FY25 Long-term Care Ombudsman Satisfaction Survey

1.Facility name:
2.What is your admittance status?
3.Who do you contact when you have a problem with your care in the facility? Check all that apply.
4.How did you hear about the Ombudsman program?
5.Do you understand your resident's rights?
6.How did you learn about resident's rights?
7.Do you understand what the Ombudsman Program does?
8.Do you want to know more about the Ombudsman Program?
9.Do you know how to contact the Ombudsman?
10.Have you ever asked the Ombudsman for help?
11.Below are a few statements that describe how you feel about the Ombudsman services. For each statement, please check the box of response that best describes the statement that applies to you. Skip this question if you have never received assistance from the Ombudsman.
Strongly agree
Agree
Disagree
Strongly disagree
I am satisfied with the way the Ombudsman handled my problem
My problem was resolved to my satisfaction
I am satisfied with the time it took to handle my problem
I had sufficient contact with the Ombudsman while my problem was being resolved
My problem has not reoccurred
I would recommend the Ombudsman program to other residents who need help
12.If you were dissatisfied with the outcome of your complaint, please explain why.
Current Progress,
0 of 12 answered