

For issues that require regulatory enforcement — not just advocacy — file directly with the Health Facilities Administration:

Licensed facilities (nursing homes, He-P 804 and He-P 805): Contact the HFA Health Facility Licensing Unit at 603-271-9039 or [email protected].

Federally certified nursing homes: Contact the HFA Certification Unit at 603-271-9049 or [email protected].

Home health providers: Call the Home Health Complaint Hotline at 1-800-621-6232.

Reporting Suspected Abuse or Neglect

If you suspect your parent is being abused, neglected, or financially exploited — whether by facility staff, another resident, or an outside caregiver — this goes beyond the ombudsman's scope. Contact the Bureau of Elderly and Adult Services adult protective services intake at 1-800-949-0470.

New Hampshire law mandates reporting of suspected abuse or neglect of vulnerable adults. You do not need proof — a reasonable suspicion is sufficient to trigger an investigation.

Discharge Rights in Detail

A nursing home cannot simply discharge a resident because they are difficult, because their Medicaid pays less than private rates, or because their family is vocal about care quality. Legal grounds for involuntary discharge are limited to:

• The resident's needs exceed what the facility can provide
• The resident's health has improved enough that facility care is no longer needed
• The safety of other residents is endangered
• The facility is closing
• The resident has failed to pay after reasonable notice

Even when grounds exist, the facility must provide written notice, allow time for appeal, and develop a safe discharge plan. The ombudsman monitors these transitions and can intervene if the facility cuts corners.

The New Hampshire Care Decision Guide covers resident rights, complaint procedures, and quality verification tools in detail — so families know their protections before a dispute arises.

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