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10 Things You Probably Didn't Know About The Long Term Care Ombudsman Program 

Eric Greth HS

Written by Eric Greth 

Licensed Agent 

Last updated on  October 2, 2021

Forest Ridge WA.jpg

As a Financial Advisor I've worked with hundreds of senior clients over the years.  I'm embarrassed to admit that I never knew about the Long Term Care Ombudsman Program until earlier this year.  I was looking for a volunteer position in my community when I came across an opening for an Ombudsman.  I applied, was accepted, went through over 30 hours of training, and now work with the program.   

#1 - When was the Long Term Care Ombudsman program started?

In 1978 an amendment to the Older American Act (OAA) elevated the Nursing Home Ombudsman Program to a statutory level.  the statute and subsequent amendments required all state agencies on aging to establish an ombudsman program.

#2 - What areas do the Ombudsman serve?

Every state is required to have an Ombudsman Program.  All 50 states, plus Guam, Puerto Rico, and the District of Columbia have programs as of 10/03/2021.

#3 - What impact does the program have?

Nationally, in 2019 the Ombudsman program had 5,947 volunteers and 1,362 paid staff.  They investigated over 198,502 complaints and provided information on Long Term Care to another 425,084 people.  When a resident of a Long Term Care facility doesn't have friends or family who can visit them regularly, regional Ombudsmen Volunteers may be the only persons available to help identify a problem, report care concerns, and act as a voice for our most vulnerable citizens.  

#4 - What is A Long Term Care Ombudsman?

Long Term Care Ombudsmen are advocates for residents' rights in nursing homes, assisted living facilities, skilled nursing homes, and just about any other facility for the aged.  Ombudsmen help residents and their families understand and exercise their rights to quality of care and quality of life.  They are mostly volunteers certified to handle complaints and provide on-site visitation.  They meet confidentially with residents to educate and advise them of their rights.  Ombudsmen collect and document complaints and issues.    

#5 - Who Is In Charge Of The Program?

Every state is required to have an Ombudsman Program.  Currently, there are 53 state-run programs.  Here are the key organizations.


National Level

Administration for Community Living   ACL

National Long-Term Care Ombudsman Resource Center    NORC

National Consumer Voice for Quality Long-Term Care    Formerly NCCOHR

National Association of State Long-Term Care Ombudsman Programs  NASOP

National Association of Local Long-Term Care Ombudsmen   NALLTCO

State Level 

State Long Term Care Ombudsman Program

LTC Ombudsman Organization Chart
Infographic from NORC

ACL supports the needs of the aging and disability populations and improves access the health care and long-term services.  The parent agency is the U.S. Department of Health and Human Services.  Powers are granted under the Older Americans Act and the Administration on Aging.  Provides a grant to the National Consumer Voice for Quality Long Term Care to operate NORC


NORC runs a website filled with information, resources, and news from Ombudsman programs to support and inform programs across the country.  

National Consumer Voice for Quality Long-Term Care was formed in 1975 because of public concerns about the substandard care in nursing homes.  Their mission:

  • Advocate for public policies that support quality care and quality of life responsive to consumers’ needs in all long-term care settings

  • Empower and educate consumers and families with the knowledge and tools they need to advocate for themselves

  • Train and support individuals and groups that empower and advocate for consumers of long-term care

  • Promote the critical role of direct-care workers and best practices in quality-care delivery

NASOP mission statement:  As mandated by the Older Americans Act, the mission of the Long-Term Care Ombudsman Program is to seek resolution of problems and advocate for the rights of residents of long-term care facilities with the goal of enhancing the quality of life and care of residents.

NALLTCO mission statement:

  • Engage members in systemic advocacy efforts

  • Represent the advancement of the mutual objectives of the local long term care Ombudsman Programs on a national level

  • Sharing information, ideas, experiences among the membership

  • Provide ongoing educational opportunities to the membership

  • Promote the integrity of the local long term care ombudsman program nationally

State and Local Ombudsman Programs are in all 50 states, plus Guam, Puerto Rico, and the District of Columbia. There are over 500 local ombudsman entities.  Each entity runs its program based on state and local laws.  The above-mentioned national organizations provide training, support, resources, and education to the state level.  

#6 - What does an Ombudsman address?

LTC Ombudsman handles residents' complaints and represents a resident interest in both individual and systems advocacy.  They address:

  • Violation of residents' rights or dignity

  • Quality, quantity, variation, and choice of food

  • Lack of respect for residents, poor staff attitudes

  • Physical, verbal, or mental abuse, deprivation of services necessary to maintain residents' physical and mental health, or unreasonable confinement

  • Poor quality of care, including inadequate personal hygiene and slow response to requests for assistance

  • Administration and organization of medications

  • Improper transfer or discharge of patient

  • Building or equipment in disrepair or hazardous

  • Inappropriate use of chemical or physical restraints

  • Any resident concerns about the quality of care or quality of life

  • Unanswered requests for assistance

  • Quality of life, specifically resident/roommate conflict

#7 - Do Ombudsmen Investigate Allegations of Abuse, Neglect, and Exploitation?

Yes.  The Ombudsman program investigates and resolves complaints that “relate to action, inaction or decisions that may adversely affect the health, safety, welfare, or rights of the residents” and that includes complaints about abuse, neglect, and exploitation.  Ombudsmen are directed by the resident's goals for complaint resolution.  They are limited by federal disclosure requirements.  The Ombudsman program’s role in investigating allegations of abuse is unique and differs from other entities such as adult protective services and state licensing and certification agencies.  Ombudsman programs attempt to resolve complaints to the residents’ satisfaction and do not gather evidence to substantiate that abuse occurred or to determine if a law or regulation was violated in order to enforce a penalty.  If necessary, with resident consent or permission of the State Ombudsman if the resident can’t consent and does not have a legal representative, the ombudsman will disclose resident-identifying information to the appropriate agency or agencies for regulatory oversight; protective services; access to administrative, legal, or other remedies; and/or law enforcement action about the alleged abuse, neglect or exploitation.


#8 - Are Ombudsman Mandatory Reporters of abuse?

Mandatory Reporting as an Ombudsman. The Older Americans Act is clear that Ombudsmen are resident/client-directed.  That means they work at the direction of the resident/client and not the state or federal government.  In practice according to the Older Americans Act, LTC Ombudsman may not be mandated, reporters.  Some states still require Ombudsman to be mandatory reporters.  According to the National Center on Elder Abuse NCEA, there are strict federal requirements regarding disclosure of Ombudsman program information.  Resident-identifying information cannot be disclosed without resident consent, the consent of the resident representative, or a court order.  Therefore, these disclosure requirements prohibit Ombudsman programs from being mandatory reporters of suspected abuse.

#9 - What are the goals of an Ombudsman?

  1. Advocating to improve the quality of care and quality of life for residents of long-term care facilities.

  2. Empowering seniors and adults with disabilities to self-advocate.

  3. Providing information to residents about residents’ rights, long-term care options, supports, and services in nursing facilities and the community.

  4. Investigating complaints and concerns. Ombudsmen will work to resolve complaints to the satisfaction of residents.

  5. Listening to understand an issue from the resident’s perspective.

  6. Maintaining confidentiality. Ombudsmen may not discuss or disclose any information without the individual’s permission

#10 - Can someone other than a resident bring a concern to the Ombudsman program?


Absolutely yes.  In that case, the ombudsman will contact the resident to see if the resident has similar concerns and wants to proceed with a complaint.  Then the Ombudsman will explain the role of the program, the complaint and investigation process, share information about the resident's rights, ask about the specifics, document the information, and proceed on behalf of the resident.  

Find a Local Long-Term Ombudsman Program
By State | With Phone Number | Website

Use the dropdown to find additional information on your local Long Term Care Ombudsman Program.  All states have local resources with contact names, phone numbers, addresses, and in most cases a website address.

Last updated November 1, 2021

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