The committee was charged to assess the effectiveness of the LTC ombudsman programs in the areas set forth in Section 211 of the 1992 OAA amendments. Also, the committee was charged to identify and, when appropriate, make recommendations on public policy strategies by which the program can better achieve its objectives. The committee’s deliberations address the following:

  • the availability of, access to, unmet need for, and effectiveness of the ombudsman program for residents of LTC facilities (including B&C facilities and other similar adult care facilities);

  • the adequacy of federal and other resources available to operate the programs throughout the United States;

  • the extent of compliance and an analysis of factors that enhance or impede compliance with the program’s mandates and standards;

  • the presence of any actual and potential conflicts of interest in the administration and operation of the programs; and

  • the need for and feasibility of providing ombudsman services to older individuals who do not reside in LTC facilities but are users of health and LTC services, such as home health care. This analysis is to draw from existing state ombudsman programs that serve elderly individuals who reside in settings other than LTC facilities.

To inform itself on issues pertaining to this charge, the committee engaged in several factfinding activities. Information was gathered from site visits; commissioned papers; structured, systematic contacts with directors of state units on aging, state and local LTC ombudsmen, LTC physicians, and grassroots advocacy groups; a one-day invitational symposium; a public hearing; two “open-mike” sessions at national professional conferences; discussions with four national associations of LTC facility providers; and a technical panel that was convened twice and called upon as needed throughout the course of the study. (For more detail on the committee’s activities, see Appendix C.)


This report addresses the issues raised by the congressional mandate and its charge. The committee offers findings and recommendations where it concluded that current strengths of the state LTC ombudsman program could be built upon or present deficiencies warranted explicit correction. Before moving into questions related to policy, the report describes in Chapter 2 the current status of the ombudsman program. Chapter 3 then discusses the question of whether the program complies with current mandated activities and

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