Nursing Facilities
Ombudsman Notification Log
Please utilize the Ombudsman Notification Log in Word or Excel. The log should be emailed to the Local Ombudsman monthly with the subject line: Facility Name—Ombudsman Log month/year.
Ex: Sunny Meadows Nursing Home—Ombudsman Log April 2026
Ombudsman Notification Log (Word)
Ombudsman Notification Log (Excel)
Ombudsman Notification Log Sample
Quick Reference Guide
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Additional Information
Does a written discharge notice need to be issued to individuals who are being discharged from skilled rehab?
Yes, a facility’s requirement to notify and explain via the SNF ABN that the individual is no longer receiving Medicare Part A services based on the SNF’s belief that Medicare Part A will not pay for the resident’s stay, is separate and unrelated to the admission and discharge requirements under 42 CFR §483.15.
Does the Ombudsman Program need to receive notification when a resident expires?
No, it is not a requirement for the Ombudsman Program to be notified of residents who expire. However, if a resident died at an acute care facility in an emergency or scheduled transfer, that would information be listed on the Ombudsman Notification Log.
Do copies of notices for residents listed on the Ombudsman Notification Log need to be sent individually?
No, it is not necessary to send individual notices for residents that are listed on the Ombudsman Notification Log. If a copy of the notice is needed, the Local Ombudsman will reach out to the facility to obtain the notice.
Local Ombudsman: Ombudsman assigned to the facility
State Ombudsman: Manager of the State Long-Term Care Ombudsman Program
Transfer: Resident is temporarily sent to another certified facility, but return to original facility is expected.
Discharge: Movement of a resident to another certified facility or location to the community and returning to the original facility is not expected.
Emergency Transfer: Resident was transferred on an emergency basis to an acute care facility (e.g. hospital) and return was expected.
Scheduled Transfer: Resident was transferred temporarily for a scheduled procedure and was out of the facility for more than 24 hours.
Scheduled Discharge (Skilled Rehab only): Resident has communicated that they are ready to leave the facility after completing a short-term, skilled rehabilitation program.
Discharge (including voluntary & emergency): Resident is being discharged due to a reason listed in §483.15(c).
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If the facility discharges while the resident is hospitalized, the facility must follow all discharge requirements listed in §483.15(c).
- While it is required to list Disability Rights Louisiana (previously the Advocacy Center) on the notice as the Protection and Advocacy Agency for residents under §483.15(c)(5)(vi) & (vii), sending a copy is unnecessary and breaches resident confidentiality.
If the facility discharges while the resident is hospitalized, the facility must follow all discharge requirements listed in §483.15(c).