Ombuds Staffing Levels

States can maintain adequate staffing levels of long-term ombuds. The federal long-term care ombuds program, administered and partially funded by the states, provides ombuds who act as advocates to help residents and their families obtain a better quality of life in long-term care settings.1

Does the state’s long-term care ombuds staffing level meet the Institute of Medicine’s (IOM) minimum acceptable standards?

States receive a "meets policy" if their ratio of paid ombuds per long-term care facility beds is one to 2,000 or fewer, the minimum determined by the 1994 landmark IOM report. States receive a "no policy" if their ratio is greater than one to 2,000 or more.2

State Strength of Policy Change from 2007
Alabama Meets Policy Same
Alaska Meets Policy Same
Arizona Meets Policy Better
Arkansas No Policy Same
California Meets Policy Better
Colorado Meets Policy Same
Connecticut No Policy Same
Delaware Meets Policy Same
District of Columbia Meets Policy Same
Florida No Policy Same
Georgia Meets Policy Same
Hawaii No Policy Same
Idaho Meets Policy Same
Illinois No Policy Same
Indiana No Policy Same
Iowa No Policy Same
Kansas No Policy Same
Kentucky Meets Policy Same
Louisiana No Policy Worse
Maine No Policy Worse
Maryland Meets Policy Same
Massachusetts Meets Policy Same
Michigan No Policy Same
Minnesota No Policy Same
Mississippi Meets Policy Same
Missouri No Policy Same
Montana Meets Policy Same
Nebraska No Policy Same
Nevada Meets Policy Same
New Hampshire No Policy Worse
New Jersey No Policy Same
New Mexico Meets Policy Same
New York No Policy Same
North Carolina No Policy Same
North Dakota No Policy Same
Ohio Meets Policy Same
Oklahoma Meets Policy Same
Oregon No Policy Same
Pennsylvania No Policy Same
Rhode Island Meets Policy Same
South Carolina Meets Policy Same
South Dakota No Policy Same
Tennessee No Policy Same
Texas No Policy Same
Utah Meets Policy Same
Vermont Meets Policy Same
Virginia No Policy Same
Washington No Policy Same
West Virginia Meets Policy Same
Wisconsin No Policy Same
Wyoming Meets Policy Same

Policy Indicator Counts
Meets Policy: 
Limited Policy: 
Weak Policy: 
No/Harmful Policy: 

Data Source:U.S. Department of Health and Human Services, Administration on Aging, "National Ombudsman Reporting System Data Tables: Table A-1: Selected Information by State for FY 2008 [Column T]," available at, accessed September 8, 2010.


1 42 U.S.C. § 3058g (2000).

2 Institute of Medicine, Real People, Real Problems: An Evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act (Washington: National Academy Press, 1994), 175, Table 5.5d. The ratio of paid ombuds program staff (funded by state, regional, and local governments, with some state responsibility for overseeing the regional and local programs) to the number of beds in all facilities is obtained by comparing the number of paid ombuds program staff to the number of beds in all facilities (licensed nursing facilities, and licensed board and care, and similar facilities). Although states may have an effective volunteer ombuds corps, the IOM report determined that the appropriate measure involved paid ombuds.  The number used in the Report Card is for full-time equivalents (FTEs), i.e., not all of the ombuds serve this role in a full-time capacity.

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