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State Long Term Care Ombudsman Programs: Factors Associated With Perceived Effectiveness

Correspondence: Address correspondence to Carroll L. Estes, PhD, Institute for Health & Aging, University of California, San Francisco, 3333 California Street 340, San Francisco, CA 94118. E-mail: cestes{at}itsa.ucsf.edu

Purpose: This article reports findings from a nationwide study on factors associated with the perceived effectiveness of state Long Term Care Ombudsman Programs (LTCOPs). Design and Methods: Researchers conducted telephone interviews with ombudsmen from the 50 state programs as well as from Washington, DC, and Puerto Rico. Data from the National Ombudsman Reporting System were incorporated into the study, and statistical tests analyze associations between self-rated program effectiveness and adequacy of resources, organizational placement–autonomy, interorganizational relationships, and other variables. Results: Several factors limit the perceived effectiveness of state LTCOPs, including insufficient funding and insufficient LTCOP autonomy caused by organizational placement. Despite these problem areas, state ombudsmen report that their programs meet statutorily mandated requirements with varying degrees of effectiveness. Findings show significant positive associations between program funding and paid and volunteer staff levels and between the ratio of long-term care beds per ombudsman and the percentage of nursing facilities visited. Sufficient funding is positively associated with perceived effectiveness of work with nursing facilities.Implications: Sufficient resources, sufficient organizational autonomy, and a supportive political and social environment are key elements in achieving varying types of perceived effectiveness in the state LTCOPs. Research is needed to extend this work to local ombudsman programs and to compare self-rated effectiveness with other outcome measures.

Key Words: Long Term Care Ombudsman Program • Resources • Organizational placement • Organizational autonomy • Long-term care quality • Perceived effectiveness