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 • Growth in Nursing Homes History Development
Evaluation Conclusions Job Description Rewards
– 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
Long-Term Care Ombudsman Program
Development •
Ombudsman Program
History
–
Idea developed by Dr. Arthur Flemming
Development
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Influenced by Swedish model
Evaluation
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Proposed to President Nixon and included in his nursing home agenda in 1971
Conclusions Job Description
•
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
Rewards
Long-Term Care Ombudsman Program
Development—Initial Steps • History Development
Evaluation Conclusions Job Description Rewards
Long-Term Care Ombudsman Program
•
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 • History Development
Evaluation Conclusions Job Description Rewards
Long-Term Care Ombudsman Program
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 • Success of first Ombudsman Programs judged by History Development
Evaluation Conclusions Job Description Rewards
– Number of community programs – Effectiveness in receiving and resolving complaints in • An effective and • A constructive manner. AoA Commissioner Flemming 1976
Long-Term Care Ombudsman Program
Conclusions History Development
Evaluation Conclusions Job Description
• 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.”
Rewards AoA Commissioner Flemming 1976
Long-Term Care Ombudsman Program
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.
History Development
Evaluation Conclusions Job Description Rewards
Long-Term Care Ombudsman Program
Job Description • Prevention History Development
Evaluation Conclusions Job Description Rewards
– 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
Long-Term Care Ombudsman Program
– Identify, investigate, and resolve complaints made by, or on behalf of, residents
Job Description • Intervention History Development
Evaluation
– Seek legal and other remedies to protect residents – Analyze, comment on, and monitor laws, regs, and governmental policies on behalf of residents
Conclusions Job Description Rewards
Long-Term Care Ombudsman Program
– Facilitate public comment pertinent to residents
Job Description-Summary • On behalf of residents, ombudsmen are advocates for History Development
Resolving Individual Complaints
Evaluation Conclusions Job Description Rewards
Long-Term Care Ombudsman Program
Resolving Systems Issues Laws, Regulations, Policies
Rewards Ombudsman perspective on the job: History Development
Evaluation Conclusions Job Description Rewards
“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
Long-Term Care Ombudsman Program
Rewards Ombudsman perspective on the job: History Development
Evaluation Conclusions Job Description
“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.�
Rewards
Vivian Omagbemi, Maryland Local LTCO
Long-Term Care Ombudsman Program
Rewards Ombudsman Perspective on the job: History Development
Evaluation Conclusions Job Description Rewards
“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 Long-Term Care Ombudsman Program
Rewards The look on the administrator’s face when you tell her History Development
Evaluation Conclusions Job Description Rewards
Long-Term Care Ombudsman Program
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 high‌Priceless
Rewards History Development
Ah, the power of… an ombudsman!”
Evaluation Conclusions Job Description Rewards
Long-Term Care Ombudsman Program
Carol Schmidt, Maryland LTCO Volunteer
Thanks to the History Development
Evaluation Conclusions Job Description Rewards
Long-Term Care Ombudsman Program
Administration on Aging for their
support in the development and distribution of this presentation
The National Long-Term Care Ombudsman Resource History Development
Evaluation
Center thanks all ombudsmen who work so diligently on behalf of long-term care residents.
Conclusions Job Description Rewards
Long-Term Care Ombudsman Program