Many of the same problems facing long-term care operators across the country have also increasingly arisen as obstacles for state long-term care ombudsman programs in recent years, according to a report from the US Government Accountability Office.
Ombudsman programs are federally mandated to advocate for long-term care residents in all 50 states, Washington DC, Puerto Rico and Guam. While not regulators themselves, they may make recommendations to regulators and typically operate on a mixture of funding from federal, state and local governments.
As the US population ages and nursing home residents’ needs become more complex, ombudsman programs have struggled to keep up with the rising demand, Thursday’s report confirmed.
These heightened needs could arise from either more health conditions among residents or adverse events in facilities, according to interviews with five state ombudsman programs conducted by the GAO for the report.
“Officials from three states told us their programs now handle complex cases such as eviction from, or sexual assault that occurs in, facilities,” the report explained. “Officials from two states told us ombudsmen are increasingly serving residents with complex needs related to mental health, substance misuse, or cognitive impairment.”
Federal and state watchdogs have turned their attention onto nursing homes more frequently and sharply in recent months — triggering provider fears of an increasingly punitive approach to government oversight.
The presence of an ombudsman at a nursing home’s annual survey has been linked to increased likelihood of deficiencies from that survey.
But ombudsman programs are also suffering from funding issues and downstream staffing shortages that may sound all too familiar to providers.
An increase in the number of assisted living facilities in recent years means that ombudsman programs have been stretched thin. In 2022, state ombudsman programs spent around $140 million, including about $68 million of federal funding.
Meanwhile, staffing numbers that took a hit during the COVID-19 pandemic have still not recovered and a lack of sufficient funding means that replacement candidates may be offered as little pay as $13 or $14 an hour.
With resources scarce and demands on those limited resources only increasing, state ombudsman programs told the GAO that they are struggling to meet the needs of the residents they are designed to advocate for.
The publication of the GAO report signals government concern about these ongoing challenges, but it is unclear what steps may be taken to remedy them. GAO officials did not respond to McKnight’s requests for comment Thursday.
