History and Responsibility

The Long-Term Care Ombudsman Program

History and Responsibilitiesunder the

Older Americans Act

Sara S. Hunt, ConsultantNational Long-Term Care Ombudsman Resource Center

May 2004

Long-Term Care Ombudsman Program

HistoryDevelopment

EvaluationConclusions

Job DescriptionRewards

History• Growth in Nursing Homes

– 1965 Medicare and Medicaid•Provided public money for care

• What Happened– Abuse– Neglect– Substandard care– Fires resulting in deaths

• Publicity About Poor Care and Owner Profits• Congressional Hearings 1970• Apparent that systems to protect individuals had failed• Improvements in quality of care needed


HistoryDevelopment



Development

• Ombudsman Program

– Idea developed by Dr. Arthur Flemming

– Influenced by Swedish model

– Proposed to President Nixon and included in his nursing home agenda in 1971

• Presidential directive — help states establish units to respond to complaints made by or on behalf of individual patients

• Nursing Home Ombudsman Demonstration Projects contracts granted in 1972


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Development—Initial Steps

• Projects had impressive record of complaint resolution

• In 1975 all states could seek funds for ombudsman activities

– Funding through the Administration on Aging (AoA)– To develop capabilities of Area Agencies on Aging for

ombudsman activities


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Development—Growth• 1978 All states were required to operate a Nursing

Home Ombudsman Program– Enacted in amendments to Older Americans Act

(OAA)– 1981 changed to Long-Term Care Ombudsman

Program due to expanded responsibilities


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Evaluation• Success of first Ombudsman Programs judged by

– Number of community programs

– Effectiveness in receiving and resolving complaints in

• An effective and

• A constructive manner.

AoA Commissioner Flemming

1976


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Conclusions

• The laws and regulations enacted will be of little avail unless

– “…communities are organized…to deal with the individual complaints of older persons living in nursing homes.

– The individual in the nursing home is powerless.”

AoA Commissioner Flemming

1976


HistoryDevelopment



Job Description

• The Ombudsman Program was created to represent individuals in long-term care facilities.

• Ombudsmen help individual residents benefit from relevant laws and regulations.


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Job Description

• Prevention

– Provide information to residents

– Promote development of citizen organizations

– Provide technical support for resident and family councils

– Recommend changes in laws, regs, and policies to benefit residents

– Provide access to ombudsman

– Assist residents in asserting rights

– Identify, investigate, and resolve complaints made by, or on behalf of, residents


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Job Description

• Intervention– Seek legal and other remedies to protect residents

– Analyze, comment on, and monitor laws, regs, and governmental policies on behalf of residents

– Facilitate public comment pertinent to residents


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Job Description-Summary

• On behalf of residents, ombudsmen are advocates for

Resolving Individual Complaints

Resolving Systems IssuesLaws, Regulations, Policies


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RewardsOmbudsman perspective on the job:

“The opportunity to speak up for someone who cannot do so for herself, to advocate for individuals or groups of people who otherwise might have no voice, no ‘seat at the table,’ keeps every day fresh and gives every meeting the potential to be important.”

Esther Houser, Oklahoma State LTCO


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RewardsOmbudsman perspective on the job:

“The greatest experiences I have had working as an ombudsman are

listening to people and treating them as a valued human being;

working with citizens to become volunteer ombudsmen, and facilitating

staff, residents, and families to communicate with each other.”

Vivian Omagbemi, Maryland Local LTCO


HistoryDevelopment



Rewards

Ombudsman Perspective on the job:

“The handshake and thank you from a family member after

a 2 hour care plan meeting…$500 That beautiful smile

lighting up the face of the resident that you just promised

to come back and chat with again real soon…$50,000

Filling out monthly reports and progress notes…$5


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Rewards

The look on the administrator’s face when you tell her

that you personally have observed the facility in making

a mistake that she considered nothing more than

complaining by family member whose expectations were

too high…Priceless


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Rewards

Ah, the power of…an ombudsman!”

Carol Schmidt, Maryland LTCO Volunteer


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Thanks to the

Administration on Aging for their

support in the development and

distribution of this presentation


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The National Long-Term Care Ombudsman Resource

Center thanks all ombudsmen who work so diligently

on behalf of long-term care residents.

History and Responsibility

Documents

ombudsman programs

ombudsman activitiesfunding

poor care

longterm care facilities

nursing home agenda

nursing homes1965 medicare

individual residents

relevant laws