Specialized Information for:

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

LTCO Program Advocacy in Assisted Living Facilities Compendium

The LTCO Program Advocacy in Assisted Living Facilities Compendium is intended to assist long-term care ombudsmen programs (LTCOP) in increasing their effectiveness in advocacy for and with residents in assisted living facilities (e.g. residential care, board and care). The Compendium is a work in progress, beginning with the section on program assessment, development, and management. The tools and resources will be posted on the NORC website as they are developed. You are encouraged to check the Compendium on a routine basis and to share your best practices and information related to this topic with NORC. Consult the Introduction and Overview for a more detailed explanation of this resource.

Introduction and Overview

Section I: Program Assessment, Development, and Management

Program Assessment, Development, and Management Section Overview

Program Assessment

Program Management


Section II: Training

The Thin Edge of Dignity (June 2014)
Dick Weinman, retired professor of broadcast communications at Oregon State University, author and former radio personality delivers a moving presentation about his experience in an assisted living facility.

  • Discussion Guide for Thin Edge of Dignity Video
    Developed by the Oregon Department of Human Services, Aging and People with Disabilities State Unit on Aging, this guide helps to facilitate a discussion around the video; calling attention to the assisted living setting and the types of person-centered practices that might be put into place to better accommodate older adults and persons with disabilities.

Translating Nursing Home Ombudsman Skills to Assisted Living: Something Old, Something New - Teaching Guide (May 2008)

This document is to assist long-term care ombudsman programs in teaching the content of the paper to LTCO to enable them to be more effective advocates for residents in assisted living.

Translating Nursing Home Ombudsman Skills to Assisted Living: Something Old, Something New  (March 2003)
State ombudsman programs vary in the length of experience they have in assisted living. This paper shows how, regardless of the differences among states, ombudsman skills and knowledge gained in nursing homes can be applied to individual and systemic advocacy in assisted living. There are also aspects of assisted living noted in this paper that pose special challenges and that call for different approaches. (Appendices not included. Call the Center if you need copies of the appendices.)


Section III: Issue Advocacy

Resources from LTCOPs

Residential Care Home Toolkit (2016)
This toolkit contains 12 resident rights issues and the facts behind each topic.


Checklist - For consumers to use when shopping for an appropriate ALF for themselves or their loved ones.

Bochure - Describes the rights of ALF residents, including the state language regarding discharging a resident.


Section IV: Systems Advocacy

Sizing up assisted living: an examination of long-term care ombudsman complaint data (July 2018)
Abstract: Long-term care ombudsmen are resident advocates who receive, investigate, and resolve complaints relating to quality of care and violations of resident rights in assisted living (AL). More research is needed to understand systemic differences in source, type, and number of ombudsman complaints in AL. Ombudsman complaint data (n = 5,705 complaints) in small, medium, and large ALs in Dallas, Texas were analyzed using proportion Z tests. Findings suggest that all facilities had a high number of environmental complaints. Compared to larger facilities, small ALs have a disproportionately high number of complaints, a significantly higher number of complaints related to access to information, visitors, and ombudsmen, lower number of complaints related to care and staffing, family are less likely to complain, and residents are least likely to voice concerns. We recommend strategies for ombudsmen and AL providers to better meet residents’ needs. We conclude with a call to action underscoring the increasing importance of the role of the ombudsman in AL.

Karen J. Magruder, LMSW, Staff Ombudsman, The Senior Source, Texas Ombudsman Program; Noelle L. Fields, PhD; and Ling Xu, PhD

Assisted Living: Promising Policies and Practices
This report provides information and insights into best practices and policies for assisted living. The report focuses on areas of public interest and concern which we have identified as particularly important to ensuring resident safety and the ability of residents to realize assisted living’s “promise” of a resident-centered and directed, home-like environment. They include: (1) staff training requirements, (2) dementia care, (3) whether a registered nurse is employed, and (4) state oversight and quality assurance. LTCCC has compiled an Assisted Living State Requirements Chart showing, for every state in the country, the state’s status in regard to key policies and requirements. Both the report and the chart are available on LTCCC’s website, www.nursinghome411.org.



View archive here

Ombudsman Advocacy Challenges in Assisted Living: Outreach and Discharge

Quality in Medicaid Waiver Assisted Living: The Ombudsman Program's Role and Perspective

Ombudsman Advocacy Challenges in Assisted Living: Outreach and Discharge (March 2001)
This technical assistance paper is presented in two sections. It begins by describing challenges programs face in doing assisted living outreach and practical steps they might take to more effectively reach assisted living consumers and providers. It continues with a focus on Ombudsman intervention in discharge cases.


Hide text


Return to Top