Program Management
Good program management frees long-term care ombudsmen to serve residents. Whether local or state, ombudsmen are challenged to effectively manage their programs. NORC presents information on a wide variety of issues ombudsmen must address to run their programs efficiently. The resource documents contained here are organized by topic.
Quality in Medicaid Waiver Assisted Living: The Ombudsman Program's Role and Perspective (December 2005)
This paper presents highlights of a teleconference for State Ombudsmen discussing their role and perspectives on quality in Medicaid waiver assisted living. The conference was convened by The National Association of State Units on Aging (NASUA) on April 26, 2005. Thirteen state ombudsmen and program staff from 10 states (Alaska, Arkansas, Arizona, Georgia, Illinois, Louisiana, Ohio, Pennsylvania, Virginia, Wisconsin) and the District of Columbia, participated.
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.
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Long-Term Care Ombudsman Participation in the Development of State Aging Plans
This issue brief, supported in part, by a grant from the Administration on Aging, Department of Health and Human Services, provides examples and tips for State Units on Aging and for State Long-Term Care Ombudsmen on using the state plan to benefit consumers living in long-term care facilities.
Time and Leadership: Keys to Building Synergy between State Ombudsmen and State Aging Directors (October 2006)
This document contains a summary of discussion highlights from a teleconference for state ombudsmen and state aging directors to discuss the relationship between the state ombudsman program and the state unit on aging. Georgia State Aging Director, Maria Greene, and then Georgia State Ombudsman, Becky Kurtz, offered their perspectives on the topic. A question and answer session and open discussion amongst participants followed. An edited transcript of the entire session is also included.
Resource Brief: Ombudsman Program Memorandum of Understanding (April 2006)
This paper, by the National Association of State Units on Aging and Disabilities (NASUAD), presents an analysis of data collected from 50 state ombudsman programs about their use of memorandum of understanding with other agencies and programs. In addition to a summary of the findings, it includes a chart containing information about each MOU, and two sample MOUs.
Ombudsman Best Practices: Enhancing Consumer Access Through Coordination Focus: Ombudsman and Aging I&R/A Programs (January 2004)
This paper focuses on how access to the ombudsman program can be enhanced through establishing relationships with I&R/A programs.
Long-Term Care Ombudsmen and Adult Protective Services: Roundtable Discussion Session Summary
Ten years after the meeting in 1993 , discussions were held once again between NASOP and NAPSA at the Ombudsman Spring Training Conference. This informal roundtable discussion session in April 2003, acknowledged the continued commitment of both professional associations to jointly address issues and to better serve clients through collaboration. This document, prepared by Sara Hunt, ORC Consultant, summarizes the session.
Coordination Between Long-Term Care Ombudsman and Adult Protective Services Programs and Related Issues: Report on a Meeting Sponsored by the Administration on Aging on October 25-26,1993, in Washington, DC
This document summarizes the 1993 conference on the relationship of ombudsman programs to protective services. The points made are still relevant today.
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Best Practices: Confidentiality (December 2000)
This paper discusses Long Term Care Ombudsman Program (LTCOP) best practices related to confidentiality. Examples of LTCOP policies and procedures from various states are included to illustrate how programs operationalize these concepts. (The appendices are not included in the document and can be accessed here.)
Supporting Well Informed Consumers: The Role of the Long-Term Care Ombudsman (May 2005)
This paper grew out of a session with the same title at the 2004 Annual State Ombudsman Conference, where panelists Becky Kurtz, Sharon Zoesch, and Linda Sadden shared their practices and stimulated dialogue on the responsible sharing of LTCOP data with consumers. The paper explores federal requirements and national recommendations; uses for LTCOP data; program practices in sharing data; essential elements for responsible sharing; and key points on the hallmarks of programs that are sharing data and the need for continued dialogue on this issue.
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The Role of the LTC Ombudsman in Culture Change: Promoting Resident Directed Care in Nursing Homes and Assisted Living
This new resource brief, developed by Center Consultant, Sara Hunt, is designed to generate ideas about how long-term care ombudsmen can promote systemic, resident-directed care practices in facilities. Included are examples of state and local ombudsman program involvement in promoting culture change practices, offers tips for ombudsman advocacy, discusses the role of the ombudsman, and lists salient resources.
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Resource Brief: Ombudsman Program Data Management Systems (July 2004)
This brief describes software systems used by ombudsman programs to collect, analyze and report data about cases and complaints handled by ombudsman. It includes information on resources for maintenance, upgrade, and expansion of those systems.
Computer Survey (June 2000)
NORC conducted a study identifying software being used in different states for complaint and other program data. See also the spreadsheet of survey results.
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Applying Ethical Principles to Individual Advocacy Joan Gibson presentation summarized by Sara S. Hunt, National Ombudsman Resource Center (National Eldercare Institute on Elder Abuse and State Long Term Care Ombudsman Services) (1992)
This resource paper contains a discussion of the ethical dilemmas facing long-term care ombudsmen in their daily practice. It includes decisional capacity, the use of a values history and suggests a process ombudsmen might use for individual case advocacy.
Advocacy in Ethical Issues: A Multi-Disciplinary Approach: A Guide for Ombudsmen Carolyn Wanner, National Long Term Care Ombudsman Resource Center (1995)
This technical assistance paper captures the panel presentations and the state long-term care ombudsman consensus during the “Advocacy in Sticky Situation” session at the 1994 annual state ombudsman training conference. A case study was presented followed by responses from different professional disciplines and a long-term care ombudsman. The unique role of the long-term care ombudsman and application to long-term care ombudsman program management were discussed and compiled.
Conflict of Interest and the Long-Term Care Ombudsman Program (July 2009)
Identifying and preventing, removing or remedying conflicts of interest is not a simple task. There is not an established solution for every potential conflict of interest situation. Addressing conflict of interest requires continual vigilance, dialogue, assessing the potential impact on residents, and thoughtful strategies to remove or remedy the conflict. The easiest solution is to avoid the conflict of interest. This paper discusses the Older Americans Act provisions and dimensions of conflict of interest. Key resources and approaches utilized by several state and local ombudsman programs are included as examples of program management practices to address issues.
Ethical Issues in Ombudsman Advocacy Sara S. Hunt and Jean Wood, National Long-Term Care Ombudsman Resource Center (1991)
This article summarizes a presentation by Joan Gibson and long-term care ombudsman consensus regarding appropriate long-term care ombudsman actions in case examples. There are three sections: an ethical framework for long-term care ombudsmen, ombudsman responsibilities with advance directive issues and ombudsman responsibilities with residents who cannot consent.
In-Service Training Guide for Ombudsmen: Ethical Issues in Case Advocacy (1989)
The purpose of this training guide is to sensitize ombudsmen to some of the ethical issues that arise in the course of case advocacy and provide guidance in resolving these issues. "Working Through Ethical Dilemmas in Daily Ombudsman Practice" is the primary resource for this training and should be read by the trainer before teaching this session.
Safety, Self-Determination, and Choice in Long-Term Care: The Consumer and Ombudsman Experience Beverley Laubert & R. Michael Laubert, Chapter 5, Ethics, Law, and Aging Review, Vol. 9, 2003
This article uses case illustrations to discuss how long-term care ombudsmen handle their own view of protection against harm and the “right” course of action with their mandated responsibility to support consumer rights and autonomy to make decisions. The role of the advocate ombudsman as distinct from the role of other professions is delineated.
Working Through Ethical Dilemmas (1989)
Ethical issues arise when there are questions, or uncertainties, about the "right" thing to do in a given situation. An ethical issue can become a "dilemma" when an individual, or group of individuals, must choose between two or more plans/actions when no one choice is clearly satisfactory. While ombudsmen are well acquainted with ethical dilemmas that typically arise, guidance for working through some of these has been lacking. This paper describes some of the various ethical dilemmas that ombudsmen encounter. Neither specific solutions nor prescriptive guidelines are given to resolve the dilemmas.
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Charting the Long-Term Care Ombudsman Program's Role in a Modernized Long-Term Care System
This Long-Term Care Ombudsman Program Strategic Directions Work Group Meeting Report, prepared by NORC and NASUA, seeks to help long-term care ombudsmen to define their role and develop coordination efforts in a new long-term care system. Visit NORC's Rebalancing the Long-Term Care System webpage.
Home Care Ombudsman Programs Status Report: 2007
Ombudsman programs in twelve states are authorized or mandated under state law to provide advocacy on behalf of consumers who receive home and community based care. Over the last seven years the Long-Term Care Ombudsman Program's involvement in home care advocacy has changed little; the numbers of complaints, types of individual and systems issues, and the level of support have remained relatively stable. This paper updates and expands information previously collected on home care ombudsman programs in 2000. New information reported here was gathered in April/May 2007 through a web-based questionnaire and a teleconference.
Strategy Brief: Ombudsman Program Involvement in Nursing Home Transition Activities (December 2004)
This report presents promising practices and discussion highlights from National Dialogue Forum #2 convened by NASUA on the topic. [Note that Appendices D and F are not included. Contact the author at NASUA for a hard copy.]
The Role of the Long-Term Care Ombudsman in Home Care Advocacy (June 2001)
This technical assistance paper, prepared by the National Association of State Units on Aging (NASUA), includes information on the scope of Home Care Ombudsman Programs' responsibilities, the types of complaints which may be reported, program funding, access issues, training and systems advocacy activities.
Strategy Brief: Ombudsman Program Connections to Home- and Community-Based Service (July 2004)
This document presents discussion highlights from a National Dialogue Forum convened by NASUA on the topic. The primary issues discussed by the participants included: the ombudsman program's role in providing information about home care to consumers; consumer access to home care services; advocacy for quality home care options and relationships with the home- and community-based services system.
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Legal Counsel and Representation of the Long-Term Care Ombudsman Program (March 2005)
This paper contains information about the entities that provide legal counsel and representation to the ombudsman program at the state and local levels. It includes the types of support provided, and how ombudsman programs assist consumers to obtain legal assistance when necessary. [Note that Appendices E, F, and G are not included. Contact NASUAD or NORC for a hard copy.]
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Strategy Brief: The Ombudsman Program and Caregiver Support
The information presented in this document is based on promising practices identified by state ombudsmen in response to an email sent to all programs in May, 2006 and information provided during the National Dialogue Forum. The National Dialogue Forum consisted of two teleconferences held on May 16 and 18, 2006.
Strategy Brief: Ombudsman Program Advocacy in Guardianship (May 2006)
This report presents promising practices and strategies used by ombudsmen concerning guardianship and alternatives to guardianship for nursing home residents with limited decision-making capacity and no surrogate decision-maker. Included are discussion highlights from National Dialogue Forum #4 convened by the National Association of State Units on Aging (NASUA) on the topic in June 2005. This was the fourth 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 May 2005 in preparation for two conference calls. (This is a large file - 800 KB. It may take a few moments to download.)
Strategy Brief: Ombudsman Program Responses to Diversity (September 2005)
This report presents promising practices and strategies used by ombudsmen serving diverse resident populations. Included are discussion highlights from National Dialogue Forum #3 convened by the National Association of State Units on Aging (NASUA) on the topic. This is the third in a series of Forums NASUA has convened on challenging issues facing State Long-Term Care Ombudsmen.
The Consumer Guide for Advancing Excellence in America’s Nursing Homes
The Advancing Excellence in America’s Nursing Homes Campaign has released a new resource to helps consumers get involved in improving the quality of nursing homes; the guide contains ideas and resources to help residents, family members, citizen advocacy group members, ombudsmen and others get involved and increase their participation in the campaign at both nursing home and state levels.
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Long-Term Care Ombudsman Certification Survey (March 2010)
Coordinated by NORC and NASOP, this survey looks at certification and initial training requirements for long-term care ombudsmen. Forty-two states participated in the survey.
Long-Term Care Ombudsman Program: Structure, Responsibilities, Quality and Funding (September 2003)
This overview of state long-term care ombudsman programs (SLTCOPs) is a snapshot in time. It contains self-reported results from the 53 SLTCOPs.
Unique Characteristics of Ombudsman Programs (Updated October 2002)
This report focuses on being aware of the misconceptions of LTCO programs and how to address them.
Esprit de Corps: Cultivating Unity in the Statewide LTCO Ombudsman Program (April 1999)
Session summary designed to provide new insight into the dynamics between responsibility of administering a federally mandated statewide program and creating a sense of common purpose, an esprit de corps, among everyone working in the program.
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NORC receives many requests from SLTCO regarding the development or updating of policies and procedures. Below is a sample of various state policies and procedures for ombudsman programs that you may refer to when called upon to assist your state.
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Ombudsman Program Outcome Measures: Final Report (May 2006)
This report by the National Association of State Units on Aging and Disabilities (NASUAD), presents the results of a three-year information gathering project conducted between 2000 and 2004 and guided by the Ombudsman Outcomes Work Group. The project was designed to identify possible outcome measures to describe ombudsman program impact on residents' lives in addition to those used by and reported to NORS. (This is a very large file - 1.2 MB. If you have trouble downloading the document, contact the Center for a copy.)
Enhancing the Effectiveness of Local Long-Term Care Ombudsman Programs in New York and California
This University of California, San Francisco-Institute for Health & Aging- project, was headed by Carroll Estes, PhD, Principle Investigator. It identifies and examines factors that affect performance of the local LTCOPs in California and New York State and provides the results of two summits in April 2005 and September 2005 respectively.
A Self-Evaluation and Continuous Quality Improvement Tool for State and Local Ombudsman Programs
Developed by Robyn Grant, MSW, for both state and local ombudsmen programs. Click here for links to a Tool for State Ombudsmen and a Tool for Local Ombudsmen to assess their own programs. The self-evaluation is designed to give ombudsmen knowledge about what his or her program is doing well and where it needs to be improved. This page also provides links to resources and materials relevant to the tool. Individual components of the tools are also available.
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Study of the CA LTCOP Volunteer Program
Facing a decline of over 20 percent of its volunteers, the California LTC Ombudsman Program initiated a research project in order to learn ways to improve both recruitment and retention of volunteers. The project was funded by the California Health Care Foundation (CHCF) and carried out by Wold and Associates. Qualitative and quantitative findings from a survey of 250 current and former volunteers have provided comprehensive information and descriptive data about ombudsman volunteer experiences. based on these findings, the report recommends specific strategies for enhancing the volunteer experience and improving the program's effective.
Volunteer Consultants: Extending the Reach of Ombudsman Programs (May 2003)
The Long-Term Care Ombudsman Program has traditionally relied on volunteers to fulfill its mandated requirement to serve residents in long-term care facilities. In this paper, the term "volunteer consultant" is used to describe a professional who, without reimbursement, provides technical assistance, case consultation, advice/guidance, or advocacy support to the Ombudsman Program for the purpose of helping the program with specific tasks related to the professional's area of expertise.
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