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Friday, February 24, 2012

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 2010, there were 53 state LTC Ombudsman Programs operating in all 50 states, the District of Columbia, Guam, and Puerto Rico, and 578 local programs. Title VII programs received about $21.8 million in FY2011 and FY2012. Total FY2010 funding for ombudsman activities from all sources combined (federal and non-federal) was $87.7 million, the most recent year for which data on funding from all sources are available. Of that total, 58% ($50.9 million) represented funding from federal sources.

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 FY2010, ombudsmen reported just over 16,600 nursing facilities and about 52,700 other residential long-term care facilities operating nationwide. This translated to a nationwide ratio of one paid ombudsman for every 59 facilities and one paid ombudsman for every 2,500 resident beds. With respect to staffing, the program receives significant support from volunteers. In FY2010, almost 1,200 paid staff and just over 8,800 certified volunteers investigated about 212,000 resident complaints. Issues regarding residents’ care were the chief complaint in nursing homes, followed by residents’ rights issues in FY2010. Among residents in other long-term care facilities, the top complaint categories in FY2010 were quality of life and residents’ rights.

The OAA Amendments of 2006 (P.L. 109-365) authorized appropriations for the LTC Ombudsman Program through FY2011. Thus, the authorization of appropriations for the LTC Ombudsman program has expired. Congress has continued to appropriate funding for OAAauthorized activities for FY2012. The 112th Congress may choose to reauthorize the Act. In doing so, federal policymakers may consider amending or deleting existing authorities under the Act or establishing new authorities, including those under the LTC Ombudsman Program. In addition, Congress will likely consider annual appropriations for LTC Ombudsman Program activities, as well as appropriations for newly established authorities enacted under the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) that support the program.

This report describes the LTC Ombudsman Program, including the program’s legislative history, administrative function, and FY2010 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: February 15, 2012
Number of Pages: 14
Order Number: RS21297
Price: $29.95

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