Systemic Advocacy Index

Systemic Advocacy

The ombudsman program promotes systems change to address the quality of life for residents of long term care facilities. See items labeled for most recent additions to this index.

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Documents

View From the Inside: Conversations With Residents Living in the Grant Park Care Center in Washington, DC (April 2009). In September 2008, the Grant Park Care Center Resident Council agreed to work with The Catholic University law students to present residents' voices to nursing home administrators, current owners, the DC Department of Health and Centers for Medicare and Medicaid Services. The "conversations" gathered within this document are intended to offer insight into resident concerns and will hopefully prompt the nursing home owners and administrators to make positive operational changes for Grant Park Care Center’s residents.

Personal Needs Allowances for Residents Long-Term Care Facilities: A State by State Analysis (March 2009). This brief is a complete revision to the 2001 and 2004 papers on PNA and includes the most recent PNA data by state and compares it with previous years. The document also compares PNAs for nursing home residents with PNAs for residents of assisted living facilities under the Medicaid Home- and Community-Based Service Waivers. Finally, the paper summarizes both state and national efforts to raise the PNA for residents in long-term care facilities.

Strategy Brief: The Ombudsman Program and Legislative Advocacy (May 2006). This report presents promising practices and strategies identified by ombudsmen concerning legislative advocacy. Included are discussion highlights from National Dialogue Forum #5 convened by the National Association of State Units on Aging (NASUA) on the topic in September 2005. This was the fifth in a series of Forums NASUA convened on challenging issues facing State Long-term Care Ombudsmen. Also included is information gathered from an email solicitation to all programs in September 2005 in preparation for two conference calls.

Personal Needs Allowance for Long Term Care Residents (December 2004). This document is an updated version of the analysis undertaken by the Center in 1999 and previously updated in 2001. The 2004 report is being updated once again and will be posted shortly. Here is the 2006 table of PNA by state in excel format and in pdf.

Long-Term Care Ombudsman Program: Ombudsmen Talk about Guardianship (February 2004). This paper presents highlights from a discussion of challenges that State Long-Term Care Ombudsmen encounter in the guardianship and surrogate decision-making arena and how their programs are attempting to address these issues. The discussion took place during two teleconferences conducted by NASUA for the Ombudsman Resource Center.

Translating Nursing Home Ombudsman Skills to Assisted Living: Something Old, Something New (March 2003). State ombudsman programs vary in the length of experience they have in assisted living. This paper shows how, regardless of the differences among states, ombudsman skills and knowledge gained in nursing homes can be applied to individual and systemic advocacy in assisted living. There are also aspects of assisted living noted in this paper that pose special challenges and that call for different approaches. (Appendices not included. Call the Center if you need copies of the appendices.)

Translating Nursing Home Ombudsman Skills to Assisted Living: Something Old, Something New – Teaching Guide(May 2008). This document is toassist long-term care ombudsman programs in teaching the content of the paper to LTCO to enable them to be more effective advocates for residents in assisted living.

The Role of Long Term Care Ombudsmen in Nursing Home Closures and Natural Disasters (January 2000). The purpose of this paper is to identify the multiple roles of state, local, and volunteer long-term care ombudsmen in nursing home closures and natural disasters when the need arises to move residents to alternative sites. The material is presented in six stand-alone sections. (Appendices not included. Call the Center if you need copies of the appendices.)

Personal Needs Allowance for Long Term Care Residents (December 2001). This document is an updated version of the analysis undertaken by the Center in 1999. Table of PNA by state in excel format.

Ombudsman Advocacy Challenges in Assisted Living: Outreach and Discharge (March 2001). This technical assistance paper is presented in two sections. It begins by describing challenges programs face in doing assisted living outreach and practical steps they might take to more effectively reach assisted living consumers and providers. It continues with a focus on Ombudsman intervention in discharge cases.

Supporting Culture Change to Promote Individualized Care in Nursing Homes, (May 2000).Overview of the issues, relevant practice precedents and examples of best practices in implementing culture change in nursing homes.

Joining Forces for Residents: Citizen Advocates and Long Term Care Ombudsmen, (March 2001). A session at the 2000 Annual Meeting of the National Citizens' Coalition for Nursing Home Reform focused on ways citizen advocacy groups (CAGs) and Long Term Care Ombudsman Programs (LTCOPs) have worked together to achieve a common goal.

Personal Needs Allowance: A State by State Analysis, (January 2000). This analysis was undertaken by the Ombudsman Resource Center in the fall of 1999 in order to respond to ombudsmen requests for current PNA levels. pdf

Summary of Workforce Issues and Residents: No Quick Fix? Be Creative in Systems Advocacy, (April 2000). Highlights the discussions about workforce issues, and residents at the National Ombudsman Training Conference.

Progress on the Health Care Financing Administrations Initiative (April 1999). Summary of the major presentations and reports from presentations and dialogue regarding the Health Care Financing Administration's (HCFA) activities in response to the President's Nursing Home Initiatives announced in 1998.

Best Practices: Results of Dental Survey of Long Term Care Providers in One Hundred North Carolina Counties (June, 2000). This survey, designed and implemented by the NC LTCOP, confirmed a lack of resources in North Carolina to take care of the dental needsof long term care residents. It also found that the shortage of dental care is particularly acute for residents relying on governmental assistance. The paper includes methodology, results and quotes from respondents.

Best Practices: Ombudsman Initiatives Addressing Neglect and Abuse (January 2001). This paper provides an analysis of 13 long term care Ombudsman Programs and their approaches to combating neglect and abuse in long-term care facilities. See also appendices in Excel format: Overview appendix; Training Group appendix.

Ombudsman Best Practices: Using Systems Advocacy to Improve Life for Residents (June, 2002). This paper provides a framework for engaging in systems advocacy. It highlights "real life" examples including strategies and approaches for effecting change, and resources for creative ideas and lessons learned.

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Best Practices

Best Practices are developed for the sharing of ideas in various categories among ombudsmen. These are informal documents that are program-based not research-based. The documents below fall into the systemic advocacy category. A sub-category on addressing abuse and neglect was added in July 2003.

The Following BPs were submitted for the State Long-Term Care Ombudsman Spring Training Conference and appear in the Conference notebook.

April 2006 (posted June 2006)

Access to Adult Family Homes, Washington

Acknowledging Facility Best Practices, New Hampshire

Assisting Family Councils, Kentucky

Coalition Against Financial Exploitation of the Elderly (CAFEE), Oklahoma

How to Choose a Nursing Home: Checklist, Texas

Increasing Program Funding, Kansas

Involuntary Discharge, District of Columbia

Legislative Advocacy, Kentucky

Legislative Advocacy, New Hampshire

Ombudsman Referrals to HCBS Waivers, Michigan

Partnering with Volunteer Visitation Program, North Carolina

Partnering with the State's Attorney General in prosecuting a negligent group home, Nevada in prosecuting a negligent group home

Partnerships with Legal Aid, Virginia

Public Education about Resident-Directed Care Planning, New Hampshire

Recognizing Provider Best Practices, Kentucky

April 2003

Advance Directives information distributed, Missouri

Advocating for Air-Conditioning in long-term care facilities, Illinois

Assisted Living Assessments - Improving the regulations, Rhode Island

Assisted Living Pilot Project seeks to identify unlicensed assisted living facilities, Texas

Creating Awareness of Nursing Home Staffing Issues through partnership in statewide campaign, Minnesota

Dining with Dignity, Resident Celebrations and Quarterly Reports to all present and potential funding sources, Kentucky

Educating Law Enforcement Officers on elder abuse, Nevada

Medicaid Accountability Measures improved through LTCOP efforts, Iowa

Minimum Staffing Ratios in nursing homes and other changes, Maine

Nursing Home Closures improved by multi-disciplinary team efforts, Delaware

Ombudsman as Court Appointed Resident Advocates in nursing home closures, Texas

Opposing CoN application, Oklahoma

Qualifications of Facility Operators: Raising the bar, Wisconsin

Resident's Rights upheld through LTCOP intervention, Maine

Best Practices on Addressing Abuse and Neglect

Reporting Abuse and information sharing, Kentucky

Reviewing Deaths associated with suspected abuse and neglect, Maine

April 2002

Governor's Blue Ribbon Panel on Workforce Issues in Long-Term Care being established, Colorado

Holding Providers Legally Accountable through work on a consortium, Wisconsin

Legislative Proposal to increase CNA training hours from 75 to 100, Connecticut

Opposing Legislation on tort reform, Ohio

Promoting Best Practices and Models of Care, Texas

Promoting Resident Centered Care, Nebraska

Strengthening Resident Councils to effect systems and systemic changes, Connecticut

Task Force on Quality Long Term Care, Kentucky

April 2001

Access Dental Care: Developing a way to obtain Dental Care for the Residents in our Long-Term Care Facilities, North Carolina

Funding Needed for full time Ombudsman, Alabama

Interagency Briefing hosted by Ombudsman Program, Alaska

Long Term Care Council aims to coordinate services across departments, California

April 2000

Model Relocation plan for an inner city nursing home facing closure, Connecticut

Proposal of Own Legislature, Connecticut

Statewide "Summit"convened to address retaining workers, Wisconsin

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Special Events

Residents' Rights Week Designated by the National Citizens' Coalition for Nursing Home Reform (NCCNHR) each year in the first week of October to honor residents living in all long-term care facilities. Read about its history; order previous years' packets on line; view an educational poster; and find other resources such as books, manuals and videos.