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Enhancing the Performance of Local Long-Term Care Ombudsman Programs: A Toolkit

This toolkit is designed to help state and local Long-Term Care Ombudsman Programs improve their performance as advocates for residents of nursing homes and other long-term care facilities. It describes best practices for 10 key issues for ombudsman programs.

The Issue: Under the 1978 Older Americans Act, every state must have a Long-Term Care Ombudsman Program (LTCOP). These programs are charged with protecting and representing the interests of nursing home residents. Administered by the Administration on Aging, each state's LTCOP operates at the local or community level with a mixture of volunteers and paid staff. Under the leadership of the state long-term care ombudsman, state-level programs set policy. Local programs send ombudsmen—mainly trained volunteers—to nursing homes and other long-term care facilities to help residents and their families resolve problems. There is considerable variation in the performance of local LTCOPs.

Organization: University of California, San Francisco, Institute for Health and Aging; National Long-Term Care Resource Center

Target Audience: Long-term care ombudsmen (and other interested parties, such as nursing home residents and administrators, consumer advocacy organizations, researchers, and policymakers)

The Intervention: This two-year project sought to identify factors affecting the performance of the local ombudsman programs and develop interventions to improve their effectiveness. Focusing on local programs in California and New York, the researchers interviewed ombudsmen and state officials and examined data from the National Ombudsman Reporting System. They then worked with policymakers and ombudsmen from across the country to develop a best-practices toolkit.

The toolkit describes best practices for the following 10 key issues, which will help ombudsman address the needs and desires of people in nursing homes and other long-term care settings:

  • adequacy of resources
  • board and care advocacy
  • cultural competency
  • elder abuse
  • end-of-life care
  • legal support
  • rehabilitative, convalescent, and post-acute care
  • systems advocacy
  • training
  • volunteers

Examples of successful practices met several criteria; for example, the practice could be replicated by other programs or was a unique approach to a particular issue. The best practices were developed by 34 ombudsmen programs in 19 states. To encourage the exchange of ideas, the toolkit includes contact information for leaders from each of the local ombudsmen programs, as well as organizations that can provide advice and help.

Other resources available on the National Long-Term Care Ombudsman Resource Center Web site include:

  • A chartbook: A comprehensive guide to improving ombudsmen programs, intended for practitioners as well as policymakers and researchers. It includes findings from the research project and recommendations for improving program performance.
  • Briefing papers: Summaries of research and concerns related to key topics in nursing home quality.
  • A post-acute care training module: Advice on serving and advocating for these residents, including a screening tool for determining when Medicare coverage should be available for skilled nursing facility care.

December 2006

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