Long Term Ombudsman Program, Nursing Homes

Long Term Ombudsman Program

Keith Horcasitas, LCSW, MHA


Accompanying the passage of the Older Americans Act of 1965 was the enactment of the Medicare and Medicaid healthcare programs. These programs pointed to a more concerted national and state effort to deal with the needs of the aged, especially the institutionalized.

But concerns involving long-term care were not adequately addressed and further efforts were required to address these needs. The development of the Ombudsman Program is one response to the long-term concerns of the aged.

The term ombudsman had its origin in Sweden where the “Justitieombudsman” office was created in 1809 to receive governmental complaints from citizens and to protect them against injustice. The ombudsman was someone independent and impartial who would review and attempt to resolve civil problems.

The Ombudsman Program was initiated in writing in the United States in 1971 through former President Nixon’s Eight Point Initiative, which was concerned with improving the quality of care in nursing homes.

President Nixon directed the Department of Health, Education and Welfare, now the Department of Health and Human Resources, to assist the states in establishing investigative units that would respond in a responsible and constructive way to complaints made by or on behalf of nursing home residents.

By 1975, after legislative mandates and effective demonstration projects, the development of a nationwide Ombudsman Program was initiated. Former Commissioner of Aging, Arthur S. Fleming, gave much impetus to this when he invited all state Agencies on Aging to submit proposals to promote, coordinate, monitor and assess nursing home activities within their service areas.

Louisiana has a statewide Ombudsman Program directed by the Governor’s Office of Elderly Affairs in Baton Rouge. In East Baton Rouge Parish and some surrounding parishes, the program is administered per the Advocacy Center For the Elderly and Disabled, a not-for-profit organization.

According to Peggy Essick, local Long-Term Care Ombudsman Program Coordinator, there are volunteer opportunities for adults interested in helping. She noted, “We are looking for strong listeners and good problem solvers. We can offer them a continous learning environment and the chance to meet some really remarkable individuals.”

Individuals can volunteer to serve as Long-Term Care Visitors or as Volunteer Ombudsman:

Long-Term Care Visitors:

• Complete 6 hours initial training and 6 hours continuing education each year
• Visit weekly with residents in assigned facilities
• Help residents understand their rights
• Provide information about the Ombudsman Program and refer problems to Certified Ombudsman

Volunteer Ombudsman:

• Complete a more rigorous training including four days of classroom training, a written examination, a 12-hour internship in a nursing home and 15 hours continuing education each year
• Visit weekly with residents in assigned facilities
• Investigate and resolve problems

For individuals who have loved ones in a nursing home, it can be helpful to get to know the ombudsman who is assigned to that facility. They are facilitators and are not to be seen in an adversarial manner. If problems between a resident/resident’s family and a nursing home persist without adequate resolution, ombudsmen can certainly be helpful.

As was noted in the previous column about Home Health Compare, individuals can also review the performance of nursing homes based upon independent measures also at www.medicare.gov/NHCompare.

As a part of my Graduate Social Work/MSW Curriculum at San Diego State University, wherein I had to do a Field Placement for one year, I was able to assist the Ombudsman Program per the San Diego Area Agency on Aging. I strongly encourage anyone who has an inclination to assist and advocate for the elderly to consider the local Ombudsman Program.

For more information about the Ombudsman Program and for further consideration of its volunteer opportunities, check www.louisiana.gov/elderlyaffairs/LTC_ombudsman.html.

Keith Horcasitas, LCSW, MHA