Policies and Procedures
Training
- Person-Centered Care – Video Series Teaching Guide (PDF)
- State Long-Term Care Ombudsman Initial Certification Training Manual (PDF)
For Staff Ombudsmen Only
- FFY25 Ombudsman Minimum Expenditure Requirement (PDF)
- Ombudsman Program SharePoint (Staff Ombudsmen Only)
Program Forms
Instructions for Opening a Form
Some forms cannot be viewed in a web browser's PDF viewer and must be opened in the Adobe Reader application on your desktop system. Read instructions on opening these forms.
- Form 8602 – Code of Ethics (PDF)*
- Form 8607 – Individual Conflict of Interest Screening for a Representative of the Office (PDF)*
- From 8609 – Long-Term Care Ombudsman Complaint for Regulatory Services Investigation (PDF)
- Form 8610 – Certified Ombudsman II Recommendation (PDF)
- Form 8613 – Conflict of Interest Identification, Removal and Remedy (PDF)
- Form 8614 – Grievance Regarding Ombudsman Certification Decision (PDF)
- Form 8618 – Initial Certification Training Log (PDF)
- Form 8619 – Case Record (PDF)
- Form 8620 – Long-term Care Ombudsman Activity Report (PDF)
- Form 8621 – Staff and Volunteer Application to Enter Certification Training (PDF)* Or, have applicant apply using this link: Apply now.
- Form 8622 – Consent for Criminal History Check (PDF)*
- Form 8623 – Certified Ombudsman Application (PDF)
- Form 8624-O – Consent to Release Records (DOC)
- Form 8624-W – Consent to Release Records (DOC)
- Form 8625-D – Designation of a Long-term Care Ombudsman as Representative and Request to Appeal a Nursing Facility Discharge (PDF)
- Form 8625-M – Designation of a Long-Term Care Ombudsman as Representative and Request to Appeal a Medicaid Decision (PDF)
- Form 8628 – Acknowledgement of Ombudsman Access to Confidential Record (PDF)
An * after a form name indicates the form is part of a volunteer applicant’s initial application paperwork.