- Government Reports
- Federal Laws & Regulations
- State Laws & Regulations
- Research About the LTCOP
- Resources & Reference Documents
- Compliance Review of the State of Florida Long-Term Care Ombudsman Program, Administration on Aging (September 2011)
- Poorly Performing Nursing Homes: Special Focus Facilities Are Often Improving, but CMS’s Program Could Be Strengthened, U.S. Government Office of Accountability (March 2010)
- OIG Report: Gaps Continue to Exist in Nursing Home Emergency Preparedness and Response During Disasters: 2007–2010
Federal regulations require that Medicare- and Medicaid-certified nursing homes have written emergency plans and provide employees with emergency preparedness training. In a 2006 report about nursing homes that experienced hurricanes, the OIG found emergency plans lacked many provisions recommended by experts. In response, the Centers for Medicare & Medicaid Services (CMS) issued guidance checklists for emergency planning of health care facilities, long-term care (LTC) ombudsman programs, and State survey agencies (SA). The OIG conducted the above study to assess emergency preparedness and response of nursing homes that experienced more recent disasters.
- Final Rule: 45 CFR Parts 1321 and 1327 State Long-Term Care Ombudsman Programs (February 2015)
Since 1992, the functions of the State Long-Term Ombudsman program have been delineated in the Older Americans Act; however, regulations have not been promulgated. In the absence of regulatory guidance, there has been significant variation in the interpretation and implementation of the program among States. Recent inquiries from States and an AoA compliance review in one State have highlighted the difficulty of determining State compliance in carrying out the Long-Term Care Ombudsman program functions. This rule provides the first regulatory guidance for States' Long-Term Care Ombudsman programs to provide clarity about implementation. This the final rule will not be effective until July 1, 2016, in order to give states time to make changes.
- Proposed Rule: State Long-Term Care Ombudsman Program (June 18, 2013)
The Administration on Aging (AoA) of the Administration for Community Living (ACL) within the Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking, with request for comments, to implement provisions of the Older Americans Act, mainly the State Long-Term Care Ombudsman program. This proposed rule replaces AoA's 1994 Notice of Proposed Rulemaking.
- State Long-Term Care Ombudsman Programs NPRM: Consumer Voice Briefing (July 2013)
This presentation by Becky Kurtz, Director, Office of LTCO Programs with AoA of ACL, gives an overview of the proposed rule, as well as information on how and where to submit comments on the rule by the August 19, 2013 deadline.
- Older Americans Act Reauthorization Act (S.192) - January 2015
- Older Americans Act (Title VII, Chapter 2, Sections 711/712)
- Nursing Home Reform Law of 1987
- Medicaid Provisions
- Medicare Provisions
- State Operations Manual: Chapter 7 - Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities
- State Operations Manual, Appendix P, Survey Protocol for LTC Facilities (Part I)
- State Operations Manual, Appendix PP, Guidance to Surveyors for LTC Facilities
- References to Ombudsmen in Federal Nursing Home Law and Regulations
- Home and Community Based Services Final Regulations
The final Home and Community-Based Services regulations set forth new requirements for several Medicaid authorities under which states may provide home and community-based long-term services and supports. See the below for additional resources from CMS and the National Senior Citizens Law Center:
- Informational Bulletin - Final regulations for HCBS provided under Medicaid’s 1915(c), 1915(i) and 1915(k) authorities
- Press Release - Final regulations for HCBS provided under Medicaid’s 1915(c), 1915(i) and 1915(k) authorities
- Fact Sheets Regarding Final Regulation CMS-2249-F/CMS-2296-F
- State Transition Plans for New Medicaid HCBS Regulations: Four Tips for Consumer Advocates
- AoA Program Instructions, Information Memoranda and Other AoA Issuance
- August 10, 2011 AoA Memorandum re: Clarification on the Definition of "Facility Coverage" for NORS Reporting
- CMS Guidance
- Survey and Certification Emergency Preparedness Initiative: S&C Emergency Preparedness Checklist Revision (February 2014)
- Installation of Automatic Sprinkler Systems in Nursing Homes - August 13, 2013 Deadline (REVISED December 2013)
- CMS Letter on Use of Civil Monetary Penalty (CMP) Funds by State (December 2011)
- Use of Civil Money Penalty (CMP) Funds by States (September 2011)
- Nursing Home Regulations Plus
An online compilation of state and federal nursing home regulations. Nursing Home Regulations Plus also contains a comparative analysis of numerous topics dealing with nursing home regulations.
- LTCOP Enabling Statutes and Regulations by State
- LTCOP: A Summary of State Enabling Statutes Paper (2002)
- Webinar: Evaluation Study Design for Long-Term Care Ombudsman Programs under the Older Americans Act: Research Design Options (July 2013)
This webinar discussed the new Evaluation Study Design for Long-Term Care Ombudsman Programs under the Older Americans Act: Research Design Options, developed by NORC at the University of Chicago and funded by the Administration for Community Living/Administration on Aging. Click here to read the full report. The researchers from NORC Chicago gave an overview of the new evaluation tool, and participants were given an opportunity for questions and discussion. Representatives from the Administration on Aging at the Administration for Community Living also gave a quick update on next steps for the evaluation tool.
- Long-Term Care Ombudsman Program Strategy Session (December 2011)
Prepared by the National Ombudsman Resource Center
- State LTC Ombudsman Program: A Primer For State Unit Directors and Executive Staff (2011), Prepared by the National Association of State Unit Directors of Aging and Disabilities
- The Role of Ombudsmen in Assuring Quality for Residents of Long-Term Care Facilities:Straining to Make Ends Meet (National Health Policy Forum, December 2009)
- Real People, Real Problems: An Evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act (Institute of Medicine (IoM), 1995)
- Study of the State LTCOP (2001), by Carroll Estes et al, Institute for Aging and Health, University of California, San Francisco - follow up to the IoM study
- Enhancing Effectiveness of Local LTCOPs (Carroll Estes, et al)
- Systems Advocacy and the Local Long-Term Care Ombudsman Program (2008, Brooke Hollister, PhD)
- The LTCOP: Rethinking and Retooling for the Future (2003 - The Bader Report)
- State Ombudsman Data: Nursing Home Complaints (1999)
- Long-Term Care Ombudsman Program: Bibliography of Published Articles, Developed by Wayne Nelson, PhD, Professor, Department of Health Science, Towson University
- LTCOP: Overall Capacity (1999)
- State Ombudsman Data - Nursing Home Complaints (2003)
- National Spending for Long Term Services and Supports (LTSS) (Carol O'Shaughnessy 2011)
Long-term services and supports (LTSS) for the elderly and younger populations with disabilities are a significant component of national health care spending. In 2011, spending for these services was $210.9 billion (9.3 percent of all U.S. personal health care spending), almost two-thirds paid by the federal-state Medicaid program. This publication presents data on LTSS spending by major public and private sources.
- Piecing Together Quality Long-Term Care - A Consumer's Guide to Choices and Advocacy
This guide from the National Consumer Voice for Quality Long-Term Care (the Consumer Voice) and accompanying fact sheets are designed for advocates and consumers who are currently receiving or who may in the future receive long-term services and supports in the community. The purpose of these materials is to inform advocates and consumers about options for long-term services and supports, and to empower consumers - through education - to effectively advocate on their own behalf.
- Administration on Aging's Annual Report to Congress (FY 2011) - The section related to the LTCOP begins on page 41.
- Medicaid and Long-Term Care (Bradley Gellar 2011)
- Administration on Aging's Annual Report to Congress (FY 2009) - The section related to the Long-Term Care Ombudsman Program begins on page 36.
- Fact Sheet: Medicaid Therapeutic Leave (March 2011)
- Ombudsman Compendium on Recruitment, Training and Retention
- Medicare Interactive, Created by the Medicare Rights Center, Medicare Interactive can help find answers about Medicare benefits.
- Medicare Prospective Payment in SNFs and its Impact on Nursing Home Residents: Questions for Ombudsmen Considering the Care of Medicare Patients in Nursing Homes (2001)
- Nursing Homes: Who Owns Them (2001)
- A Reporter’s Toolkit: Medicaid
- Staffing section of the Consumer Voice website
- Medicaid Bed Hold Policies by State (October 2012)
- Bedhold for Nursing Home Residents: Know the Facts (September 2012)
- Improving the Quality of Care in Nursing Homes (IoM, 1986)
- Nursing Home Staffing Standards in State Statutes and Regulations (Charlene Harrington, 2010)