Module 1 - History and Role of the Long-Term Care Ombudsman Program

Overview

This module provides basic information about the purpose, history and unique aspects of the Long-Term Care Ombudsman Program.

Learning Objectives: At the conclusion of this module individuals will know:

  • Why the Long-term Care Ombudsman Program (LTCOP) was developed;
  • The primary responsibilities of the long-term care ombudsman (LTCO); and
  • The unique aspects of the LTCOP.

Duration: 2 hours

If you are having trouble viewing the module, click here for some technical tips.

SECTION 1: How the Long-term Care Ombudsman Program Began

This section discusses the precipitating events, genesis and formative intent and structure of the Long-Term Care Ombudsman Program. The program's rich history has guided its implementation on the national level and within each state. To fully understand the program and to be effective as long-term care ombudsmen, a knowledge of the program's history, legal basis and development is essential.

Click the full screen button on the window below to read about how the long-term care ombudsman program began.

Video: Advocate For Resident's Rights

Watch the following video and use your own words to briefly describe what you learned regarding the following points:

1. The Role of the Long-Term Care Ombudsman (LTCO)

2. The Purpose of the Long-Term Care Ombudsman Program (LTCOP)

3. Five skills ombudsman need

4. Characteristics of the LTCO

To start the video, click on the white play button in the middle. This video is 16 minutes long. You can stop and start it at your own pace.

Here is a brief guide to the frequently used acronyms in the training material:

AoA - Administration on Aging

ACL - Administration for Community Living

CMS – Centers for Medicare & Medicaid Services

LTCC– Long-Term Care

LTCO – Long-Term Care Ombudsman

LTCOP – Long-Term Care Ombudsman Program

NCCNHR – National Citizens Coalition for Nursing Home Reform (now the National Consumer Voice for Quality Long-Term Care, or the “Consumer Voice”).

NORC – National Ombudsman Resource Center

OAA - Older Americans Act

Regs – Regulations

SLTCO – State Long-Term Care Ombudsman

SLTCOP – State Long-Term Care Ombudsman Program

SECTION 2: The LTCOP Under the Older Americans Act

This section details the responsibilities, structure and approach of the LTCOP under the Older Americans Act, as well as the status of the current LTCOP.

Click the full screen button on the window below to read more.


Video: Listen to what ombudsmen and residents say about the work of the Ombudsman Program in the following video:

Review the history and roles of the Ombudsman Program by clicking through the PowerPoint presentation below:

History and Responsibilities Under the Older Americans Act (PPT)

SECTION 3: Unique Aspects of the LTCOP

This section details the aspects of the LTCOP that set it apart from other programs and from other employee roles in the long-term care system. Because these aspects are frequently sources of misunderstanding and tension when long-term care ombudsmen interact with others, it is imperative to have a clear understanding of the LTCO role based on the Older Americans Act.

Click the full screen button on the window below to read more.


Video: Listen to Ombudsman program representative and residents talk about the Ombudsman Program in the following video:

Review the unique characteristics of the Ombudsman program by clicking through the Power Point presentation below:

Unique Characteristics (PPT)

SECTION 4: Accountability

This section describes the ways in which long-term care ombudsman programs have been evaluated and held accountable to its Older Americans Act responsibilities.

Click on the download button on the window below to learn more.


Review the code of ethics of the Ombudsman Program by clicking through the PowerPoint presentation below:

Code of Ethics (PPT)

Click on the full screen button on the window below to learn more.

SECTION 5: Long-Term Care Ombudsman Program Associations

There are two national membership associations for LTCO. Several states also have statewide associations of local LTCOPs.

  • The National Association of State Long-Term Care Ombudsman Programs was organized in 1985 and is a not-for-profit association. Its members are SLTCO. Its mission statement says, “NASOP is dedicated to improving the quality of life and quality of care of long-term care consumers through strong, effective state ombudsman programs.”
  • The National Association of Local Long-Term Care Ombudsmen (NALLTCO) adopted By-Laws in 1996 following many years of informal meetings. Its membership consists of local LTCO. Its purpose is:

“To organize and provide a common voice for local long-term care ombudsmen for the advancement of their mutual objective of providing for their professional development, insuring the integrity of local programs and their ability to effectively advocate for long-term care residents; the exchange and sharing of information, opportunities and resources available through the Administration on Aging as well as other organizations; the mutual sharing of information, ideas and experiences among local ombudsmen’s staff; and providing information to policy makers on legislation and regulations impacting local ombudsman program and long- term care residents.”

SECTION 6: National Long-Term Care Ombudsman Resource Center

The National Long-Term Care Ombudsman Resource Center provides support, technical assistance and training to the 53 State Long-Term Care Ombudsman Programs and their statewide networks of over 500 regional (local) programs. The Center’s objectives are to enhance the skills, knowledge and management capacity of the State programs to enable them to handle residents’ complaints and represent resident interests (individual and systemic advocacy). Funded by the AoA, the Center is operated by the National Citizens’ Coalition for Nursing Home Reform (NCCNHR), in cooperation with the National Association of State Units on Aging (NASUA). Many of the resources developed by the Center and by LTCOPs are available via the Internet at www.ltcombudsman.org.

SECTION 7: Why Ombudsmen Stay with the Program

In spite of the broad scope of ombudsman responsibilities and the continual struggle for adequate resources, many LTCO remain committed to serving residents. They stay on the job in the face of on-going challenges and few monetary rewards. In the section below some LTCO shared their reasons for sticking with the program.


  • “I had spent several years working with and for nursing homes. Over time I became demoralized by my inability to make the lasting systemic changes I thought were necessary for even just adequate resident care. I felt I couldn’t stay in the field if there was virtually no hope of making things better. It wasn’t until I worked with the Ombudsman Program and NCCNHR that I felt hope return - there IS a place where I can contribute to making care not only adequate but exemplary; and there are actually people who feel the same way..”

-Mary Edwards, Local Long-Term Care Ombudsman, Maryland


  • “I have stayed in the LTCO job for 20 years because of the satisfaction of helping someone who is generally powerless to prevail against the ‘system;’ the joy of meeting and coming to know very interesting people; the challenge of working out complex problems and then building a repertoire of solutions to use again and again. There is a deep satisfaction in becoming ‘expert’ in an area where so much help is needed. Folks really don’t know where to turn and there is so much personal satisfaction in being able to help in a very concrete, useful manner.”

-Kathy Gannoe, District Long-Term Care Ombudsman, Kentucky


  • “All I could think of was that TV commercial: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 sit and chat with again real soon.....$50,000; Filling out monthly reports and documenting [LTCO] progress notes.....$5; The look on the Administrator’s face when you tell her that you personally have ‘caught’ [observed] the facility in a mistake being made that she previously considered nothing more than complaining by an overly involved family whose expectations were too high.....Priceless. Ah, the power of.....an ombudsman!”

-Carol Schmidt, Local Long-Term Care Ombudsman, Maryland