Index

ORC Library

Short cuts:

OAA

OBRA

IOM

ODR

Compendium

Reference Documents

The Basics

The following documents are key to understanding the Long-Term Care Ombudsman Programs and key issues.

Older Americans Act (OAA) : Amendments of 2006

Older Americans Act Reauthorization of 2000.

Text of OAA Sec. 3058g. State Long-Term Care Ombudsman program

Read a short summary of the critical changes in the reauthorization of OAA. For a printable version click here. 

For a more detailed guide to the entire reauthorized act, download a pdf file here.

Read more about the Act on the AoA website

Text of the 2000 Reauthorization (amendments only).

Compilation of OAA reauthorization activities in 2000 and 2005  and other information on The Center for Social Gerontology (TCSG) website.

Full text of the 1992 Older Americans Act

Omnibus Budget Reconciliation Act of 1987 (OBRA '87) : Nursing Home reform has been an on-going activity for over two decades. A monumental legislative step in the right direction was taken with the passage of OBRA '87.

Read a summary of OBRA. Also available in pdf format.

See the Federal Regulations, Title 42, including Table of Contents, and Index of terms (all pdf files).

Find the Medicaid provisions, Title 1919, including Table of Contents and Medicaid Index of terms (all pdf files).

Read the Medicare provisions, Title 1819, including Table of Contents and Medicare Index of terms (all pdf files).

Institute of Medicine (IOM) : In 1995, the Institute of Medicine (IoM) published the first in-depth assessment of the Long Term Care Ombudsman Program (LTCOP).

Read a summary of the IOM evaluation of long-term care ombudsman programs. Available in pdf format. 

The full IoM report is available online at http://www.nap.edu/books/NI000028/html/.

Study of the State Long Term Care Ombudsman Programs (2001) by Carroll Estes and funded by the Henry J. Kaiser Family Foundation. Review the complete 2001 follow-up study by Dr. Carroll L. Estes, Institute of Health and Aging, University of California - "Effectiveness of the State Long Term Care Ombudsman Programs (June 2001)."  Available in pdf format.

Review the June 2001 Summary of the recommendations about ombudsman program effectiveness including program funding and placement. Available in pdf.

"Effectiveness of the State Long Term Care Ombudsman Programs (June 2001) by Carroll Estes.  This power point presentation details the highlights of the report. Read the Presentation of the study in pdf.

This comprehensive reference tool is intended for individuals who are responsible for recruiting, training, and retaining effective long-term care ombudsmen (both paid and volunteer).  The completed tool includes three chapters and their respective appendices. The overview and Compendium chapters on Recruitment,  Retention and Training are available now.

The Ombudsman Desk Reference is a guide for State Long Term Care Ombudsmen to use in their daily task of providing information to the public.  They might draw from it for press releases or when meeting with members of their state legislatures.  The guide contains sections on long term care statistics, state and local agency contacts, federal agencies and programs, resource contacts, legislative contacts, laws and regulations, a glossary, and general references. Newly updated sections appear below:

Statistics: This section of the Ombudsman Desk Reference, was updated by Deanna Okrent, ORC Consultant, in September 2003 and modified for the website in February 2005. You may download a pdf file here. (Exhibits are not included. For a copy of the exhibits, contact John Kafka at the center, 202-332-2275).

  Legislative Contacts: This section of the Ombudsman Desk Reference, was updated by Rhashida Beynum, ORC Information Specialist, January 2007. You may download a pdf file here.

The Center responds to ombudsmen needs for information in many ways. Reference documents include general information in detailed reports.

Long-Term Care Ombudsman Program: A Summary of State Enabling Statutes (April 2002). Prepared by The National Association of State Units on Aging, this summary compares state statutes concerning the authority of the Long-Term Care Ombudsman Program to access residents and facilities and resolve complaints. 

Medicare Prospective Payment in SNFs and its Impact on Nursing Home Residents: Questions for Ombudsmen Considering the Care of Medicare Patients in Nursing Homes: This report was prepared by Janet Wells, NCCNHR's Director of Public Policy, for the Ombudsmen Resource Center, and sent to State Long Term Care Ombudsmen in May, 2001. It aims to help ombudsmen understand the Prospective Payment System and its impact on Medicare beneficiaries' ability to get the services they need under Medicare, and may be used as a training tool. For an additional copy you may download a pdf file here.

Nursing Homes: Who Owns Them: Advocates often need to identify nursing home owners and operators to help change a facility's practices and improve the care provided to residents. In addition to discussing why there is a need for identifying nursing home ownership, this paper provides a guide for tracking nursing home owners and managers at the federal and state level and also provides policy recommendations for collecting the information. The paper was authored by Ana Rivas-Beck, J.D., NCCNHR's Law and Policy Specialist. A pdf copy of the paper (without the appendices) may be downloaded here. For a copy of the appendices please contact the center at 202-332-2275.

Ombudsman Resource List (February 2008): This resource for ombudsmen will be updated periodically.  It lists documents, videos and other resources available through the center and also through NASUA, NCCNHR, and AARP.  It includes contact information and instructions on how to get the materials. (printable pdf version)

This section provides further  information about the Ombudsman Program and topics relevant to ombudsman work.

          A Reporter's Toolkit: Medicaid. (November 1, 2007). An Alliance for

          Health Reform Toolkit - Produced with support from the Robert Wood

          Johnson Foundation. View the toolkit.

          Nursing Home Staffing Standards in State Statutes and

          Regulations. (January 2008), by Charlene Harrington. View the report.

Nursing Facilities, Staffing, Residents and Facility

Deficiencies, 2000 through 2006. (September 2007).  Thanks

to Charlene Harrington, principle investigator for permission to

post this latest edition key reference document on quality of care

data in nursing homes. Access the book here.

The Long-Term Care Ombudsman Program: Rethinking and Retooling for the Future. ("The Bader Report" April 2003).  This publication provides the proceedings, recommendations, and background materials from the 2002 retreat of the National Association of State Long-Term Care Ombudsman Programs (NASOP) made possible with the help of the Helen Bader Foundation.  NASOP's goal is to strive for excellence in the ombudsman program to ensure a better quality of life for long-term care residents. Embracing the notion of evaluation from those inside and outside the program NASOP analyzes current challenges, and concludes that the program must change as needed, remain contemporary and retool for the future.  Copies of this report have been mailed to all state ombudsmen, local ombudsman program directors, local ombudsmen, state unit directors, participants in the Bader Retreat, and national aging organizations. If you did not receive a copy or know someone that needs a copy, contact Beverley Laubert, NASOP President, at blaubert@age.state.oh.us, or 1-800-309-3282.  The report is also available in pdf on the Wisconsin LTCOP's website at: http://longtermcare.state.wi.us/home/whitepaper03_FINAL.pdf 

State Ombudsman Data: Nursing Home Complaints.  This Office of Inspector General report, released July 2003, is based on an analysis of NORS data from 1996 - 2000, interviews with 46 state and local ombudsmen in 9 states, and a more in-depth analysis of the data in those states - CA, CT, AL, MD, MO, SC, TX, SD, NY. The summary of the OIG Report Findings states, "Nationally, the number of nursing home complaints increased, but the types of complaints have not changed significantly. However, the data are not comprehensive. NORS data should not be used to compare States with respect to the volume and types of complaints, because local ombudsmen do not report all nursing home complaints in NORS, and they do not always use the same categories to classify complaints."  AoA has made a commitment to address data inconsistencies and this is one of the Center's priorities. Available here in pdf. Go to the index to access other OIG reports.

Selected Annotated Bibliography of Research Conducted on the Ombudsman Program 1990-2000 (June 2001). This annotated bibliography prepared by Kevin W. Borders, Ph.D. of the University of Louisville, Kent School of Social Work, covers the following research topics: Complaint System, Evaluation, Partnerships, Volunteers. It provides a brief abstract of what appears in each paper listed. Available in pdf.

Office of Inspector General Reports: In 1999, the U.S. Department of Health and Human Services Office of Inspector General conducted two studies of the Ombudsman Program. These documents provide additional information about how the program functions. Go to the index to access the full reports.