Search Penny Hill Press

Wednesday, January 5, 2011

Older Americans Act: Long-Term Care Ombudsman Program

Kirsten J. Colello
Specialist in Health and Aging Policy

Quality of care in long-term care settings has been, and continues to be, a concern for federal policymakers. The Long-Term Care (LTC) Ombudsman Program is a consumer advocacy program that aims to improve the quality of care, as well as the quality of life, for residents in long-term care settings by investigating and resolving complaints made by, or on behalf of, such residents. Established under Title VII of the Older Americans Act (OAA), the Administration on Aging (AoA) within the Department of Health and Human Services (HHS) administers the nationwide program. As of 2008, there were 53 state LTC Ombudsman Programs operating in all 50 states, the District of Columbia, Guam, and Puerto Rico, and 572 local programs. Total FY2008 funding for ombudsman activities from all sources combined (federal and non-federal) was $86.4 million. Of that total, more than half ($49.9 million) represented funding from federal sources. The OAA Amendments of 2006 (P.L. 109-365) reauthorized the ombudsman program for five years through FY2011.

Due to the requirement that ombudsmen investigate and resolve complaints of all residents in residential long-term care facilities, the workload of staff and volunteers is substantial. In FY2008, ombudsmen reported just over 16,700 nursing facilities and more than 50,000 other residential long-term care facilities operating nationwide. This translated to a nationwide ratio of one paid ombudsman for every 51 facilities and one paid ombudsman for every 2,200 resident beds. With respect to staffing, the program receives significant support from volunteers. In FY2008, over 1,300 paid staff and 8,700 certified volunteers investigated just under 272,000 resident complaints. Issues regarding residents’ care were the chief complaint in nursing homes, followed by residents’ rights issues in FY2008. Among residents in other long-term care facilities, the top complaint categories were quality of life and residents’ rights.

Legislation enacted in the 111
th Congress provides some additional support to state LTC Ombudsman Programs. The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148, as amended) includes, among its many provisions, programs to prevent elder abuse, neglect, and exploitation. Included in these “elder justice” activities are two types of grant programs that directly assist state LTC Ombudsman Programs. The first aims to improve the capacity of ombudsman programs while the second addresses ombudsman training with respect to elder abuse. Both authorize appropriations to fund these initiatives.

This report describes the LTC Ombudsman Program, including the program’s legislative history, administrative function, and FY2008 funding amounts by source. It also identifies selected issues for federal policymakers, including staffing and resources; in-home care ombudsman; and specialized ombudsman training.

Date of Report: December 20, 2010
Number of Pages: 14
Order Number: RS21297
Price: $29.95

Follow us on TWITTER at or #CRSreports

Document available via e-mail as a pdf file or in paper form.
To order, e-mail
Penny Hill Press  or call us at 301-253-0881. Provide a Visa, MasterCard, American Express, or Discover card number, expiration date, and name on the card. Indicate whether you want e-mail or postal delivery. Phone orders are preferred and receive priority processing.