State Ombudsman Programs and Long-Term Care: Overview

As a leader of a long-term care facility, one of your primary responsibilities is to support the health, safety, and welfare of your residents. Your state ombudsman is a valuable resource that can help you adhere to local policies surrounding quality of care delivery. But what exactly is a state ombudsman and what do they do?

This guide will summarize everything you need to know about working with a state ombudsman for nursing homes and other long-term care settings. We’ll provide an overview of what ombudsman programs are, why they were created, and how they relate to your facility’s operations.

What Is a Long-Term Care State Ombudsman?

An ombudsman is an individual who serves as an impartial party to investigate and settle complaints made by individuals against organizations. In the U.S., the federal government oversees a Long-Term Care (LTC) Ombudsman Program designed to protect the rights of residents in nursing homes, assisted living facilities, and other residential care centers.

While this is a federal program, each state administers their own LTC ombudsman services. The specific structure of state programs can vary, but LTC ombudsmen are typically trained to:

• Educate LTC residents and families on how to exercise their rights
• Investigate and resolve complaints made by residents or families against facilities
• Facilitate communication between residents and facilities
• Help facilities comply with local care regulations
• Monitor the quality of care delivered in LTC facilities
• Make recommendations for local policies affecting residents’ rights

Why Were State Ombudsman Programs Created?

In the 1960s, several publications came to light revealing how the abuse and neglect of residents was rampant across LTC facilities. Congress began compiling testimonies of individuals affected by poor LTC conditions. One report in particular highlighted two notable events that significantly increased public concern:

• An uncontrolled fire that spread inside a northern Ohio nursing home led to 32 resident deaths due to oxygen deprivation from smoke fumes.
• A salmonella food poisoning epidemic went undetected inside a Baltimore nursing home, leading to 25 resident deaths.

In response to these events, Congress made amendments to the Older Americans Act, paving the way for the Long-Term Care Ombudsman Program. The program was officially trialed across five states in 1972, training teams of ombudsmen to enforce health and safety standards across various LTC facilities.

After the success of the trials, the ombudsman program was eventually adopted in each state under the oversight of the Administration on Community Living. All states – as well as the District of Columbia, Puerto Rico and Guam – now have their own ombudsman office that oversees a process for recruiting, training, and deploying staff and volunteers who advocate for the rights of LTC residents.

How Does a State Ombudsman Work With Facilities?

While an LTC ombudsman primarily works to resolve complaints made against facilities, they’ll usually advise anyone who has concerns about the rights of residents, including facility leaders seeking regulatory guidance. So you can reach out to your local ombudsman at any time, even if your facility is not undergoing an investigation.

Here are a few examples of why you might want to reach out to an ombudsman.

• You’re seeking more information on visitation rights
• You want advice on how to improve quality of care for your residents
• You’re not sure what local regulations apply to your facility
• You’d like more resources on how to educate staff about upholding resident rights

Tips for Investigations

In the event that someone files a complaint and you’re subject to an investigation, remember that an ombudsman’s goal is to provide impartial resolution for both residents and facilities. By working collaboratively with your ombudsman, medical staff and patients alike can benefit from their guidance. Here are a few tips on how you can help an investigation go smoothly.

• Communicate: Providing all necessary information requested by the ombudsman will help them complete investigations as quickly as possible.

• Cooperate: While it may feel like an ombudsman is working against you during an investigation, they really want to work with you to help improve your facility. With this in mind, it’s important to remain cooperative and respectful throughout the process.

• Act: If an ombudsman finds an issue, act accordingly by following their recommendations to implement any necessary changes to your care delivery.

State-Specific Ombudsman Programs

If you’re actively seeking guidance, you may be wondering – who is my local ombudsman? Each state provides a list of contacts based on your area of residence. States will administer their ombudsman programs in a way that best suits the needs of their local residents. You can find more information about state-specific services in our tailored guides below.

Want More Resources to Improve Care for Your Residents?

Now that you know what a state ombudsman is, you may be looking for more ways to deliver higher quality care to your residents. Sign up for IntelyCare’s free newsletter to read more timely tips, guides, and strategies that will help you optimize your facility’s operations.