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Trends in Long‐Term Care Ombudsman Program Funding and Its Relationship to Nursing Home Resident Care.

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Title: Trends in Long‐Term Care Ombudsman Program Funding and Its Relationship to Nursing Home Resident Care.
Authors: KENNEDY, KATHERINE A. (AUTHOR), KOSAR, CYRUS (AUTHOR), WILLIAMS, MADISON S. (AUTHOR), THOMAS, KALI S. (AUTHOR)
Source: Milbank Quarterly. Dec2025, Vol. 103 Issue 4, p1204-1223. 20p.
Subjects: Elder care, Research funding, Deinstitutionalization, Medical quality control, Long-term health care, Evaluation of human services programs, Scientific observation, Medical care for people with disabilities, Primary health care, Health policy, Patient advocacy, Descriptive statistics, Discharge planning, Government aid, Medical care for older people
Abstract: Policy PointsFunding that states' Long‐Term Care Ombudsman Programs (LTCOPs) receive must cover all activities in that state related to the care of all individuals in nursing homes (NHs) and board and care (i.e., residential care communities, assisted living, and similar care homes); over time, duties and demands have expanded without similar increases in funding.States are contributing more to their federally mandated LTCOPs than they have historically.Evidence from this study suggests that increased spending on LTCOPs is associated with improved NH resident care, supporting the National Academies of Sciences, Engineering, and Medicine's recent call for increased funding to LTCOPs. Context: Funded partially by the Older Americans Act, state Long‐Term Care Ombudsman Programs (LTCOPs) provide a critical role in serving as advocates for older adults in long‐term care (LTC) facilities. Ombudsmen regularly visit residents, resolve disputes, and assist with discharge planning. In 2022, the National Academies of Sciences, Engineering, and Medicine called for increased LTCOP funding to improve nursing home (NH) quality. However, it is unclear how changes in program funding are associated with the care provided to NH residents. Based on the functions that the LTC Ombudsmen are intended to provide, we hypothesized that increases in LTCOP spending would be associated with improved care in NHs. Methods: We examined 20‐year trends in funding for the LTCOP (2000 to 2019). Using 2011‐2019 data from the National Ombudsman Reporting System, LTCFocus.org, Centers for Medicare & Medicaid Services Care Compare, and the Area Health Resource File, we examined the relationship between LTCOP spending per LTC bed at the state level and NH outcomes, controlling for year, state, facility, and market characteristics. Findings: Overall, LTCOP funding increased over 20 years. However, the share of federal contributions to the LTCOP has decreased from 58.8% in 2000 to 46.9% of the total program's budget in 2019. The LTCOP spent an average of $37.30 per LTC bed in 2019, with wide state variation. In 2011, the average share of residents receiving antipsychotics was 25.4%, the share of those who were physically restrained was 2.9%, and the share of those with low‐care needs was 13.5%. For every $100 annual increase in total spending per bed, there was a statistically significant 1.32, 1.13, and 2.95 percentage–point decrease in the share of residents receiving antipsychotics, those who were physically restrained, and those who with low‐care needs, respectively. Conclusions: States that have increased funding for their LTCOP observe better NH resident care. These findings support calls to increase funding for LTCOPs. [ABSTRACT FROM AUTHOR]
Copyright of Milbank Quarterly is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Trends in Long‐Term Care Ombudsman Program Funding and Its Relationship to Nursing Home Resident Care.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Policy PointsFunding that states' Long‐Term Care Ombudsman Programs (LTCOPs) receive must cover all activities in that state related to the care of all individuals in nursing homes (NHs) and board and care (i.e., residential care communities, assisted living, and similar care homes); over time, duties and demands have expanded without similar increases in funding.States are contributing more to their federally mandated LTCOPs than they have historically.Evidence from this study suggests that increased spending on LTCOPs is associated with improved NH resident care, supporting the National Academies of Sciences, Engineering, and Medicine's recent call for increased funding to LTCOPs. Context: Funded partially by the Older Americans Act, state Long‐Term Care Ombudsman Programs (LTCOPs) provide a critical role in serving as advocates for older adults in long‐term care (LTC) facilities. Ombudsmen regularly visit residents, resolve disputes, and assist with discharge planning. In 2022, the National Academies of Sciences, Engineering, and Medicine called for increased LTCOP funding to improve nursing home (NH) quality. However, it is unclear how changes in program funding are associated with the care provided to NH residents. Based on the functions that the LTC Ombudsmen are intended to provide, we hypothesized that increases in LTCOP spending would be associated with improved care in NHs. Methods: We examined 20‐year trends in funding for the LTCOP (2000 to 2019). Using 2011‐2019 data from the National Ombudsman Reporting System, LTCFocus.org, Centers for Medicare & Medicaid Services Care Compare, and the Area Health Resource File, we examined the relationship between LTCOP spending per LTC bed at the state level and NH outcomes, controlling for year, state, facility, and market characteristics. Findings: Overall, LTCOP funding increased over 20 years. However, the share of federal contributions to the LTCOP has decreased from 58.8% in 2000 to 46.9% of the total program's budget in 2019. The LTCOP spent an average of $37.30 per LTC bed in 2019, with wide state variation. In 2011, the average share of residents receiving antipsychotics was 25.4%, the share of those who were physically restrained was 2.9%, and the share of those with low‐care needs was 13.5%. For every $100 annual increase in total spending per bed, there was a statistically significant 1.32, 1.13, and 2.95 percentage–point decrease in the share of residents receiving antipsychotics, those who were physically restrained, and those who with low‐care needs, respectively. Conclusions: States that have increased funding for their LTCOP observe better NH resident care. These findings support calls to increase funding for LTCOPs. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Milbank Quarterly is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/1468-0009.70061
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      – Code: eng
        Text: English
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        PageCount: 20
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    Subjects:
      – SubjectFull: Elder care
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Deinstitutionalization
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      – SubjectFull: Medical quality control
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      – SubjectFull: Long-term health care
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      – SubjectFull: Evaluation of human services programs
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      – SubjectFull: Discharge planning
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      – SubjectFull: Government aid
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      – SubjectFull: Medical care for older people
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      – TitleFull: Trends in Long‐Term Care Ombudsman Program Funding and Its Relationship to Nursing Home Resident Care.
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              Text: Dec2025
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