Older Americans Act: Long-Term Care Ombudsman Program (CRS Report for Congress)
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| Release Date |
Revised July 28, 2015 |
| Report Number |
RS21297 |
| Report Type |
Report |
| Authors |
Kirsten J. Colello, Specialist in Health and Aging Policy |
| Source Agency |
Congressional Research Service |
| Older Revisions |
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Summary:
Quality of care in long-term care settings has been, and continues to be, a concern for federal
policymakers. The Long-Term Care (LTC) Ombudsman Program is a consumer advocacy
program that aims to improve the quality of care, as well as the quality of life, for residents in
LTC settings by investigating and resolving complaints made by, or on behalf of, such residents.
Established under Title VII of the Older Americans Act (OAA), the Administration on Aging
(AoA) within the Administration for Community Living in the Department of Health and Human
Services (HHS) administers the nationwide program. As of 2013, there were 53 state LTC
Ombudsman Programs operating in all 50 states, the District of Columbia, Guam, and Puerto
Rico, and 575 local programs. Title VII programs received about $20.7 million in FY2015. Total
2013 funding for ombudsman activities from all sources combined (federal and nonfederal) was
$92.5 million, the most recent year for which data on funding from all sources are available. Of
that total, 55.8% ($51.6 million) represented funding from federal sources.
Due to the requirement that ombudsmen investigate and resolve complaints of all residents in
residential LTC facilities, the workload of staff and volunteers is substantial. In 2013, ombudsmen
reported just over 16,500 nursing facilities and about 53,400 other residential LTC facilities
operating nationwide. This translated to a nationwide ratio of one paid ombudsman for every 57
facilities and one paid ombudsman for every 2,400 resident beds. With respect to staffing, the
program receives significant support from volunteers. In 2013, over 1,200 paid staff and about
8,300 certified volunteers investigated more than 190,000 resident complaints. Issues regarding
residents’ rights were the chief complaint in nursing homes, followed by residents’ care issues in
2013. Among residents in other LTC facilities, the top complaint categories in 2013 were quality
of life and residents’ rights.
The OAA Amendments of 2006 (P.L. 109-365) authorized appropriations for the LTC
Ombudsman Program through FY2011 (authorizations of appropriations expired on September
30, 2011). Congress has continued to appropriate funding for OAA-authorized activities for
FY2012 through FY2015. The 114th Congress may choose to reauthorize the OAA. In doing so,
federal policymakers may consider amending or deleting existing authorities under the Act or
establishing new authorities, including those under the LTC Ombudsman Program. In addition,
Congress will likely consider annual appropriations for LTC Ombudsman Program activities, as
well as appropriations for authorities enacted under the Elder Justice Act enacted in the Patient
Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) that support the program.
This report describes the LTC Ombudsman Program, including the program’s legislative history,
administrative function, other resident advocacy activities, and 2013 funding amounts by source.
It also identifies selected issues for federal policymakers, including staffing and resources, inhome
care ombudsman, and specialized ombudsman training. The Appendix includes a summary
of provisions included in S. 192, the Older Americans Reauthorization Act of 2015, that would
amend the LTC Ombudsman Program.
