Objective

To determine whether the New York State Office for the Aging’s (NYSOFA) Long-Term Care (LTC) Ombudsman Program is 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.

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 NYSOFA. The Office’s mission is to serve as an advocate and resource for both older adults and persons with disabilities who live in 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 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.

Key Findings

• Certain system-generated Office data (complaint records, number of volunteers and paid staff, and number of LTC facilities and associated beds) may not be sufficiently reliable for NYSOFA’s use for analysis at the facility, regional program, or complaint level, which may limit its usefulness in decision making.
• 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. As of January 2019, about 600 of the approximately 1,500 LTC facilities in the State – about 40 percent – have an assigned volunteer ombudsman, leaving the remaining 900 facilities to be covered by only 50 paid local staff, which is about half the recommended minimum number. Eleven of the 15 regional programs fell short of the recommended minimum number of staff for the federal fiscal year 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.

Key Recommendations

• Improve the reliability of system-generated Office data by working with the existing vendor to address unresolved issues and by implementing ways to prevent and detect input errors.
• Take steps to identify and understand reasons for the decline in volunteers and differences in regional program results. Use the resulting information to develop and implement strategies to improve access to ombudsman services.