Factors Associated With Perceived Effectiveness of Local Long-Term Care Ombudsman Programs in New York and California

Abstract

Objectives: Long-term care (LTC) ombudsmen advocate for the health, safety, welfare, and rights of residents in LTC facilities. This article examines factors associated with self-rated effectiveness of local LTC Ombudsman Programs (LTCOPs) in California and New York across the five statutorily mandated activities under the Older Americans Act: complaint investigation, resident/family education, community education, monitoring laws, and policy advocacy. Method: Data were collected from telephone interviews with coordinators of local LTCOPs in California and New York and from the National Ombudsman Reporting System. Analyses examined factors associated with effectiveness: program size, resource adequacy, organizational autonomy, interorganizational relationships, and program outputs. Results: Resource and autonomy measures are significantly associated with different effectiveness measures in each state. Staff full-time equivalencies and coordinator hours per week in New York and the quality of training in California are significantly associated with effectiveness in most mandated activities. Discussion: Findings highlight variability within and between the local LTCOPs in California and New York.

Keywords

Long-Term Care Ombudsman Program long-term care quality perceived effectiveness

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References

Administration on Aging. (2008). Table A-7: Designated local ombudsman entities. Retrieved October 15, 2009, from http://www.aoa.gov/AoAroot/aoa_programs/elder_rights/ombudsman/national_state_data/2008/index.aspx

Administration on Aging. (2009). LTC ombudsman national and state data. Retrieved October 28, 2009, from http://www.aoa.gov/AoARoot/AoA_Programs/Elder_Rights/Ombudsman/National_State_Data/index.aspx

Administration on Aging and the Office of the Inspector General. (1993). State implementation of the ombudsman requirements of the Older Americans Act. Washington, DC: U.S. Department of Health and Human Services.

Allen

P. D.

(2006). Long-term care ombudsman volunteers: Making a measurable difference for nursing home residents. International Journal of Volunteer Administration, 24(2), 5-14. Available at http://www.ijova.org/PDFVOL24_NO2IJOVA_VOL24_NO2_Allen_LongTermCareOmbudsmanVolunteers.pdf

Allen

P. D.

Klein

W. C.

Gruman

(2003). Correlates of complaints made to the Connecticut long-term care ombudsman program: The role of organizational and structural factors. Research on Aging, 25, 631-654.

Buford

A. D.

(1984). Advocacy for the nursing home resident: An examination of the ombudsman function and its relationship to licensing and certification activities in insuring quality of care. Washington, DC: Institute of Medicine Committee on Nursing Home Regulation.

California Advocates for Nursing Home Reform. (2009). Governor’s severe cuts to ombudsman program expose elders to abuse and neglect. Retrieved October15, 2009, from, http://www.canhr.org/newsroom/releases/2008/PressRelease20081010.html

Cherry

R. L.

(1991). Agents of nursing home quality of care: Ombudsmen and staff ratios revisited. The Gerontologist, 31, 302-308.

Cherry

R. L.

(1993). Community presence and nursing home quality of care: The ombudsman as a complementary role. Journal of Health and Social Behavior, 34, 336-345.

10.

Colello

K. J.

(2008). Older Americans Act: Long-Term Care Ombudsman Program (CRS Report for Congress, Order Code RS21297). Retrieved October 15, 2009, from http://aging.senate.gov/crs/aging12.pdf

11.

Denzin

N. K.

(1978). The research act (2nd ed.). New York: McGraw Hill.

12.

Estes

C. L.

Zulman

Goldberg

Ogawa

(2002). The Long Term Care Ombudsman Program: Independence and the ability to fully represent residents. In Lindberg

(Ed.), The Long Term Care Ombudsman Program: Rethinking and retooling for the future (17-21). Midland, MI: National Association of State Long Term Care Ombudsman Programs.

13.

Estes

C. L.

Zulman

D. M.

Goldberg

S. C.

Ogawa

(2004). State Long-Term Care Ombudsman Programs: Factors associated with perceived effectiveness. The Gerontologist, 44, 104-115.

14.

Freeman

I. C.

(2000). Uneasy allies: Nursing home regulators and consumer advocates. Journal of Aging and Social Policy, 11, 127-135.

15.

General Accounting Office. (1992). The Older Americans Act: Access to and utilization of the Ombudsman Program (Report No. GAO/PEMD-94-19). Washington, DC: Author.

16.

Green

Johnson

(1996). Dissemination and utilization of health promotion and disease prevention knowledge: Theory, research and experience. Canadian Journal of Public Health, 87, s11-s17.

17.

Hollister

(2008). Systems advocacy and the local Long-Term Care Ombudsman Program. Unpublished doctoral dissertation, University of California, San Francisco.

18.

Huber

Borders

K. W.

Badrak

Netting

F. E.

Nelson

H. W.

(2001). National standards for the Long-Term Care Ombudsman Program and a tool to assess compliance: The Huber Badrak Borders Scales. The Gerontologist, 41, 264-271.

19.

Huber

Borders

K. W.

Netting

F. E.

Kautz

J. R.

(2000). Interpreting the meaning of ombudsman data across states: The critical analyst-practitioner link. Journal of Applied Gerontology, 19, 3-22.

20.

Huber

Netting

F. E.

Kautz

J. R.

(1996). Differences in types of complaints and how they were resolved by local long-term care ombudsmen operating in/not in area agencies on aging. Journal of Applied Gerontology, 15, 87-101.

21.

Hunt

(2004a). History and role of the long-term care ombudsman program. Washington, DC: National Long-Term Care Ombudsman Resource Center.

22.

Hunt

(2004b). History and role of the long-term care ombudsman program: Teaching notes. Retrieved March 4, 2009, from http://www.ltcombudsman.org/uploads/LTCtchngnotesHandR.pdf

23.

Institute of Medicine. (1995). Real people, real problems: An evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act. Washington, DC: Institute of Medicine, Division of Health Care Services, National Academy of Sciences.

24.

Israel

B. A.

Schulz

A. J.

Parker

E. A.

Becker

A. B.

Allen

A. J.

III Guzman

(2003). Critical issues in developing and following community-based participatory research principles. In Minkler

Wallerstein

(Eds.), Community-based participatory research for health (pp. 57-76). San Francisco:Jossey-Bass.

25.

Kassner

Reinhard

Fox-Grage

Houser

Accius

(2008). A balancing act: State long-term care reform (Research Report 2008-10). AARP Public Policy Institute. Retrieved October 15, 2009, from http://assets.aarp.org/rgcenter/il/2008_10_ltc.pdf

26.

Keith

P. M.

(2000). Correlates of primary orientations of volunteer ombudsmen in nursing facilities. Journal of Aging Studies, 14, 373-384.

27.

Keith

P. M.

(2001a). Role orientations, attributions to nursing facility personnel, and unresolved complaints of volunteers in an ombudsman program. Journal of Gerontological Social Work, 34, 33-40.

28.

Keith

P. M.

(2001b). Support from others and efficacy of volunteer ombudsmen in long-term care facilities. International Journal of Aging and Human Development, 52, 297-310.

29.

Monk

Kaye

L. W.

Litwin

(1984). Resolving grievances in the nursing home: A study of the ombudsman program. New York: Columbia University Press.

30.

National Association of State Ombudsman Programs. (1998). Long-Term Care Ombudsman Program core principles: Independence in representing residents (NASOP Position Paper). Washington, DC: Author.

31.

National Association of State Ombudsman Programs. (2003). The LTCOP: Rethinking and retooling for the future. Atlanta, GA: Author.

32.

National Ombudsman Resource Center. (2009). Ombudsman program history. Retrieved October 15, 2009, from http://www.ltcombudsman.org/about-ombudsmen/program-history

33.

Nelson

H. W.

Hooker

DeHart

K. N.

Edwards

J. A.

Lanning

(2004). Factors important to success in the volunteer long-term care ombudsman role. The Gerontologist, 44, 116-120.

34.

Nelson

H. W.

Huber

Walter

K. L.

(1995). The relationship between volunteer long-term care ombudsmen and regulatory nursing home actions. The Gerontologist, 35, 509-514.

35.

Nelson

H. W.

Netting

F. E.

Huber

Borders

K. W.

(2004). Factors effecting volunteer ombudsman effort and service duration: Comparing active and resigned volunteers. Journal of Applied Gerontology, 23, 309-323.

36.

Netting

F. E.

Huber

Borders

K. W.

Kautz

Nelson

H. W.

(2000). Volunteer and paid ombudsmen investigating complaints in six states: A natural triaging. Nonprofit and Voluntary Sector Quarterly, 29, 419-438.

37.

Netting

F. E.

Huber

Kautz

J. R.

(1995a). Volunteer and paid long-term care ombudsmen: Differences in complaint resolution. Journal of Volunteer Administration, 13, 10-21.

38.

Netting

F. E.

Huber

Paton

R. N.

Kautz

J. R.

(1995b). Elder rights and the Long-Term Care Ombudsman Program. Social Work, 40, 351-357.

39.

Office of the Inspector General. (1991a). Effective ombudsman programs: Six case studies (Report No. OEI-02-90-02122). Washington, DC: U.S. Department of Health and Human Services.

40.

Office of the Inspector General. (1991b). Ombudsman output measures: Management advisory report (Report No. OEI-02-90-02121). Washington, DC: U.S. Department of Health and Human Services.

41.

Office of the Inspector General. (1991c). Successful ombudsman programs (Report No. OEI-02-90-02120). Washington, DC: U.S. Department of Health and Human Services.

42.

Office of the Inspector General. (1999a). Long-Term Care Ombudsman Program: Complaint trends (Report No. OEI-02-98-00350). Washington, DC: U.S. Department of Health and Human Services.

43.

Office of the Inspector General. (1999b). Long Term Care Ombudsman Program: Overall capacity (Report No. OEI-02-98-00351). Washington, DC: U.S. Department of Health and Human Services.

44.

Office of the Inspector General. (2003). State ombudsman data: Nursing home complaints (Report No. OEI-09-02-00160). Washington, DC: U.S. Department of Health and Human Services.

45.

Older Americans Act of 1978, 42 U.S.C. §3058g (Public Law 106-501).

46.

Persson

(2004). Volunteer ombudsmen in the nursing home: Obstacles to retention. Journal of Aging Studies, 18, 204-214.

47.

Pillemer

(1986). Risk factors in elder abuse: Results from a case control study. In Pillemer

Wolf

(Eds.), Elder abuse: Conflict in the Family (pp. 239-264). Dover, MA: Auburn House.

48.

U.S. Census Bureau. (2004). Table 1-RES: Estimates of the resident population by selected age groups for the United States and for Puerto Rico: July 1, 2004 (SC-EST2004-01-RES). Retrieved October 15, 2009, from http://www.census.gov/popest/states/asrh/SC-est2004-01.html

49.

U.S. Census Bureau. (2008). Table 2: Estimates of change for the minority population for the United States and States and state rankings: July 1, 2006 to July 1, 2007. Retrieved October 15, 2009, from http://www.census.gov/popest/states/asrh/

50.

Wheaton

S. K.

(2008, February 7). Memo on “improving NORS case and complaint data consistency and uniformity.” Washington, DC: Administration on Aging.

51.

Whitford

A. B.

Yates

(2002). Volunteerism and social capital in policy implementation: Evidence from the long-term care ombudsman program. Journal of Aging and Social Policy, 14(3), 61-73.