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About the Long-Term Care Ombudsman Program

The Long-Term Care Ombudsman program (Ombudsman program/LTCOP) advocates for residents of nursing homes, residential care communities (e.g., board and care homes, assisted living facilities), and other similar adult care facilities.

Under the Older Americans Act (OAA), every state is required to have an Ombudsman program that addresses complaints and advocates for improvements in the long-term care system. Each state has an Office of the State Long-Term Care Ombudsman (Office), headed by a full-time State Long-Term Care Ombudsman (Ombudsman) who directs the program statewide. Across the nation, staff and thousands of volunteers are designated by State Ombudsmen as representatives to directly serve residents.

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The Long-Term Care Ombudsman Program is Under Threat...What's Happened So Far:

In April of this year, a budget passback from the Office of Management & Budget (OMB) to the Department of Health & Human Services (DHHS) proposed to cut $40 billion from the DHHS 2026 budget. Each year, government agencies submit their proposed budget to the president for inclusion in the president’s proposed fiscal year budget. OMB reviews the proposed budget and then “passes it back” to the agency with additions, changes, or deletions. The agency can appeal the pass back. Ultimately, however, it is the president’s budget, and what is included is up to the president. Importantly, a proposed budget lays out a president’s priorities, but it is Congress that passes budgets. Congress is in no way bound by the president’s proposed budget.

The passback makes draconian cuts to many DHHS programs, including the Long-Term Care Ombudsman program (LTCOP), a vital program that, among many services, provides advocates for residents of long-term care facilities. The dissolution of the LTCOP would place all residents in settings served by Ombudsman program representatives at risk.

May 2025: The “skinny,”  version of the president’s FY2026 discretionary budget, a high-level overview of the Administration’s priorities, was released. There are no explicit references to cuts to LTCOP in the skinny budget. However, the full budget has yet to be released.  The skinny budget does not include funding levels for several agencies within DHHS, such as the Administration for Community Living (currently targeted for dismantling by the Administration), and the Administration for Children and Families (the agency where it is reported that the Long-Term Care Ombudsman Program and other Elder Justice Programs are being moved).  When the full FY2026 budget proposal is released, we will know whether the proposed cuts to the LTCO, which were in budget passback, are included.

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In the Last Year the Ombudsman Program:

Conducted 379,982 facility visits to speak with residents in more than 50,000 long-term care facilities

Received and investigated 205,322 complaints

Supported residents and family members by attending over 20,528 resident council meetings and more than 1,284 family council meetings

Key Responsibilities of the LTCOP Include:

Investigating and resolving complaints on behalf of residents.

Ombudsman programs address a wide range of concerns, including improper discharges, medication errors, call bell response delays, privacy and dignity violations, and allegations of physical, emotional, or financial abuse.

Maintaining a regular presence in facilities and observing care conditions.

Through frequent facility visits, Ombudsman program representatives engage with residents,
identify recurring issues such as inadequate staffing, and track trends affecting the overall
quality of care and life.

Educating and empowering residents, families, and the community.

The LTCOP provides information on residents’ rights, abuse prevention, care planning, and how to choose or navigate long-term care services, including helping residents make informed decisions and advocate for themselves.

Advocating for systemic improvements in long-term care

The LTCOP promotes changes that enhance resident protections, encourage transparency and accountability, and improve care quality—such as supporting legislation for higher staffing ratios or holding facilities accountable when providing substandard care. They bring attention to systemic failures and work with lawmakers, regulators, and community partners to advance meaningful, resident centered improvements in long-term services and supports.

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Find a Long-Term Care Ombudsman Program in Your Area

Long-term care ombudsmen are advocates for residents of nursing homes and assisted living facilities. Ombudsmen provide information about how to find a facility and what to do to get quality care.

Based on the National Ombudsman Reporting System (NORS) Data:

53

State Long-Term Care Ombudsman programs

1,500

Full-Time Staff

3,400

Volunteer Representatives Trained to Investigate and Resolve Complaints

Frequently Asked Questions (FAQs)

What Does the Long-Term Care Ombudsman Do?

State Ombudsmen and their designated representatives work to resolve problems individual residents face and effect change at the local, state, and national levels to improve quality of care.

In addition to identifying, investigating, and resolving complaints, Ombudsman program responsibilities include:

  • Educating residents, their family and facility staff about residents’ rights, good care practices, and similar long-term services and supports resources
  • Ensuring residents have regular and timely access to Ombudsman services
  • Providing technical support for the development of resident and family councils
  • Advocating for changes to improve residents’ quality of life and care
  • Providing information to the public regarding long-term care facilities and services, residents’ rights, and legislative and policy issues
  • Representing resident interests before governmental agencies
  • Seeking legal, administrative, and other remedies to protect residents

What Does the Ombudsman Program Represent?

The Ombudsman program’s mandate is to represent the resident and assist at his or her direction. The Older Americans Act (OAA) requires the Ombudsman program to have resident consent prior to investigating a complaint or referring a complaint to another agency. When someone other than the resident files a complaint, the ombudsman must determine, to the extent possible, what the resident wants.

What Types of Complaints Does the Ombudsman Program Investigate?

Ombudsmen handle a variety of complaints about quality of life and care, such as a violation of residents’ rights, a slow response to requests for assistance, and improper discharge/eviction. Not all complaints are about the care provided by a facility, some complaints are about outside agencies, services, or individuals (e.g., Medicaid or Medicare benefits). They can also receive and respond to complaints from individuals other than the resident (e.g. family member) but need resident permission to investigate or share information.

How Can I Contact the Ombudsman Program?

To learn about long-term care facilities in your area and/or report concerns regarding care or other problems to the Ombudsman program, find the program near you.

How Can I Get Involved?

Most Ombudsman programs work with trained and designated volunteers. To help advocate with, and for, long-term care residents find the program near you.

How Do I Find More Information about the Ombudsman Program?

Share How the Ombudsman Program Has Helped You

We want to hear from YOU

Tell us about a time when a representative from the long-term care Ombudsman program has assisted you or your family. By sharing your story, you help inform our advocacy.

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