Published on October 3, 2007
The Long-Term Care Ombudsman Program: The Long-Term Care Ombudsman Program History and Responsibilities under the Older Americans Act Sara S. Hunt, Consultant National Long-Term Care Ombudsman Resource Center May 2004 History: 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 Development: 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 Development—Initial Steps: 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 Development—Growth: 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 Evaluation: 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 Conclusions: 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 Job Description: 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. Job Description: 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 Job Description: 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 Job Description-Summary: Job Description-Summary On behalf of residents, ombudsmen are advocates for Resolving Individual Complaints Resolving Systems Issues Laws, Regulations, Policies Rewards: Rewards Ombudsman 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 Rewards: Rewards Ombudsman 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 Rewards: 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 Rewards: 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 Rewards: Rewards Ah, the power of… an ombudsman!” Carol Schmidt, Maryland LTCO Volunteer Slide17: Thanks to the Administration on Aging for their support in the development and distribution of this presentation Slide18: The National Long-Term Care Ombudsman Resource Center thanks all ombudsmen who work so diligently on behalf of long-term care residents.