|
Elder
Rights: LTC Ombudsman
LTC Ombudsman National State Data
Executive Summary:
FY 1996 Long-Term Care Ombudsman Report
The Long-Term Care Ombudsman Program was established under the
Older Americans Act to advocate on behalf of older residents
of long-term care facilities. Ombudsman programs in every state
and hundreds of local or regional areas carry out a variety of
activities to assist residents and their loved ones to obtain
a good quality of life and care in nursing homes, assisted living,
and other types of long-term care facilities.
This report provides the first compilation of data from all
state ombudsman programs on the types of problems reported by
those who turn to the program for assistance and on other activities
carried out by ombudsmen. Thus, the national totals for FY 1996
constitute the baseline for this information. (Comparable data
on program operations were provided by all states for FY 1995.)
Ombudsmen opened 126,606 new cases and closed 116,242 cases,
involving 179,111 complaints, in FY 1996. Most complaints were
filed by residents of facilities or by friends or relatives of
residents. Seventy-four percent of complaints were verified,
and 72.1 percent of all complaints were resolved or partially
resolved to the satisfaction of the resident or complainant.
Eighty-one percent of the cases closed involved nursing homes.
The five most frequent nursing home complaints concerned:
- accidents, improper handling
- requests for assistance unheeded
- personal hygiene neglected
- lack of respect for residents, poor staff attitudes
- lack of adequate care plan, resident assessment
Seventeen percent of the cases closed involved board and care
homes, including assisted living, adult care, and similar levels
of care facilities. The five most frequent complaints involving
these types of homes concerned:
- menu quality, quantity, variation, choice
- physical abuse
- medications administration, organization
- lack of respect for residents, poor staff attitudes
- equipment/building disrepair, hazard, poor lighting, and
fire safety
FY 1996 program funding from all sources totaled $41,519,334,
approximately one million dollars above the FY 1995 funding level.
There were 570 local programs, five more than in FY 1995, and
847 full-time equivalent staff serving the program in FY 1996.
The number of ombudsman volunteers increased dramatically during
this two-year periodCfrom 6,421 certified and a total of 11,580
for FY 1995 to 6,622 certified and a total of 12,657 for FY 1996.
Although the state ombudsman reports show that the number of
nursing facilities decreased from 18,911 in FY 1995 to 18,066
in FY 1996, the number of beds in nursing facilities increased
during the two-year period, demonstrating that fewer nursing
facilities are growing larger in size. The number of licensed
board and care-type facilities and beds, including assisted living,
adult care, residential care and similar homes, increased dramatically
from 35,304 facilities with 662,199 beds in FY 1995 to 39,369
facilities with 673,903 beds in FY 1995.
The ratio of paid ombudsman full-time equivalents (FTE) to total
number of long-term care facility beds was 1 to 2,973 in FY 1996.
This was approximately one-third greater than the ratio of one
FTE to 2,000 beds which the Institute of Medicine, in its comprehensive
assessment of the Long-Term Care Ombudsman Program, said was
required for ombudsman programs to fulfill the responsibilities
assigned to them in the Older Americans Act.
Ombudsmen nationwide provided 46,015 hours of training in 9,199
training sessions to 27,568 ombudsman trainees; gave 7,321 training
sessions and 62,962 individual consultations to facility managers
and staff; provided information and consultation to 188,067 individuals;
participated in 9,776 facility surveys, 11,942 resident council
meetings, 4,685 family council meetings, and 8,985 community
education sessions; provided 3,406 press interviews and issued
3,252 press releases. They reported visiting 70.7 percent of
all nursing facilities and 28.1 percent of all board and care
and similar types of homes on a regular basis, not in response
to a complaint.
Ombudsman work on laws, regulations and government policies
and actions is referred to as issues advocacy. It is significant
that almost half (eight) of the seventeen states reporting that
state ombudman staff spend thirty percent or more of their time
on issues advocacy are among the twelve states whose programs
are located outside the state agency on aging (CO, DC, FL, MI,
VT, WA, WI and WY).
Issues identified by the states are listed below in the order
of the frequency with which they were mentioned in the state
reports.
- Regulation and enforcement issues, especially as related
to poor performing facilities: 16 states (AK, CA, DC, MI, MA,
NC, NV, OH, PA, KS, RI, TX, UT, VT, WI, WA)
- Limited long-term care options, especially for Medicaid-eligible
and moderate-income individuals: 11 states (DC, IN, MI, MN,
NC, NH, TN, VT, WV, WA, MA)
- Chronic shortage of qualified, trained, equitably compensated
staff to assist residents - 10 states (CO, DC, FL, IN, LA,
MA, MT, NC, OH, TX)
- Ombudsman Program Issues: 10 states (AK, CA, KS, MD, MS,
NH, NJ, PR, WA)
- Board and care homes/assisted living (also related to topic
# 1, regulation and enforcement issues): 9 states (KS, LA,
ME, NM, OR, PA, WI, WV, WA)
- Involuntary transfers, discharge and readmission issues,
especially related to residents with dementia and mental health
problems: 9 states (AZ, IN, KS, KY, MA, MO, NH, OR, WA)
- Resident abuse; adult protective services: 6 states (AK,
MD, MN, NH, OR, SC)
- Abuse Registries: 3 states (AK, NJ, UT)
- Bioethical (advance directives and right to refuse medical
treatment) issues: 2 states (IN, NJ)
- Medicare, Medicaid anti-fraud and abuse: 2 states (IL, NY)
- Managed care: 2 states (FL, MA)
- Guardianship and legal issues: 2 states: (MO, RI)
- Family councils: 1 state (SC)
- Physician accountability: l state. (WA)
- Behavior of Residents and Families: 1 state (MO)
Ombudsman best practice in advocacy, public education and problem
solving provided in the report reflect the wide range of projects
and activities which ombudsmen undertake to improve the long-term
care system for residents.
|