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What Is the Long-Term Care Ombudsman Program?

The Long-Term Care Ombudsman Program is an umbrella term for federally-funded, state-run programs created by an amendment to the Older Americans Act. Each state has a long-term care ombudsman agency tasked with investigating and resolving complaints by residents of nursing facilities, board and care facilities, and other adult care homes. Ombudsmen also serve as advocates for adult care residents before government agencies and aging and health organizations.

The Purpose of the Long-Term Care Ombudsman Program

In 1972, the federal government funded demonstration ombudsman programs in five states. In 1978, the federal government required all states to implement ombudsman programs, with defined functions and responsibilities including:

  • Identifying, investigating, and resolving complaints made by adult care residents against long-term care providers and public agencies
  • Informing residents of their rights and how to seek help
  • Representing the interests of residents before government agencies and other organizations
  • Seeking administrative, legal, and other remedies to protect residents’ health, safety, welfare, and rights
  • Monitoring and analyzing laws, regulations, and other government policies that affect the health, safety, welfare, and rights of adult care residents
  • Gaining access to long-term care facilities and residents' records, and maintaining the confidentiality of those records

Ombudsman Investigations

According to the Administration on Aging, an agency of the U.S. Department of Health and Human Services, ombudsmen investigated over 190,000 complaints by adult care residents in 2013. Of these, 73% were resolved to the complainant's satisfaction. Ombudsman program staff or volunteers visited 70% of all nursing homes and 29% of all board and care facilities in the U.S.

The most common resident complaints involved wrongful eviction, unanswered requests for assistance, lack of respect shown to residents, poor quality of life in a care facility, and issues with medication.

Ombudsmen as Advocates

The Older Americans Act specifically requires long-term care ombudsmen to act as advocates for adult care residents. Common forms of advocacy include:

  • Procedural advocacy - State ombudsman programs coordinate with each other and with other government agencies in order to better respond to residents' needs.
  • Issue Advocacy - Ombudsman programs identify trends in residents' complaints in order to notify government agencies, care facilities, and the public of these trending concerns.
  • Legislative advocacy - Ombudsmen analyze and comment on local, state, and federal laws and regulations on behalf of adult care residents.

Ombudsmen Independence and Controversies

A key aspect of long-term care ombudsman programs is their independence and ability to act on behalf of adult care residents without interference. Typically, ombudsman programs are housed within a state's Department of Aging. According to a 2007 report by the National Association of State Long-Term Care Ombudsman Programs, 42% of responding ombudsmen were discouraged by their state's department of aging from acting as advocates for adult care residents. In the past few years, there have been a number of controversies concerning the independence of ombudsman programs.

In 2011, Florida's governor allegedly forced the resignation of the state's long-term care ombudsman, due to a contentious relationship between the two. This led to a state Senate hearing as well as a federal Administration on Aging investigation.

In 2012, California passed a law strengthening the independence of the state's ombudsmen, after they complained of an inability to take views that clashed with those of the governor or other state officials. Among other requirements, this law requires California's ombudsman program to develop an annual advocacy report, reestablish an inactive advocacy council, and maintain an updated website for adult care residents.

Getting Help

To find contact information for your state's ombudsman program, start here. In addition, there should also be signs posted at adult care facilities providing the contact information for the state ombudsman. If you have questions regarding your rights under the Older Americans Act, you should consult with an elder law attorney.

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