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National Long-Term Care Ombudsman Resource Center (NORC)

About the Long-Term Care Ombudsman Program and How NORC Supports the Program’s Work

About NORC?

NORC provides support, technical assistance, and training to the 53 State Long-Term Care Ombudsman Programs and their statewide networks. NORC’s objectives are to enhance the skills, knowledge, and
management capacity of the State programs to enable them to effectively represent resident interests in both individual and systems advocacy.

NORC is funded by the U.S. Administration for Community Living (ACL) and operated by the National Consumer Voice for Quality Long-Term Care (Consumer Voice). Consumer Voice has actively supported Ombudsman programs by operating NORC for over 30 years.

NORC provides support, technical assistance, and training to the 53 State Long-Term Care Ombudsman Programs and their statewide networks. NORC’s objectives are to enhance the skills, knowledge, and
management capacity of the State programs to enable them to effectively represent resident interests in both individual and systems advocacy.

NORC is funded by the U.S. Administration for Community Living (ACL) and operated by the National Consumer Voice for Quality Long-Term Care (Consumer Voice). Consumer Voice has actively supported Ombudsman programs by operating NORC for over 30 years.

What We Do

To ensure the needs of Ombudsman programs across the country are being addressed, NORC incorporates input from Ombudsman programs, the National Association of State Ombudsman Programs (NASOP), the National Association of Local Long Term Care Ombudsmen (NALLTCO), and other relevant organizations in our work.

To support Long-Term Care Ombudsman programs in advocacy with, and for, residents in long-term care, NORC:

Training

Provides training opportunities, including webinars, online courses, and in-person sessions.

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Technical Assistance

Provides consultation for Ombudsman programs, both one-on-one and in groups.

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Resources

Develops and disseminates resources to assist with skill development and program management.

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Program Promotion

Increases awareness of the important role of the Ombudsman program in improving long-term care.

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Volunteer Support

Supports Ombudsman program volunteer recruitment, training, and retention.

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Information and Referral

Provides information to residents and families, including referrals for Ombudsman program services.

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Meet the Team

Amity Overall-Laib

Director

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Katie O’Hearn

Manager, Program and Outreach

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Lori Walsh

Policy and Program Specialist

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MEET THE CONSUMER VOICE TEAM

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About the Ombudsman Program

What is the Long-Term Care Ombudsman program?

The Long-Term Care Ombudsman program (LTCOP/Ombudsman program) is the only federal program mandated to advocate with, and for, residents of long-term care facilities. The LTCOP advocates for residents of nursing homes, residential care communities (e.g., board and care homes, assisted living facilities), and other similar adult care facilities.

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What does the LTCOP do?

The LTCOP resolves problems that impact residents’ rights, quality of life, and quality of care, and works to improve policies at the local, state, and national levels. In addition to identifying, investigating, and resolving complaints, Ombudsman program responsibilities include:

Educating residents, their families, and facility staff about residents’ rights, good care practices, and similar long-term services and supports resources.

Ensuring residents have regular and timely access to ombudsman services.

Providing technical support for the development of resident and family councils.

Advocating for changes to improve residents’ quality of life and care.

Providing information to the public regarding long-term care facilities and services, residents’ rights, and legislative and policy issues.

Representing resident interests before governmental agencies.

Seeking legal, administrative, and other remedies to protect residents.

What concerns does the program address?

Ombudsman programs help residents, family members, and others understand residents’ rights and support residents in exercising their rights guaranteed by law.

Ombudsman programs handle a variety of complaints about quality of life and care, including improper discharges, medication errors, call bell response delays, privacy and dignity violations, and allegations of physical, emotional, or financial abuse.

Who can use Ombudsman program services?

All states, as well as Washington D.C., Puerto Rico, and Guam, are required to have an Office of the State Long-Term Care Ombudsman headed by a full-time State Long-Term Care Ombudsman who directs the statewide program. The Ombudsman program’s mandate is to represent the resident and assist per resident direction.

Anyone can contact the program with concerns. However, when someone other than the resident files a complaint, the program must determine, to the extent possible, what the resident wants and follow resident direction (as possible). All services provided by the LTCOP are free and confidential.

How do I contact an Ombudsman program?

Locate an Ombudsman program by clicking below.

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According to the National Ombudsman Reporting System (NORS) Data

53

State Long-Term Care Ombudsman Programs

1,500

Full-Time Staff

3,400

Volunteer Representatives Trained to Investigate & Resolve Complaints

Long-Term Care Ombudsman Program History

1970s

The Nursing Home Ombudsman Program was created as part of President Nixon’s initiative to improve conditions…

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1980s

In 1981, OAA amendments expanded Ombudsman Program coverage to include board and care homes. The program name…

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1990s

The 1992 amendments to the OAA created the Vulnerable Elder Rights Protection Activities, Title VII of the OAA…

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2000s

The 2000 OAA amendments retained and updated Ombudsman program provisions in Titles II, III and VII…

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2010s

The Long-Term Care Ombudsman Programs Final Rule was published in February 2015. To allow states appropriate time…

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2020s

2020 OAA amendments clarified that the LTCOP can provide and financially support recognition for individuals…

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Get Involved

Interested in learning more about NORC and/or the Long-Term Care Ombudsman program?

Volunteer

Locate an Ombudsman program near you to inquire about volunteer opportunities.

VOLUNTEER

Join Our Listserv

Join our Listserv to learn about our resources, training opportunities, and more!

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Resources

Learn more about the Ombudsman program with these key resources.

What You Must Know

This brief resource explains what the Ombudsman program does and does not do and provides answers to frequently asked questions.

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Infographic

Brief visual overview of the impact and importance of the Ombudsman program.

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Stay Connected

Sign up for NORC emails to be the first to know about new resources and upcoming training opportunities.

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Contact Us

We are here to help! Contact us for assistance or information.

CONTACT
Amity Overall-Laib
Director, National Long-Term Care Ombudsman Resource Center

Amity Overall-Laib currently serves as the Director of the National Ombudsman Resource Center (NORC). Prior to this role, Amity served as a local long-term care ombudsman in Texas for six years advocating for residents in 65 nursing homes and 130 assisted living facilities in a 12-county region. During her tenure in Texas, she led the formation of the Gulf Coast Culture Change Coalition, resulting in two free conferences for long-term care consumers, providers, advocates, and regulators promoting Culture Change practices and has presented during local, state, and national conferences. Amity also had the pleasure of representing fellow local ombudsmen on the Board of Directors for NALLTCO (National Association of Local Long Term Care Ombudsmen). Amity was previously a consultant to NORC and then served as theManager of Program and Policy. Amity has a master’s degree in sociology from the University of Houston.

Katie O’Hearn
Manager, Program and Outreach

Katie O’Hearn joined the National Ombudsman Resource Center in November 2015 and currently serves as the Manager of Program and Outreach. In her role, she is responsible for updating and managing the NORC website and clearinghouse of information, assisting with special projects, providing technical assistance, and enhancing outreach and communication with state and local Ombudsman programs. Prior to joining the Consumer Voice, she worked as an intern for C-SPAN, volunteered in a nursing home, and worked as a Communication Consultant with the Consumer Voice and NORC. Katie graduated Magna Cum Laude from Saint Vincent College in 2015 with a B.A. in Communication and a minor in Marketing.

Lori Walsh
Policy and Program Specialist

Lori earned a Bachelor of Science in Elementary Education at Salem State University in Salem, Massachusetts, working her way through school as a nursing assistant in a local nursing home. She joined CARIE as a Long-Term Care Ombudsman in 1997 after advocating on behalf of Philadelphia nursing home residents who were restricted in their right to vote.  In her 27-year tenure at CARIE, she held several positions but most recently, as a program director where she supported staff on various advocacy initiatives, including managing two long term care ombudsman programs. Forever interested in systemic advocacy, Lori went back to school during the pandemic and obtained a master’s degree in public and policy and management from the University of Pittsburgh. She joined Consumer Voice in 2024. In her position, she supports state advocacy to improve accountability and transparency in nursing home finances and ownership.

1970s

The Nursing Home Ombudsman Program was created as part of President Nixon’s initiative to improve conditions and respond to widespread reports of abuse in the nation’s nursing facilities. To test effectiveness, the initiative started nursing home ombudsman demonstration projects in seven states. In 1978, amendments to the Older Americans Act (OAA) defined program functions and responsibilities and required every state to have an Ombudsman program.

1980s

In 1981, OAA amendments expanded Ombudsman Program coverage to include board and care homes. The program name was changed from Nursing Home Ombudsman to Long-Term Care Ombudsman to reflect this change. In 1987, OAA amendments made substantive changes in the Ombudsman Program, including requiring states to ensure LTCOP access to facilities, residents, and resident and facility records; immunity to the Ombudsman and program representatives for the good faith performance of their duties; and prohibitions against willful interference with the official Ombudsman program duties.

1990s

The 1992 amendments to the OAA created the Vulnerable Elder Rights Protection Activities, Title VII of the OAA. The Ombudsman program was moved into Title VII, which also included Programs for Prevention of Elder Abuse, Neglect, and Exploitation; the State Elder Rights and Legal Assistance Development Program; and an Outreach, Counseling, and Assistance Program. The 1992 amendments also included the creation of an Office of the State Long-Term Care Ombudsman (the State Ombudsman Office) and some clarification of conflicts of interest.

2000s

The 2000 OAA amendments retained and updated Ombudsman program provisions in Titles II, III and VII, including making the conflict of interest provisions more specific and narrowing the Ombudsman Title III minimum funding requirement. In 2004, in response to Government Accounting Office (GAO) recommendations, the Administration on Aging (AoA) launched National Ombudsman Reporting System (NORS) Consistency Training, a four-part program to improve the consistency and uniformity in recording case, complaint and other data in the NORS system, nationwide. The 2006 OAA amendments included the term “assisted living” in the revised definition of “board and care” as it applies to section 712 of the Act.

2010s

The Long-Term Care Ombudsman Programs Final Rule was published in February 2015. To allow states appropriate time to make necessary changes to comply with the final rule, the effective date was July 1, 2016. The rule added clarity to many of the program responsibilities and provisions in the Older Americans Act. The 2016 OAA amendments provided more clarity and additional authority to the Long-Term Care Ombudsman program in several areas. Highlights of the amendments pertinent to the Ombudsman program include: authorized the program to serve all long-term care facility residents regardless of their age; authorized the program to serve residents transitioning from a long-term care facility to a home-care setting (when feasible); clarified that the program may work to resolve complaints on behalf of residents unable to communicate their wishes, including those lacking an authorized representative; required programs to actively encourage and assist in the development of resident and family councils in long-term care facilities; clarified that the program is considered a “health oversight agency” for purposes of the Health Insurance Portability and Accountability Act (HIPAA).

2020s

2020 OAA amendments clarified that the LTCOP can provide and financially support recognition for individuals designated as volunteer representatives and may reimburse or otherwise provide financial support for any costs, such as transportation costs, incurred by representatives of the program. In 2024, the OAA Final Rule was published in February with an effective date of October 2025. The rule included minor modifications and added language in 45 CFR §1321 related to State Unit on Aging responsibilities. It clarified the State Long-Term Care Ombudsman Program responsibilities and requirements, including requiring Ombudsman programs enter into memoranda of understanding with legal assistance programs and long-term care facility licensure and certification entities, and clarification of Ombudsman program authority and independence.