Objective

To determine the extent of implementation of the five recommendations made in our initial audit report, Long-Term Care Ombudsman Program (Report 2018-S-48).

About the Program

Under the federal Older Americans Act of 1965 (Act), to be eligible for certain federal grants, each state is required to establish an Office of the State Long-Term Care Ombudsman. In New York, this office (hereafter referred to as the Office) is administratively housed within the New York State Office for the Aging (NYSOFA). The Office’s mission is to serve as an advocate and resource for both older adults and persons with disabilities who live in Long-Term Care (LTC) facilities, such as nursing homes, assisted living, and board and care homes. According to NYSOFA, there are about 1,500 facilities in the State, housing more than 160,000 residents who have a need for ombudsman services.

The Office’s responsibilities include helping to ensure that residents have regular, timely, private, and unimpeded access to ombudsman services; identifying, investigating, and resolving complaints made by or on behalf of residents in a timely manner; establishing procedures for training authorized representatives and local ombudsmen and their staff; and systems advocacy, including analyzing and monitoring laws and regulations that relate to LTC facilities and submitting an annual report that covers progress and problems in providing services. Although ombudsmen may be paid staff or volunteers, the Office relies heavily on a large corps of trained volunteers to visit the approximately 1,500 LTC facilities in the State, establish relationships with residents, and respond to resident complaints.

Our initial audit report, issued on October 3, 2019, sought to determine whether NYSOFA’s LTC Ombudsman Program was carrying out its responsibilities under the law, including adequately advocating for the needs of the people it’s intended to serve. Our audit covered the period October 1, 2015 to January 30, 2019. During the initial audit, we found that certain system-generated Office data may not have been sufficiently reliable for NYSOFA’s use for analysis at the facility, regional program, or complaint level, which may limit its usefulness in decision making. Furthermore, we found that many residents of LTC facilities in the State lack regular access to ombudsman services, due in part to a decline in the number of volunteers combined with a lack of paid regional program staff. Many facilities are not visited quarterly by an ombudsman, as recommended, leaving residents and their families without a reliable, regular avenue for voicing concerns. Specifically, 11 of the 15 regional programs fell short of the recommended minimum number of staff for the federal fiscal year (FFY) ending September 30, 2018, and about 30 percent of facilities were not visited by an ombudsman, leaving residents with reduced access to these important services. In addition, we also found that many volunteers were not meeting training requirements. Finally, we found that the Office could benefit from developing a long-term systems advocacy plan that is informed by reliable data.

Key Finding

NYSOFA has made significant progress in addressing the problems we identified in the initial report, and has implemented all five of the recommendations.