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Resident Satisfaction Survey

Please complete this survey to share your experiences about the Long-Term Care (LTC) Ombudsman program. The survey should only take 5 – 10 minutes to complete and is designed to assess the resident’s experience with the LTC Ombudsman program, to gather feedback about the program and to identify areas or ways that the LTC Ombudsman program can improve on its services. The survey is intended to be completed by residents in long-term care or their representatives.
Part A - Interaction with the Long-Term Care Ombudsman
1.Please select your role in filling out this survey
2.Please select the region in Alaska where your long-term care facility is located
3.How did you hear about the Long-Term Care Ombudsman Program?
4.How would you rate the responsiveness of the Long-Term Care Ombudsman?
5.Was the Ombudsman courteous and helpful?
6.Did the Ombudsman treat you with dignity and respect?
7.Did the Ombudsman clearly explain their role and what they could help with?
8.Since meeting with your Ombudsman, do you have a better understanding of your rights living in your long-term care facility?
9.Since meeting your Ombudsman, do you feel more comfortable advocating for yourself and addressing concerns?
Part B - Did the Ombudsman help you address your concerns? If yes, please complete the following questions.
10.Was your concern addressed in a reasonable amount of time (72 hours)?
11.Did the Ombudsman obtain your permission to address your concerns?
12.Do you feel the Ombudsman listened to your concern and included you to help resolve the issue?
13.If your concern required a referral to another service provider or agency, did the Ombudsman direct you to those services?
14.Were you satisfied with the resolution of your complaint?
15.Did you feel you could raise your concern without fear of retaliation?
16.Did you feel your privacy and confidentiality were respected?
17.Overall, how would you rate the quality of service for the Ombudsman program?
18.Would you recommend the Long-Term Care Ombudsman services to other residents who may have a concern?
19.Would you contact our program again if you need help with addressing a concern?
20.Do you know how to contact the Ombudsman if you need help in the future?
21.What would you like the for the Ombudsman program to know; or what can we do to improve our services?