Specialized Information for:

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

Resources & Reference Documents


Assisted Living

FactStats for Residential Care Communities (2016)


Long-Term Care Ombudsman Programs

State LTC Ombudsman Program: 2019 Revised Primer for State Agencies (Updated April 2019)
This Primer is intended to support State Agency Directors to understand the unique role of the State Long-Term Care Ombudsman Program. The Primer was prepared by the National Association of States United for Aging and Disabilities.

2016 Consumer Voice Annual Conference

Long-Term Care Ombudsman Program Fact Sheet (ACL and AOA 2015)

Ombudsman Compendium on Recruitment, Training and Retention

The Long-Term Care Ombudsman Program: Milestones 1972-2016


Nursing Homes

Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 Through 2016 (April 2018)
This report provides information on recent trends in nursing facilities in the United States, drawing on data from the federal On-line Survey, Certification, and Reporting system (OSCAR) and Certification and Survey Provider Enhanced Reports (CASPER), to provide information on nursing facility characteristics, resident characteristics, facility staffing, and deficiencies by state from 2009 through 2016. Additional detail on the survey and methods underlying the data in this report are provided in the Appendix at the end of the report. This data enables policymakers and the public to monitor and understand recent changes in nursing facility care in the United States and help highlight areas of ongoing concern for current and future policymaking.

Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 Through 2016 - Supplemental Tables (April 2018) 

FactStats for Nursing Home Care (2016)

Nursing Homes: Who Owns Them (2001)

Staffing section of the Consumer Voice website

Bedhold for Nursing Home Residents: Know the Facts (September 2012)

Improving the Quality of Care in Nursing Homes (IoM, 1986)

Nursing Home Staffing Standards in State Statutes and Regulations (Charlene Harrington, 2010)


Medicaid and Medicare

Information from CMS

CMS Memo: Revision of Civil Money Penalty (CMP) Policies and CMP Analytic Tool (July 2017)

CMP Analytic Tool User's Guide (July 2017)

Summary of State Use of CMP Funds (2012 - 2016)

Civil Monetary Penalty Funds update from CMS (December 2011)

Additional Information

Medicaid and Long-Term Care (Bradley Gellar 2011)

Fact Sheet: Medicaid Therapeutic Leave (March 2011)

Medicare Interactive - Created by the Medicare Rights Center, Medicare Interactive can help find answers about Medicare benefits.

Medicare Prospective Payment in SNFs and its Impact on Nursing Home Residents: Questions for Ombudsmen Considering the Care of Medicare Patients in Nursing Homes (2001)

Medicaid Bed Hold Policies by State (October 2012)


Administration on Aging’s Annual Report to Congress

Administration on Aging's Annual Report to Congress (FY 2018) - The section related to the Long-Term Care Ombudsman Program begins on page 37.

View past reports to Congress here.


Information to Share with Consumers

Go to the Hospital or Stay Here: A Decision Guide for Residents, Families, Friends, and Caregivers
This is a decision guide for Residents, Families, Friends and Caregivers to decide whether going to the hospital is the correct move. This was developed by Florida Atlantic University. Although copyrighted, it can be printed and distributed.

Piecing Together Quality Long-Term Care - A Consumer's Guide to Choices and Advocacy 
This guide from the National Consumer Voice for Quality Long-Term Care (the Consumer Voice) and accompanying fact sheets are designed for advocates and consumers who are currently receiving or who may in the future receive long-term services and supports in the community.  The purpose of these materials is to inform advocates and consumers about options for long-term services and supports, and to empower consumers - through education - to effectively advocate on their own behalf.


Statistical Resources

Administration on Aging/Administration for Community Living (AoA/ACL)

Get current information on AoA grant programs, Older Americans' Month theme and materials and find links to many useful sites on aging.

Administration on Aging: AGing Integrated Database (AGID)

The AGing Integrated Database (AGID) is an on-line query system based on ACL-related data files and surveys. It includes population characteristics from the Census Bureau for comparison purposes. The four options or paths through AGID provide different levels of focus and aggregation of the data – from individual data elements within Data-at-a-Glance to full database access within Data Files.

NORS-National Ombudsman Reporting System

Find data and reports on long-term care ombudsman programs. All programs efforts are summarized in the National Ombudsman Reporting System (NORS) to include the number of facilities visited, the types of complaints handled, and the kinds of complaints filed with ombudsmen. Data has been collected since 1996 and gives a good picture of the extent of ombudsman activities nationally and in every state.

Federal Interagency Forum on Aging Related Statistics

Get the Federal Interagency Forum on Aging-Related Statistics report Older Americans 2008: Key Indicators of Well-Being. This report covers 38 key indicators of aspects of the lives of older Americans and their families.

Bureau of Labor Statistics

Get the Consumer Expenditure Survey annual reports and various data tables. 

Trends in Health and Aging

View trends in health-related behaviors, health status, health care utilization, and cost of care for the older population in the United States. This interactive site allows you to query NCHS's wealth of data tables to create your own. There is also a link from this site to the Federal Interagency Forum on Aging-Related Statistics.

Census Bureau Population Profiles

Find Census Bureau population profiles in many different categories.

Commonwealth Fund Reports

Many Commonwealth Fund reports are available on this site, including "The Roles of Medicare and Medicaid on Financing Health and Long-Term Care for Low-Income Seniors: A Chart Book on Medicare-Medicaid Enrollees in Four States."

General Accounting Office

From the General Accounting Office home page, click on "GAO Reports," and then scroll down to "GAO Archives." Clicking on this link will give you a friendly search engine to find a wide variety of reports.

Federal Interagency Council on Statistical Policy

The Federal Interagency Council on Statistical Policy maintains this site to provide access to the full range of statistics and information produced by 70 Federal government agencies for public use.

Kaiser Family Foundation Health Information

Get comprehensive health information for all 50 states, DC and the U.S. territories. Compare and rank data across states and compare to U.S. totals.

The Medicaid Resource Book

This book is designed to be a reference tool that provides information on who the program serves, the services it offers, and how it is funded and administered. It includes chapters on:

  • Eligibility, benefits, financing and administration
  • A Medicaid legislative history
  • A Medicaid glossary
  • Indicies to Medicaid statute and regulations

Prepared by Andy Schneider and staff members of the Commission (Pub #2236), you may request a hardcopy via publications number (800) 656-4533.

Nursing Facilities, Staffing, Residents, and Facility Deficiencies, 2004 Through 2009

This book by Charlene Harrington, et. al., published in 2010, provides quality of care data for nursing homes.

Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2003 Through 2008

This book by Charlene Harrington, et. al., published in November 2009, provides quality of care data for nursing homes.


Additional Resources and Reference Documents

National Spending for Long Term Services and Supports (LTSS) (Carol O'Shaughnessy 2011)
Long-term services and supports (LTSS) for the elderly and younger populations with disabilities are a significant component of national health care spending. In 2011, spending for these services was $210.9 billion (9.3 percent of all U.S. personal health care spending), almost two-thirds paid by the federal-state Medicaid program. This publication presents data on LTSS spending by major public and private sources.

Administration on Aging/Administration for Community Living (AoA/ACL)

AoA/ACL provides home and community-based services to millions of older persons through programs funded under the Older Americans Act. This website provides an overview of a wide variety of topics, programs and services related to aging, including the Long-Term Care Ombudsman Program.

American Bar Association Ombudsman Committee

Sponsored by the ABA Section of Administrative Law and Regulatory Practice, this site offers a discussion group, model legislation, and links to state laws, articles, and papers of interest.

Action Pact

Culture change is a mindset. It challenges nursing homes to think outside the box and adopt a social model of care, creating vibrant, elder-friendly communities that residents can call home. Visit this site for more on culture change, resident-centered care, and local initiatives.


CareWatchers is a non-profit organization that advocates for resident’s rights, quality of life and care in nursing homes. The site was designed by a volunteer ombudsman to provide information to consumers and to support the organization and development of resident councils and family councils.

Federal Benefits

This website helps people determine if they qualify for certain federal benefits programs, including Medicare, Medicaid and the State Children’s Health Insurance Program (SCHIP).


This website, mandated by the Patient Protection and Affordable Care Act, provides information on health insurance programs. The site provides links to two other online resources run by the Department of Health and Human Services: Healthfinder.gov, an inventory of health advice, and Hospital Compare, which allows users to compare the quality of care of hospitals throughout the country.

The National Center on Law and Elder Rights (NCLER)

The National Center on Law and Elder Rights (NCLER) is a resource center for the legal services and aging and disability networks, focused on the legal rights of older adults. NCLER is a one-stop support center for the legal services and aging and disability community. NCLER’s trainings, case consultations, and technical assistance are provided by Justice in Aging, the American Bar Association Commission on Law and Aging, the National Consumer Law Center, and The Center for Social Gerontology—all under one roof.

The National Health Law Program (NHeLP)

NHeLP has launched this new site which features hundreds of articles with information ranging from basic health care definitions to keeping health care costs down, coping with emergencies, dealing with denied claims, and what people can do when they lose coverage.

The United States Ombudsman Association

The United States Ombudsman Association is the national organization for public sector ombudsman professionals. Founded in 1977, USOA is North America's oldest national ombudsman association with members from local, state, federal governments, and affiliated ombudsman offices. Its purpose is to assist existing ombudsman and ombudsman organizations in improving the operation of their offices throughout the United States.



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Strategy Brief: The Ombudsman Program and Caregiver Support

The information presented in this document is based on promising practices identified by state ombudsmen in response to an email sent to all programs in May, 2006 and information provided during the National Dialogue Forum. The National Dialogue Forum consisted of two teleconferences held on May 16 and 18, 2006.

Strategy Brief: Ombudsman Program Advocacy in Guardianship (May 2006)

This report presents promising practices and strategies used by ombudsmen concerning guardianship and alternatives to guardianship for nursing home residents with limited decision-making capacity and no surrogate decision-maker. Included are discussion highlights from National Dialogue Forum #4 convened by the National Association of State Units on Aging (NASUA) on the topic in June 2005. This was the fourth in a series of Forums NASUA convened on challenging issues facing State Long-term Care Ombudsmen. Also included is information gathered from an email solicitation to all programs in May 2005 in preparation for two conference calls. (This is a large file - 800 KB. It may take a few moments to download.)

Strategy Brief: Ombudsman Program Responses to Diversity (September 2005)

This report presents promising practices and strategies used by ombudsmen serving diverse resident populations. Included are discussion highlights from National Dialogue Forum #3 convened by the National Association of State Units on Aging (NASUA) on the topic. This is the third in a series of Forums NASUA has convened on challenging issues facing State Long-Term Care Ombudsmen.


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