Specialized Information for:

Nursing HomesAssisted Living/Board & Care Home and Community Based Services



Plenary – Advocating for Real Reform Through the New Federal HCBS Regulations (2015 Consumer Voice Annual Conference, presented by: Justice In Aging)

Quality Care, No Matter Where: Successful Nursing Home Transitions Report

This report produced by the National Consumer Voice for Quality Long-Term Care examines nursing home transitions nationwide and how they can be improved from the perspective of both the individuals who had moved back into the community and the programs that assist them.  The findings from interviews and surveys with these individuals are presented, along with policy recommendations for making the transition process go more smoothly for consumers from beginning to end.

The Who, What, When, Where and How of Ombudsman Services for Home Care Consumers (November 2013)

  • Presented by: Beck Kurtz, Director of Office of Long-Term Care Ombudsman Programs - Administration of Community Living

Georgia Home Care Ombudsman (November 2013)

  • Presented by: Melanie McNeil, Georgia State Long-Term Care Ombudsman

Ombudsman Services for Home-Care Consumers in DC (November 2013)

  • Presented by: Lynne Person, DC State Ombudsman - Office of the DC Long-Term Care Ombudsman Program

Consumer to Consumer: Tips for a Successful Nursing Home Transition
Moving out of a nursing home and back into the community can be difficult.  The purpose of this Tip Sheet is to share with you suggestions for steps you can take to make your move go as smoothly as possible. These recommendations come directly from people who have already transitioned so you can learn from their experiences.
This Tip Sheet is designed to be used along with a checklist that takes you step by step through what you can do before, during and after your move in order to make your transition a success.  The checklist is included with permission of the Independent Living Research Utilization (ILRU) and IL-NET. 

How To Guide for State and Local Advocates
This How To Guide is intended to equip state and local advocates with information and tools to advocate for improvements to nursing home transitions. The recommendations found in the Quality Care, No Matter Where: Successful Nursing Home Transitions Report are elaborated on and examples are provided within this guide. 

A Right to Person-Centered Care Planning
This report from Justice in Aging analyzes how well states are implementing the 2014 rule that creates the right to person-centered care planning for Medicaid consumers of Long-Term Services and Supports.

Charting the Long-Term Care Ombudsman Program's Role in a Modernized Long-Term Care System
This Long-Term Care Ombudsman Program Strategic Directions Work Group Meeting Report, by the National Ombudsman Resource Center (NORC), prepared by the National Association of State Units on Aging (NASUA), seeks to help long-term care ombudsmen to define their role and develop coordination efforts in a new long-term care system.

Home Care Ombudsman Programs Status Report: 2007
Ombudsman programs in twelve states are authorized or mandated under state law to provide advocacy on behalf of consumers who receive home and community based care. Over the last seven years the Long-Term Care Ombudsman Program's involvement in home care advocacy has changed little; the numbers of complaints, types of individual and systems issues, and the level of support have remained relatively stable. This paper updates and expands information previously collected on home care ombudsman programs in 2000. New information reported here was gathered in April/May 2007 through a web-based questionnaire and a teleconference.

The Role of the Long-Term Care Ombudsman in Home Care Advocacy (June 2001)
This technical assistance paper, prepared by the National Association of State Units on Aging (NASUA), includes information on the scope of Home Care Ombudsman Programs' responsibilities, the types of complaints which may be reported, program funding, access issues, training and systems advocacy activities.

Strategy Brief:  Ombudsman Program Connections to Home- and Community-Based Service (July 2004)
This document presents discussion highlights from a National Dialogue Forum convened by NASUA on the topic. The primary issues discussed by the participants included: the ombudsman program's role in providing information about home care to consumers; consumer access to home care services; advocacy for quality home care options and relationships with the home- and community-based services system.

NSCLC WEBINAR: Understanding and Impacting Implementation of New Medicaid Home and Community-Based Services Rules
This webinar and a new NSCLC guide to the new rules provides consumer advocates and other stakeholders with a clear explanation of the rules and share guidance for state engagement. Advocates, state policymakers, national advocates, and regulators can learn about what the rule means for residential settings, service planning, and the community-integration transition process.

HCBS Advocacy.org
HCBSadvocacy.org is a platform for the aging and disability communities to post information and resources regarding the new HCBS settings rule and steps each state is making to comply with the new rule.

Transitions and Long-Term Care: A Look at MDS 3.0 Section Q and Money Follows the Person (January 30, 2012)
The Administration on Aging hosted a webinar giving an overview of MDS 3.0 Section Q and Money Follows the Person and detailing how these programs affect the aging network.

Webinar Materials:

ADRC Technical Resource Center 
The ADRC Grant Program, a cooperative effort of the Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS), was developed to assist states in their efforts to create a single, coordinated system of information and access for all persons seeking long term support to minimize confusion, enhance individual choice, and support informed decision-making. The ADRC Technical Assistance Exchange (TAE) provides technical assistance through one-on-one support, semi-annual ADRC national meetings, weekly newsletters, monthly webcasts and a variety of other ways.

Money Follows the Person ToolKit
Developed by the Rutgers Center for State Health Policy, National Academy for State Health Policy and the NCB Development Corporation in 2006, this toolkit compiles information from numerous sources about nurisng home transition and Money Follows the Person (MFP)  initiatives.

Money Follows the Person: Impediments to Implementation: A Fact Sheet on Program Start up, Capacity and Access
Developed by NASUAD. The Money Follows the Person Rebalancing Demonstration Program (MFP) was designed to assist states in rebalancing their long-term care systems, and to help Medicaid beneficiaries transition from institutions to the community. Since its inception, MFP has faced many barriers to implementation, most of which have resulted in the program transitioning fewer individuals than originally anticipated. In efforts to clarify the origin and impact of these early problems and ongoing capacity and access challenges, NASUAD prepared a fact sheet, outlining some of the most commonly-reported programmatic complications, such as the unanticipated consequences of statutory compliance and a lack of accessible, affordable housing for MFP participants.

Nursing Facility Transition: A Resource Kit for Long-Term Care Ombudsman
This resource kit provides information and materials for ombudsman programs about nursing facility transition. It is designed to provide state ombudsmen with an easy to use reference point for basic information about state and federal nursing facility diversion and transition initiatives and to facilitate exploration of ombudsman program roles in helping residents who wish to leave the nursing facility.

Federal Regulations

On January 10, 2014 the Centers for Medicare and Medicaid Services (CMS) issued the Medicaid Home and Community-Based Services (HCBS) settings final rule (CMS-2249-P2).  The final regulation addresses several sections of Medicaid law under which states may use federal Medicaid funds to pay for HCBS. The rule establishes requirements for the qualities of settings that are eligible for reimbursement for Medicaid HCBS provided under sections 1915(c), 1915(i), and 1915(k). Click here to read the final rule.

CMS has released several fact sheets on the final rule, which can be viewed here:

State Transition Plans for New Medicaid HCBS Regulations: Four Tips for Consumer Advocates

New Medicaid Home and Community-Based Services Rules - SLTCO Dialogue (May 28, 2014)
This webinar discussed the new Medicaid Home and Community-Based Services Rules that went into effect March 17, 2014, which for the first time set standards to ensure Medicaid HCBS is provided in the most integrated community setting and require person-centered care.  Eric Carlson with the National Senior Citizens Law Center and Robyn Grant with the Consumer Voice gave a quick overview of the new rules and how they will impact consumers, and Becky Kurtz with AoA at ACL and Elizabeth Priaulx with the National Disability Rights Network shared the federal perspective and new resources.

FAQs Concerning Medicaid Beneficiaries in Home and Community-Based Settings who Exhibit Unsafe Wandering or Exit-Seeking Behavior (December 2016)
The Centers for Medicare & Medicaid Services (CMS) released FAQs cocerning Medicaid Beneficiaries in Home and Community-Based Settings who Exhibit Unsafe Wandering or Exit-Seeking Behavior.  These FAQs give states and stakeholders guidance on how to protect individual choice and adhere to the requirements of person-centered planning for those individuals with dementia and who exhibit unsafe wandering and exit-seeking behaviors. In the FAQs, CMS highlights that "person-centered planning, staff training and care delivery are core components of provider operations to meet HCBS requirements while responding to unsafe wandering or exit-seeking behavior in an individualized manner." 

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