). 

SEPTEMBER 2019

Research Brief

Strengthening the Aging and Disability 

Networks: Use of Volunteers in Long-Term 

Care Ombudsman Programs

Author: Kim Nguyen, PhD

NORC at the University of Chicago | 4350 East-West Highway, 8th floor, Bethesda, MD 20814 | Office (301) 634-9300 

Since the Long-Term Care Ombudsman program’s inception, volunteers have played an integral role in fulfilling the 

program’s mandate to advocate on behalf of residents of long-term care facilities. Making up over 85% of Ombudsman 

program staff in 2017, the program relies heavily on volunteers to maintain a regular presence in nursing homes and board 

and care homes and to respond to resident complaints. This research brief focuses on the characteristics and motivations of 

volunteers who visit long-term care facilities, their roles and responsibilities, the training and management they receive, and 

their satisfaction with the Ombudsman program. It also describes programmatic challenges in recruiting and retaining 

volunteers, and the strategies that programs use to address these challenges. Findings suggest that volunteers provide over 

$14.6 million in additional labor assets to the program and when effectively mobilized and efficiently trained, are central to

adding needed capacity to Ombudsman programs. Data used for this this brief were collected as part of the Process 

Evaluation and Special Studies Related to the Long-Term Care Ombudsman Program conducted by NORC at the University 

of Chicago (NORC) on behalf of the Administration for Community Living (ACL). 

BACKGROUND

In 1978, the Older Americans Act (OAA) established 

the Long-Term Care Ombudsman program (LTCOP or 

Ombudsman program) to protect and promote the 

health, safety, welfare, and rights of residents living in 

long-term care facilities. To advance this goal, the 

OAA charges the program with responsibility for 

advocating on behalf of residents by identifying, 

investigating, and resolving individual complaints; 

making systemic improvements to the long-term care 

system; and providing outreach and education to 

residents and other stakeholders. These key functions 

are performed by a State Long-Term Care 

Ombudsman who heads an Office of the State LongTerm Care Ombudsman (Office or Office of the 

SLTCO) in coordination with the state or territorial unit 

on aging (SUA) in all 50 states, as well as the District 

of Columbia, Puerto Rico, and Guam. The State 

Ombudsman is responsible for statewide program 

administration and oversight of paid staff and 

volunteers. 

DATA COLLECTION

As part of the Process Evaluation and Special Studies 

Related to the Long-Term Care Ombudsman Program, 

NORC collected qualitative and quantitative data from 

program staff and stakeholders in two phases. Interview

data were collected from federal staff, national 

stakeholders, and State Ombudsmen in 2017. Survey data 

were collected from State Ombudsmen and a sample of 

local Ombudsmen and volunteers in 2018. For local data 

collection, a multistage stratified sampling approach was 

used. The sampling began with stratifying programs by the 

10 ACL regions. To ensure that the diversity of programs

was captured, a sample of 27 states was identified, and in 

these states, all local Ombudsman entities were included. 

Within each local program, all local Ombudsmen were 

invited to participate, and half of volunteer Ombudsmen

were randomly sampled and invited to participate. In 

centralized programs, staff who serve at the local level 

were included. More information on the study methods can 

be found in the Final Report that is available on ACL’s 

website (https://acl.gov

NORC at the University of Chicago Research Brief | 1 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

According to the National Ombudsman Reporting 

System (NORS; the program’s administrative reporting 

system), Ombudsman programs were responsible for 

advocating on behalf of over three million residents in 

16,376 nursing homes and 58,031 board and care 

homes in in federal fiscal year (FFY) 2017. During this 

period, Ombudsmen responded to 201,460 complaints 

from 128,091 individuals, and they provided information 

on rights, care, and related services to individuals and 

long-term care facility managers and staff on 529,098

occasions. Supporting the program in these 

responsibilities were 1,319 paid, full-time equivalent 

workers (FTEs) and 6,625 certified volunteer 

Ombudsmen1 who donated 591,362 hours of their time.

The impetus for Ombudsman programs, as they are 

known today, originated with former U.S. Commissioner 

on Aging, Dr. Arthur S. Fleming. First created as Public 

Health Service demonstration projects in 1972, the 

Ombudsman program was part of President Nixon’s 

initiative to address widely-reported problems involving 

abuse and poor quality of care in nursing homes. As 

federal law and regulations for standards of care were 

being enacted in the early 1970s, Dr. Fleming argued 

that to be effective, these legislative efforts needed to be 

supported with community-based resident advocacy. As 

Fleming stated, “Our nation has been conducting 

investigations, passing new laws and issuing new 

regulations relative to nursing homes at a rapid rate 

during the past few years. All of this activity will be of 

little avail unless our communities are organized in such 

a manner that new laws and new regulations are utilized 

to deal with the individual complaints of older persons 

who are living in nursing homes. The individual in the 

nursing home is powerless. If the laws and regulations 

are not being applied to her or to him, they might just as 

well not have been passed or issued” (AoA Technical 

Assistance Memorandum 76-24). Congress incorporated 

the Ombudsman program into the OAA in 1978. 

Setting forth the initial guidance for the program, Dr. 

Fleming envisioned that volunteers would play a central 

role in providing advocacy services to nursing home 

residents. In maintaining a routine presence in long-term 

care facilities, volunteer Ombudsmen were viewed to be 

uniquely positioned to serve as the “eyes and ears” of 

1 In the OAA, “Ombudsman” refers to the State Ombudsman. All other staff that perform duties of the Office are “designated 

representatives of the Office” although many use the term “Ombudsman” in practice. For the purposes of this research, we refer to 

designated representatives of the Office, including volunteers, as Ombudsmen. It should also be noted that NORS uses the term 

“certified” rather than “designated”.

the community to help prevent and address problems 

related to residents’ quality of care and quality of life. 

The 1987 amendments to the OAA strengthened the role 

of the Ombudsman program and affirmed that, as 

designated representative of the Office, volunteers have 

the same authority as paid Ombudsmen. Under these 

amendments, the OAA granted Ombudsmen the right to 

make unannounced visits, access relevant parties in 

relation to a complaint, investigate a complaint with 

permission from the resident or resident’s legal 

representative when the resident is deemed medically 

incapacitated, and to communicate concerns about a 

facility to the regulatory agency prior to a survey 

inspection.

Given Ombudsmen’s responsibilities and authority, the 

role is arguably one of the most challenging that a 

volunteer can assume. As advocates for long-term care

facility residents, the skills, knowledge, and commitment

that are required of Ombudsmen can be highly 

demanding. Similar to paid staff, volunteers must be 

familiar not only with resident rights and available 

resources on topics as diverse as eligibility for services 

and power of attorney, but have a working knowledge of 

a broad range of state and federal regulations that 

govern long-term care services and supports in various

settings. To fully represent the interests of residents, 

moreover, volunteers must be able to problem-solve, 

and navigate delicate or challenging relationships with 

facility staff, other agencies that may be involved in a 

complaint, as well as work effectively with residents’ 

family members. Facility visits also expose volunteers to 

a wide range of experiences, some of which can be 

upsetting, such as in cases of resident abuse or neglect. 

The next section of the brief describes the 

characteristics and motivations of volunteers who 

support the Ombudsman program. It then describes their 

roles and responsibilities, the training and support they 

receive, perceptions of their effectiveness in facilities, 

and their satisfaction with the program. Next, the brief 

focuses on Ombudsman programs’ challenges in 

attracting and supporting volunteers for these 

demanding roles and the strategies they use to address 

these challenges.

NORC at the University of Chicago Research Brief | 2 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

Exhibit 1: Characteristics of Volunteer Ombudsmen

Characteristics Mean Median Range N 

Age 70 77 27-90 633a

Length of time volunteering 5.9 years 4 years 1 month – 32 years 701b

Hours per month 14 10 1 – 160 670c

a

 Missing=78 ; b Missing=10 ; c Missing=41

CHARACTERISTICS AND 

MOTIVATIONS OF VOLUNTEERS 

Characteristics 

Volunteers who support the Ombudsman program tend 

to be of similar age to the population they serve (Exhibit 

1). Based on our sample, Ombudsman program 

volunteers had a mean age of 70 years, with a range of 

27 to 90 years. Volunteers also appeared to be highly 

committed to the program, donating an average of 14 

hours of their time each month. However, the extent of 

donated hours varied widely, ranging from one to 160 

hours each month. It is worth noting that some 

volunteers reported donating hours that were equivalent 

to a full-time job. Volunteers reported serving the 

Ombudsman program for an average of about six years, 

with one volunteer reporting serving 32 years. As 

suggested by their age and tenure, volunteers often 

begin serving the program in their mid-sixties, the typical 

age of retirement in the U.S. In our sample, 76% of 

volunteers were 65 years of age or older. As shown in 

Exhibit 2, volunteers are predominately female, nonHispanic white, and retired. LTCOP volunteers also tend 

to be highly educated, with nearly 70% reporting they 

have a bachelor’s or advanced degree. In addition, State 

Ombudsmen report that the program attracts volunteers 

who bring relevant professional experiences to their 

roles, including nurses, social workers, psychologists, 

doctors, allied health professionals, lawyers, and 

teachers. 

Motivations 

For a majority of volunteers, personal fulfillment was the 

primary motivation for serving the program (Exhibit 3). 

More than half of the volunteers in our sample also cited 

the program’s mission as a factor in their desire to 

volunteer. Twenty-seven percent volunteered because 

family or friends received long-term services and 

supports. Among volunteers who were motivated to 

serve by other reasons, factors such as a desire to give 

back to the community, and sharing the skills and 

knowledge that they had developed working in a related 

field (e.g. nursing), were reported. A small number of 

volunteers reported that they were looking for a 

volunteer or internship opportunity, or were interested in 

learning more about long-term care facilities. 

Exhibit 2: Characteristics of Volunteer Ombudsmen

Characteristics N, % 

Gender N=669a

Female 76%

Ethnicity N=653b

Hispanic 3%

Race N=647c

American Indian or Alaskan Native 1%

Asian 4%

Black or African American 4%

Native Hawaiian or Other Pacific Islander <1%

White 88%

Education N=677d

Less than High School 0%

High School or GED 5%

Some College 17%

Associate’s Degree 9%

Bachelor’s Degree 20%

Some Graduate Work 9%

Master’s Degree 32%

Juris Doctorate 3%

Doctor of Philosophy 5%

Medical Degree 1%

Employment Status N=699e

Retired 77%

Employed full-time 9%

Employed part-time 11%

Out of work and looking for paid work 2%

A homemaker 7%

A student 2%

a Missing=42; b Missing=64; c Missing=58; d Missing=34; e Missing=12 

NORC at the University of Chicago Research Brief | 3 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

Exhibit 3: Motivations for Volunteering

What motivated you to become a 

volunteer for the LTCOP? 

Volunteer 

Ombudsmen

N=703a

Personal fulfillment (e.g., enjoyment in 

helping others)

68% 

Interest in the program’s mission 55% 

Family/friends receiving long-term 

services and supports

27%

Personal experience with the program 8%

Career development 6%

Other 16%

a Missing=8 

ROLES AND RESPONSIBILITIES 

Ombudsman programs’ use of volunteers differs by state 

law and policy, as well as programmatic need or ability 

to recruit volunteers.2 States also differ in the number of 

volunteers that support their programs. According to 

NORS data, 49 of the 53 programs reported using 

volunteers in 2017.3 The number of volunteers ranged 

from zero to 948 individuals across all programs, with an 

average of 147 among programs that use volunteers. It 

should be noted that within a state or territory, volunteers 

are not necessarily evenly distributed, with the presence 

and number of volunteers varying considerably across 

local Ombudsman entities, some of which may have no 

volunteers. 

In states and territories that use volunteers, volunteers 

are primarily responsible for making visits to long-term 

care facilities (other types of volunteers may perform 

clerical tasks). Within this group, however, there are 

important differences with respect to complaint handling. 

Some volunteers may make visits to residents in order to 

provide program access and refer complaints brought to 

their attention to paid Ombudsmen staff. Other 

volunteers may be trained and designated to serve as a 

representative of the Office, a role that involves 

complaint handling. This group can be further divided 

into volunteer Ombudsmen who handle only some types 

of complaints and those who are trained to handle all 

types of complaints. Programs may use their volunteers 

in any combination of these capacities. 

Exhibit 4: Activities Performed by Volunteer Ombudsmen

Activities Performed by Volunteer Ombudsmen Volunteer Ombudsmen

N=711

Make visits (not in response to a complaint) to residents of long-term care facilities 97% 

Investigate and resolve complaints raised by, or on behalf of, residents 86% 

Distribute program brochures, letters to introduce myself, ensure that program contact information is 

prominently posted 69%

Provide information, resources, and support to resident councils 68%

Provide information and consultation to consumers (residents, families, the general public) 65%

Collect, manage, and/or report data about my case work and/or activities 57%

Provide consultations to facility staff 39%

Participate as a resident advocate in facility licensure surveys 32%

Provide information, resources, and support to family councils 28%

Provide training to other volunteers 24%

Provide community education 22%

Monitor/work on laws, regulations, government policies and actions 13%

Provide training to facility staff 12%

Other (please specify) 8%

Work with media on issues impacting residents of long-term care facilities 3%

2 Some state regulations have prohibited volunteers from conducting complaint investigations. The Long-Term Care Ombudsman 

Programs Final Rule clarified that designated representatives of the Office, both paid and volunteer, are to investigate complaints. ACL 

worked with states to address these types of compliance issue to ensure that all designated volunteers can carry out complaint 

investigation work. 

3 Four states (Mississippi, South Dakota, West Virginia, and Wyoming) reported no volunteers.

NORC at the University of Chicago Research Brief | 4 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

According to NORS, of the 8,810 volunteers who 

supported the program in 2017, 6,625 (75%) were 

certified volunteer Ombudsmen.4 Importantly, the LongTerm Care Ombudsman Programs Final Rule clarifies 

that the State Ombudsman must prohibit any 

representative of the Office from carrying out the duties 

of the Office unless they have been trained and 

approved by the Ombudsman as qualified to carry out 

the activity on behalf of the Office. At the time this report 

was prepared, State Ombudsmen with programs that 

use volunteers that are not designated (sometimes 

referred to as “friendly visitors”) reported being in the 

process of transitioning these volunteers into designated 

representatives of the Office with the expectation of 

fulfilling those duties. 

Although volunteers perform a range of activities across 

programs, a majority focuses on individual resident 

advocacy (Exhibit 4). Nearly all volunteers (97%) in our 

sample conduct routine facility visits, and 86% 

investigate and resolve complaints raised by, or on 

behalf of, residents. More than two-thirds also carry out 

education and outreach activities such as distributing 

program brochures and providing information and 

consultation to consumers. In addition, smaller numbers 

of volunteers reported performing systems advocacy 

work such as monitoring laws, regulations, and policies

(13%), and working with the media (three percent). 

4 Seven states (Alabama, Mississippi, Montana, Puerto Rico, South Dakota, West Virginia, and Wyoming) reported having no 

designated volunteer Ombudsmen. The Alabama, Montana, and Puerto Rico programs reported having “other volunteers.” It should 

also be noted that NORS uses the term “certified” rather than “designated”.

5 Office of the Assistant Secretary for Planning and Evaluation. 2015. “Compendium of Residential Care and Assisted Living 

Regulations and Policy: 2015 Edition.” 

Facility Visits 

Visits to facilities are typically unannounced and varied 

in their schedule. During these visits, volunteers interact 

with and listen to residents; observe the general 

conditions and daily activities of the facility; share 

information about Ombudsman program services with 

residents, family and staff; support resident and family 

councils; identify and address complaints; and empower 

residents to speak up on their own behalf or voice 

concerns for those who are unable to do so. 

Volunteer Ombudsmen make routine visits to both 

nursing homes and board and care homes to which they 

are assigned, although their time is largely allocated to 

nursing home visits. Repeat visits to the same facilities 

allow volunteers to build relationships with residents, 

understand their preferences, and raise residents’ 

comfort level in expressing concerns. Additionally, 

volunteers may also visit both care settings as needed in

response to facility problems and complaints. 

Volunteers who visit nursing homes were assigned an 

average of two facilities, but the number of assigned 

facilities ranged from zero to 30 in our sample (Exhibit 

5). Volunteers who visit board and care homes were 

assigned an average of five facilities, with a range of 

zero to 40. Because board and care homes tend to have 

fewer residents than nursing homes (half of all board 

and care homes have less than five beds5

) and require 

less time to visit, programs often assign volunteers a 

larger number of these facilities than nursing homes. 

Volunteers may also be assigned a mix of nursing 

homes and board and care homes. In our sample, on 

average, they were assigned to four facilities of any type. 

In rare instances, volunteers are not assigned to any 

specific long-term care facility, but they may be asked to 

make visits in response to a complaint. 

NORC at the University of Chicago Research Brief | 5 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

Exhibit 5: Assignments to Long-Term Care Facilities 

and Types of Visits 

Long-Term Care Facility Volunteer 

Ombudsmen

Nursing Homes N=711

Visits nursing homes 80%

Type of visit conducted: N=562a

Visit on a routine basis (not complaint 

driven) 95%

Visit in response to facility problems 

and resident complaints 59%

Other 8%

# of facilities assigned: N=546b

Mean - # of facilities assigned 2 

Range - # of facilities assigned 0-30

Board and Care Homes N=704c

Visits board and care homes 51%

Type of visit conducted: N=350d

Visit on a routine basis (not complaint 

driven) 93%

Visit in response to facility problems 

and resident complaints 52%

Other 4%

# of facilities assigned: N=339e

Mean - # of facilities assigned 5 

Range - # of facilities assigned 0-40

All facilities N=664f

Mean - # of facilities assigned 4 

Range - # of facilities assigned

Median - # of facilities assigned

0-60

2

a Missing=4, Not applicable=145; b Missing=20, Not applicable=145; c

Missing=7; d Missing=15, Not applicable=346; e Missing=26, Not 

applicable=346; f

 Missing=23, Not applicable=24 

Exhibit 6 shows that 93% of volunteers make at least 

quarterly visits to both nursing homes and board and 

care homes to which they are assigned. A majority of 

volunteer Ombudsmen make weekly visits to nursing

homes and at least monthly visits to board and care 

homes. 

Exhibit 6: Frequency of Facility Visits

Frequency of Visits

Nursing 

Homes

N=555a

Board and 

Care Homes

N=350b

Weekly 53% 22%

Less than weekly but at least 

once a month 26% 40%

Less than monthly but at least 

once a quarter 14% 31%

Twice a year 1% 2%

Once a year 0% 1%

As needed 3% 3%

Other 3% 1%

a Missing=11, Not applicable=145; b Missing=15, Not applicable=346 

The most common length of time volunteer Ombudsmen 

reported spending in both nursing homes and board and 

care homes is one to two hours (Exhibit 7). However, 

because of the higher numbers of residents, volunteers 

were more likely to report spending two hours or more 

during nursing home visits, compared to board and care 

homes.

Exhibit 7: Average Amount of Time Spent in 

Facilities for Each Routine Visit 

Amount of Time

Nursing 

Homes

N=554a

Board and Care 

Homes

N=342b

Less than an hour 9% 41% 

Between 1 to 2 hours 56% 46% 

Between 2 to 3 hours 28% 10% 

More than 3 hours 7% 3%

a Missing=9, Not applicable=148; b Missing=23, Not applicable=346 

In addition to making regular facility visits, a majority of 

volunteers reported investigating complaints and 

handling all types of complaints received by the program

(Exhibit 8). Among the 20% of volunteers who reported 

only handling certain types of complaints, the most 

common complaints they addressed involved basic 

needs issues such as food and the quality of services 

and staff (83%). 

When asked how they handle complaints, volunteers 

frequently reported consulting other program 

staff/volunteers, referring the complaint to the 

appropriate entity, or handling complaints on their own. 

Of the 29% of volunteers who did not report handling 

complaints on their own, many reported consulting with 

other program staff or volunteers as needed, and 

referring the complaint to the appropriate entity.

NORC at the University of Chicago Research Brief | 6 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

Exhibit 8: Complaints Handled by Volunteer 

Ombudsmen 

Complaint Handling

Volunteer 

Ombudsmen

N=710a

Investigates or assists other ombudsmen 

with complaints 87%

Of those who handle complaints... N=609b

I handle all types of complaints 80%

I handle only some types of complaints 20%

How complaints are handled: N=615c

I handle complaints on my own 71%

I support other program staff/volunteers as 

they handle complaints 32%

I consult with other program staff or 

volunteers, as needed 77%

I refer the complaint to other program staff 

or volunteers 32%

I refer the complaint to the appropriate 

entity when I have resident consent 72%

Other 6%

a Missing=1; b Missing=8, Not applicable=94; c Missing=2, Not 

applicable=94 

Note: The number of respondents considered “Not applicable” in the 

missing data refers to volunteers who reported that they do not handle 

complaints 

When asked about their effectiveness, more than threefourths of volunteers reported that a majority of their 

relationships were effective in both nursing homes and 

board and care homes (Exhibit 9). Volunteers described 

several factors that contributed to the effectiveness of 

their relationships with the facilities they visit. The most 

common of these factors was having good 

communication and responsive facility staff (40%). 

Thirteen percent of volunteers also reported that the 

facility staff's level of trust in the Ombudsman program 

and volunteers (i.e. their intentions and their work) 

determined the effectiveness of the relationship. Other 

factors that were reported to contribute to the 

effectiveness of relationships included working with 

facility staff as a team (10%), low staff turnover (six 

percent), and experience with the facility (five percent). 

Exhibit 9: Perceived Effectiveness in Nursing 

Homes and Board and Care Homes

Overall, how would you 

describe the effectiveness 

of your relationship with 

the following types of 

facilities? 

Nursing 

Homes 

N=513a

Board and 

Care Homes 

N=357b

A majority of the 

relationships are effective 78% 78% 

Some of the relationships 

are effective 18% 17% 

A few of the relationships 

are effective 3% 4% 

None of the relationships are 

effective <1% 0% 

a Missing=55; Not applicable=143; b Missing= 28, Not applicable=326 

TRAINING, RESOURCES, AND 

AREAS FOR FURTHER 

SUPPORT 

Orientation, Training, and Support

Although there are a number of different approaches to 

training volunteer Ombudsmen when they are onboarded to the program, nearly all volunteers (96%) 

reported receiving in-person training/in-services (Exhibit 

10). Other forms of training and support included 

mentoring/shadowing with experienced staff, being 

observed by more experienced staff, attending a 

resident or family council meeting, and self-study.

Exhibit 10: Orientation, Training, and Support 

Provided to Volunteer Ombudsmen 

What type of orientation, training, or 

support did you receive when you first 

joined the LTCOP as a volunteer?

Volunteer 

Ombudsmen

N=706

In-person training/In-services 96%

Mentoring/shadowing with experienced 

staff 74%

A more experienced staff member or 

volunteer observed me 36%

Attending a resident or family council 

meeting 32%

Self-study (on-line training or reviewing 

materials provided by state program) 29%

Training in a long-term care facility 21%

Self-study (on-line training or reviewing 

materials provided by the National 

Ombudsman Resource Center) 

15%

Training by legal counsel 10%

Introduction to key stakeholders in my state 5%

Other 7% 

None <1%

Missing=5

NORC at the University of Chicago Research Brief | 7 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

Exhibit 11: Perceived Helpfulness of National, State, and Local Resources

How helpful are the following resources to you? Very 

helpful

Somewhat 

helpful

Not 

helpful

Not familiar with 

resource or N/A N 

Area agency on aging (AAA) 28% 20% 4% 47% 597

Local Ombudsman entity 61% 20% 1% 17% 610

Office of the SLTCO 32% 35% 6% 27% 591

National Association of Local Long-Term Care Ombudsmen 

(NALLTCO) 8% 14% 5% 72% 542

National Ombudsman Resource Center 12% 18% 5% 65% 555

National Ombudsman Resource Center website 

(ltcombudsman.org) 11% 18% 6% 66% 536

As a result of their training, most volunteers reported that 

both their initial and ongoing trainings prepared them for 

their role. 

 98% reported that they had a staff person that they

could go to as needed.

 95% reported that their orientation training was very,

or somewhat, effective in preparing them for their

roles as a volunteer.

 88% reported that their training, ongoing support, and

professional interactions have fully prepared them to

carry out their roles as a volunteer.

 84% reported having the support of supervisory and

managerial staff to carry out their work.

Resources

Volunteer Ombudsmen receive ongoing support from a 

number of entities at the local, state, and national levels 

that help them carry out their work. As shown in Exhibit 

11, 61% of volunteers reported their local Ombudsman 

entities were very helpful in terms of providing support. 

Notably, volunteers were not familiar with the National 

Association of Local Long-Term Care Ombudsmen or 

the National Ombudsman Resource Center. Although 

these entities are intended to provide training and 

technical support to Ombudsmen, volunteers in our 

sample had little knowledge of their existence, and 

among those who did, reported that these resources 

were not applicable to their work. When asked whether 

the resources provided by the National Ombudsman 

Resource Center were sufficient for carrying out 

individual advocacy work, 61% of volunteers reported 

“Don’t know” (data not shown in exhibits).

Areas for Further Support

Additional supports that volunteer Ombudsmen reported 

they would like from the program are shown in Exhibit 

12. Volunteers most often reported wanting to have

more opportunities to discuss challenges with other

Ombudsmen (32%). Others were interested in having

more opportunities to discuss challenges with their

supervisor (19%), obtaining more feedback on their

performance and effectiveness (18%), and receiving

more formal training (18%). Thirty-seven percent of

volunteer Ombudsmen did not indicate an interest in any

of the training and support resources listed in Exhibit 12,

and many in the latter group also noted that no

additional resources were needed.

Exhibit 12: Interest in Additional Types of Training 

and Support 

What additional support would you like 

from program staff?

Volunteer 

Ombudsmen

N=711

More opportunities to discuss challenges 

with other Ombudsmen 32%

More opportunities to discuss challenges 

with supervisor 19%

More feedback on my performance and 

effectiveness 18%

More formal training 18%

More information from State 

Ombudsman/program staff 14%

SATISFACTION WITH PROGRAM

Satisfaction

Almost all (92%) of the volunteers reported being “very 

satisfied” or “somewhat satisfied” with their role as 

Ombudsmen (Exhibit 13). In open-ended responses, 

nearly every volunteer Ombudsman in our sample (97%) 

also reported that their experience was most rewarding 

because of their strong relationships with residents (built 

through frequent interactions), the advocacy that they 

NORC at the University of Chicago Research Brief | 8 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

provide on residents’ behalf, and their ability to 

successfully resolve resident complaints. Some 

volunteers also noted that collaboration with facility staff, 

being able to impact changes at the facility, and 

educating others about issues facing older adults were 

also rewarding. Eighty-eight percent of volunteer 

Ombudsmen reported that they feel they are positively 

influencing other people’s lives through their work (data 

not shown in exhibits). 

Exhibit 13: Satisfaction with Program

How satisfied are you with your 

volunteer work at the LTCOP?

Volunteer 

Ombudsmen

N=694

Very satisfied 66%

Somewhat satisfied 26%

Neutral 4%

Somewhat dissatisfied 3%

Very dissatisfied 1%

Missing=17 

PROGRAM BENEFITS AND

CHALLENGES OF USE OF

VOLUNTEERS 

For many Ombudsman programs, volunteers 

are essential for ensuring advocacy services are 

accessible to residents. Without them, programs would 

struggle to maintain an ongoing presence in long-term 

care facilities. This is especially true for programs with 

insufficient funds or staffing. The same resource 

constraints, however, also present challenges for 

programs in recruiting and supporting volunteers to 

optimize their contributions. Exhibit 14 shows the 

challenges that State Ombudsmen reported with respect 

to funding and program staff. Difficulty recruiting and 

supporting volunteers was the second most common 

challenge they reported, and this problem was reported 

almost as often as issues with funding (73% vs. 75%).

Similar levels of concern with respect to funding and 

volunteers underscore the importance of volunteers to 

basic program functions. 

6 Source: LTCOP Management Highlights 2017

Exhibit 14: Program Challenges

What challenges does your statewide 

program face?

State 

Ombudsmen

N=52

Insufficient funding 75%

Difficulty recruiting and supporting 

volunteers 73%

Difficulty hiring paid staff 27%

High turnover of volunteers 31%

High turnover of paid staff 17%

Challenges Related to Resources Needed to Support 

Use of Volunteers

State Ombudsmen have long recognized the value of 

volunteer contributions, but they also emphasize the 

need for adequate resources to ensure that this segment 

of their program’s workforce is well-trained, supervised, 

and effective. Without these resources, the cost of 

training and managing volunteers can outweigh their 

benefits, particularly when programs lack staff or 

sufficient funds for volunteer administration. In 2017, 

only 16 State Ombudsmen reported having a full, or 

part-time volunteer coordinator at the state or local 

level.6 More than two-thirds of programs lacked 

dedicated staff to recruit, oversee, and provide training 

and support to volunteers. State Ombudsmen frequently 

expressed an urgent need for a coordinator to not only 

help grow their volunteer programs, but also to free up 

staff time to conduct facility visits. Absent staff dedicated 

to volunteer management, programs must rely on paid 

Ombudsman staff to recruit and supervise volunteers, 

tasks that are added to their other responsibilities. Given 

competing priorities as well as time and resource 

constraints, programs often struggle with identifying and 

retaining volunteers who are a good fit for the 

Ombudsman role. One Ombudsman reported 

conducting exit interviews in which volunteers cited that 

the reason for their departure was rooted in their not 

being adequately supported by staff. 

Insufficient funds also prevent State Ombudsmen from 

further developing their volunteer program. For example, 

lack of financial resources limits programs’ ability to 

advertise volunteer opportunities. To help offset 

advertising expenses, State Ombudsmen described 

pooling resources across local Ombudsman entities to 

develop public service announcements (PSAs) aimed at 

volunteer recruitment. Another State Ombudsman 

reported that volunteers do not have access to the 

NORC at the University of Chicago Research Brief | 9 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

program’s complaint management system. This 

operational challenge was linked to the cost of data 

licenses, ultimately requiring paid staff to enter volunteer 

reporting data. One outcome of this cost-driven 

arrangement is the need for staff to spend time entering 

data rather than visiting long-term care facilities. At the 

same time, staff with managerial responsibilities often 

includes administrative functions, such as data entry and 

analysis, while volunteers focus on facility visits, in order 

to address resource needs.

Resource constraints also mean programs are unable to 

provide travel reimbursement to volunteers, even though 

visits to some facilities involve long travel times, 

especially in states with large rural areas. Given that 

many volunteers are older and retired, the need to cover 

their own travel expenses can be burdensome, and may 

contribute to volunteer attrition. Lack of funds also 

means that some programs have been forced to reduce 

or forgo volunteer training or recognition events. Some 

State Ombudsmen also reported paying for volunteer 

recognition events, such as luncheons or other tokens of 

appreciation, with their own money. 

Challenges Related to Ombudsman Role and 

Demographic Changes

In addition to resource-related barriers that hinder 

volunteer recruitment and retention, other challenges 

concern the Ombudsman role as well as the 

demographic composition of the program’s volunteer 

workforce. 

A key recruitment challenge for programs concerns the 

scope of the Ombudsman role itself. The high level of 

responsibility entrusted to Ombudsmen can deter 

volunteers from serving in this capacity. Because the 

nature of Ombudsmen’s work is fundamentally hard, the 

program needs volunteers who are willing to take on the 

intense commitment it requires. State Ombudsmen 

highlighted the appeal of other programs to volunteers 

because their services are both gratifying and timelimited, such as delivering meals to older adults’ homes, 

serving food in soup kitchens, or participating in activities 

at senior centers. By contrast, although the work of 

volunteer Ombudsmen can bring immense personal 

rewards, it requires volunteers to address conflict and 

observe resident conditions that may be upsetting or 

otherwise unsettling. The cumulative impact of these 

experiences may not end at the conclusion of a facility 

visit. 

Moreover, unlike most volunteer jobs, volunteer 

Ombudsmen must take a certification training course, 

undergo a criminal background check, and be screened 

for potential conflicts of interest. From a resource 

utilization perspective, volunteer selection is a lengthy 

and costly investment, with each step narrowing the pool 

of possible candidates. Further, State Ombudsmen 

reported that among volunteers who are still employed 

part- or full-time, meeting the required number of 

Ombudsman training hours can be especially difficult. 

For volunteers with competing work demands, some 

programs have conducted individual training sessions to 

address scheduling constraints. State Ombudsmen 

reported that these volunteers are less likely to remain in 

the program and attributed their attrition partly to the 

solitary nature of their training. By contrast, retirees tend 

to have more availability to meet training requirements, 

and these are often conducted in groups. State 

Ombudsmen reported that group-based training helps 

build relationships among volunteers as well as a sense 

of responsibility to one another, both of which can 

favorably impact the operational aspects of their 

volunteer duties.

Difficulties in recruiting volunteers under these 

circumstances are especially challenging among 

programs that cover rural regions. Not only do these 

areas have smaller pools of potential volunteers, but 

even when volunteers express interest, it can be 

challenging to incentivize them to travel long distances 

to remote areas of the state. One State Ombudsman 

noted the difficulty in recruiting volunteers if program 

staff do not reside in the community and are viewed as 

outsiders, particularly in smaller communities. Onboarding volunteers can be time consuming and 

inefficient for all programs, but these challenges are 

especially pronounced if only one volunteer is joining the 

program at a given time, requiring both staff and the 

prospective volunteer to travel long distances for 

training. Moreover, in small communities, many 

residents know one another. This can add challenges to

identify volunteers who are free of conflicts of interest 

that arise through personal relationships with family 

members who reside or work at facilities to which the 

volunteer would be assigned. 

The program’s volunteer workforce also presents 

challenges for retention. Given that many volunteers are 

older adults, the program loses these individuals over 

time to medical issues, caregiving responsibilities for 

family members, or declining health that prevents older 

NORC at the University of Chicago Research Brief | 10 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

volunteers from conducting facility visits. Even with these 

age-related considerations, however, older volunteers 

tended to be more committed to the program than their 

younger counterparts, remaining with the program for 

many years. In our sample, volunteers aged 65 or older 

donated more time to the program on average each 

month than those aged 64 and younger (14.2 vs.12.0 

hours) and were characterized by longer tenures (6.3 vs. 

3.5 years).

STRATEGIES FOR 

DISSEMINATION AND 

VOLUNTEER RECRUITMENT 

AND RETENTION 

Strategies for Dissemination 

To help grow their volunteer programs, State 

Ombudsmen described pursuing multiple avenues to 

disseminate information about volunteer opportunities. 

Importantly, strategies to recruit volunteers serve a dual 

purpose in educating the public who might need or 

benefit from the program’s services. Strategies to 

disseminate volunteer opportunities are presented in this 

section. 

It should be noted that local entities are afforded broad 

discretion in how to best grow volunteer programs in 

their areas. For this reason, volunteer recruitment 

strategies are varied (including subcontracting the 

recruitment service rather than promoting volunteer 

opportunities directly) and local agencies may also elect 

to not recruit volunteers at all. 

Word of mouth. Existing volunteers are among the 

program’s most important recruiting tools. Volunteers’ 

friends, neighbors, and community members learn about 

the Ombudsman program through word of mouth. One 

State Ombudsman noted that volunteers’ direct 

experience as Ombudsmen helps them assess who will 

be good candidates for the role. Paid Ombudsmen staff 

and others who have had positive experiences with the 

program were also reported to be key referral sources. 

In addition to these referrals, State Ombudsmen 

reported that professional staff from organizations that 

formerly worked with Ombudsmen have also been 

known to join the program as volunteers once they retire. 

Examples of these volunteers include retired medical 

professionals and facility surveyors. 

Media outlets (radio, television, newspapers, 

websites, social media). State Ombudsmen reported 

advertising volunteer opportunities through a wide 

variety of electronic and print media outlets. These 

included newspapers (e.g., ads, letters to the editor, 

feature articles), television (e.g., PSAs, television 

specials), radio, senior newsletters or resource guides, 

local magazines, state employee retirement booklets, 

press releases, free publications, social media, and 

websites. The latter includes websites operated by the 

Ombudsman program, its host agency at the local or 

state levels, Legal Aid, professional networking websites

such as LinkedIn, as well as volunteer-centric websites 

such as VolunteerMatch, JustServe, and United Way. 

Specific types of media were reported to be particularly 

effective in recruiting volunteers. One example is human 

interest stories highlighting how Ombudsmen have made 

a difference in residents’ lives. Others media profiled 

populations potentially in need of advocacy services, 

and volunteer Ombudsmen and the personal rewards 

they derived from their work. Although newspapers with 

large circulations were reported to generate interest, 

State Ombudsmen also noted that having stories 

featured in local community newspapers have been 

particularly successful in attracting volunteers. 

Community settings and events. Ombudsman 

programs develop and circulate posters, brochures, 

flyers, and business cards in various locations 

throughout the community, including libraries, churches, 

post offices, grocery stores, senior centers, Kiwanis 

clubs, community centers, laundromats, Goodwill stores, 

YMCAs, and long-term care facilities. They also 

distribute these materials at larger outlets such as health 

and volunteer fairs and exhibitions at shows, 

conventions, and senior expos. 

Ombudsmen staff also make presentations at many of 

the same venues and events to raise awareness about 

Ombudsman program services or issues facing older 

adults, such as financial exploitation. These community 

education events are also used to promote opportunities 

for volunteering. In addition to going out into the 

community, one State Ombudsman described hosting an 

open house to orient potential volunteers about the 

different programs that they can support.

Partnering with other organizations. State 

Ombudsmen reported collaborating with organizations 

such as AARP, Retired and Senior Volunteer Program 

(RSVP), Councils on Aging, and State Health Insurance 

NORC at the University of Chicago Research Brief | 11 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

Programs (SHIP), to help with volunteer recruitment. For 

example, based on zip codes that the program provides, 

AARP will send out notifications to its members about 

volunteer Ombudsman opportunities. However, although 

several State Ombudsmen reported working 

successfully with AARP on advertising the Ombudsman 

program, others noted that AARP in their state no longer 

assisted with volunteer recruitment. 

For some Ombudsman programs, responsibility for

volunteer recruitment falls on the local agency that 

houses the local Ombudsman entity, such as area 

agencies on aging (AAAs). Under this arrangement, 

recruitment is part of the local agency’s larger outreach 

efforts for all the aging services programs that it hosts, 

such as Meals on Wheels. This coordinated approach 

enables the Ombudsman program to reach potentially 

more volunteers because of the wider net that is cast by 

the local host agency.

Targeting specific groups. Collaborating with other 

organizations enables the program to target specific 

groups for volunteer recruitment, and individuals who are 

retired or about to retire. State agencies typically hold 

informational meetings about available benefits for 

people who are preparing to retire. One State 

Ombudsman reported ensuring that the Ombudsman 

program is included on the agenda of these meetings as 

a way to recruit state workers who are preparing to exit 

the labor force. Retired teachers are another group that 

State Ombudsmen reported targeting for volunteer 

recruitment. These efforts were implemented through the 

Retired Teachers Association and teachers’ 

conventions. 

More broadly, State Ombudsmen viewed the retirement 

of baby boomers as an opportunity for volunteer 

recruitment. One State Ombudsman observed that baby 

boomers in the state were less likely to move to warmer 

climates as they got older. Their preference to retire 

where they grew up has resulted in an increased pool of 

potential volunteers for the program. In other states, 

however, retirement was not viewed as a direct line to 

new volunteers. One State Ombudsman reported that as 

people live longer and remain active, they tended to 

travel into their 90s and are less likely to remain home 

where they can volunteer for the program.

Others reported that baby boomers have high 

expectations and a desire to do work that makes a 

difference. Overall, given their motivations as well as 

their accumulated skills and experience, baby boomers 

were viewed as a potentially good fit for the Ombudsman 

role. 

Another approach to targeted recruitment involved 

enlisting volunteers who are friends. One State 

Ombudsman reported that by recruiting in pairs, 

volunteers are more likely to have a source of support in 

visiting facilities, particularly those in rural areas. 

Working with educational institutions. State 

Ombudsmen reported working with local universities and 

colleges that require students to engage in community 

service. For example, students who are concentrating in 

social work or similar fields may be interested in 

volunteering with the Ombudsman program to meet 

volunteer hour requirements or as an internship 

opportunity. 

Expanding beyond traditional outlets and 

communities. Advertising in less traditional venues, 

such as on diner placemats and one-page news briefs 

found in coffee shops, was reported to be an effective 

recruiting tool. These strategies took advantage of the 

time that people spend in these spaces to draw attention 

to the program. Magazines produced by energy

cooperatives offered another program the opportunity to 

spread the word about their work. One State 

Ombudsman described placing an article in the 

cooperative’s magazine to reach members who may be 

interested in volunteering, particularly those who live in 

very rural areas. 

Partnering with organizations outside of the traditional 

senior services community also helps to expand the 

program’s network. One State Ombudsman reported 

that projects focused on special interests such as voting 

or specific groups such as lesbian, gay, bisexual, and 

transgender (LGBT) elders, have widened the base from 

which volunteers are recruited. Ombudsmen reported 

that as the organizations became more familiar with 

each other and demonstrated mutual support, their 

members have signed up to serve as volunteers.

Moreover, as the Ombudsman program’s staff 

diversifies, there are new opportunities for the program 

to reach out to previously untapped populations to raise 

awareness of the program as well as to recruit potential 

volunteers. One State Ombudsman reported that the 

Office of Minority Health invited a staff colleague to 

exhibit at arts festivals and family events focusing on the 

African American community. The State Ombudsman 

added that having communities reflected in program staff 

NORC at the University of Chicago Research Brief | 12 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

helps communicate the program’s advocacy services to 

groups that may not have known about them previously.

Volunteers’ Experiences with Dissemination 

Strategies

Consistent with the primary dissemination strategies 

programs employ, many current volunteers learned 

about the Ombudsman program through media outlets, 

community presentations, and word of mouth (Exhibit 

15). More than one-third of volunteers in our sample 

heard about the Ombudsman program though an article 

or advertisement. Another quarter learned about 

volunteer opportunities through interactions with 

program staff or from other volunteers. Social media was 

the least frequently reported source of information that 

led volunteers to learn about the program. 

Almost one quarter of volunteers learned about the 

program through other outlets. These sources included 

friends, coworkers, and relatives as well as print and 

online media, such as postings on volunteer-centric 

websites, AARP materials, newspapers, and pamphlets.

Exhibit 15: How Volunteers Learned of Program 

How did you learn about the LTCOP?

Volunteer 

Ombudsmen

N=711

LTCOP website 7%

LTCOP program materials (for example, 

poster, brochure) 8%

In-person conversation with program staff 

or volunteers 26% 

LTCOP article or advertisement in a 

newspaper or other publication or on 

television

34% 

Social media (for example, Facebook, 

Twitter) 2%

Family/friends received long-term services 

and supports 8%

Presentation by program staff or volunteers 10%

Other 23% 

Strategies for Volunteer Recruitment and Retention 

Although the dissemination strategies for recruitment 

described above can generate strong interest in the 

Ombudsman program, not every candidate is well-suited 

for the Ombudsman role, and attrition from the volunteer 

pool is an ongoing challenge. If volunteers are not a 

good fit for the Ombudsman role, programs risk high 

turnover as well as lost time spent investing in their 

training. For these reasons, State Ombudsmen reported 

trying to be selective in recruiting well-matched 

volunteers, despite their programs’ ongoing need for 

more volunteers overall. Otherwise, State Ombudsmen 

perceived that volunteer contributions would be limited to 

their numbers rather than advancing true advocacy. 

State Ombudsmen reported various strategies to 

address volunteer screening and onboarding, as well as 

ways to retain existing volunteers. 

Clear understanding of role. State Ombudsmen 

underscored the importance of properly vetting 

candidates in order to support long-term commitment to 

the program. Many reported losing volunteers who did 

not have a clear understanding of the nature of 

Ombudsmen work, despite strong initial interest. To help 

interested candidates understand the Ombudsman role 

from the outset, a few programs have new volunteers 

shadow another volunteer or paid Ombudsman on a 

facility visit. Early exposure to the typical activities 

involved in facility visits, the administrative reporting that 

follows, and residents’ need for long-term services and 

supports allow prospective volunteers to better assess 

whether the Ombudsman role is appropriate for them. 

Providing prospective volunteers with an opportunity to 

withdraw before too much time or resources are invested 

in completing their training was viewed by some 

programs as an effective strategy to optimize volunteer 

training efforts.

One program revised its recruitment process to include 

more difficult questions and role playing at the beginning 

of volunteer training sessions. Candidates are asked to 

consider their comfort level with a range of potential 

issues to which they may be exposed. Prior to 

processing volunteers’ certificates, the program also has 

candidates conduct some of their training online and inperson to ensure that this investment does not result in 

premature departures. As a result of these revisions, the 

State Ombudsman reported that the program onboarded fewer volunteers, but the ones who did begin 

with the program were more dedicated in the long-term 

compared to historical volunteer pools. 

Supervision. Ombudsman programs with resources that 

permit investing in volunteer management, such as a 

dedicated volunteer coordinator, were more likely to 

report benefits from volunteer contributions. These 

benefits included larger numbers of volunteers, greater 

ability to provide ongoing support, and higher volunteer 

retention. State Ombudsmen reported that many 

volunteers seek supervision, feedback, and 

accountability, and to be treated as professionals. The 

sustained attention that dedicated staff offers not only 

NORC at the University of Chicago Research Brief | 13 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

helps cultivate volunteer programs from recruitment to 

retention, but it also frees up staff time to carry out basic 

Ombudsman duties such as complaint resolution. 

Regular communication and support. To help 

volunteers feel connected to, and remain with the 

program, State Ombudsmen reported establishing 

various forums to keep volunteers apprised of program 

activities and to provide feedback and support. These 

include regularly scheduled meetings or conference 

calls, newsletters, and having regional Ombudsmen 

touch base with volunteers on a monthly basis. 

More informal opportunities for engagement were also 

reported to support retention, including ensuring frequent 

contact between Ombudsman staff and volunteers to 

discuss concerns and holding meetings in casual 

settings, such as coffee shops that offer privacy. One 

State Ombudsman found these informal gatherings to be 

conducive to sparking conversations among volunteers 

about common observations during facility visits and for 

developing strategies that volunteers could use to 

support one another. 

Ongoing training and professional development. 

State Ombudsmen reported providing continuing 

education, including trainings in which both paid staff 

and volunteers participate, to support not only skill 

building, but a sense of belonging. Volunteers also 

attend meetings to hear guest speakers share their 

expertise on key topics such as dementia. Another 

described providing opportunities for volunteers to attend 

conferences, such as those hosted by The National 

Consumer Voice for Quality Long-Term Care. One State 

Ombudsman also noted that the training course itself is 

attractive to some volunteers. This benefit, however, 

likely applies to younger volunteers who may perceive 

the role as a stepping-stone in their careers. 

State Ombudsmen also reported making a concerted 

effort to use data to enhance their training curricula in a 

manner that supports volunteer recruitment and 

retention. After identifying areas in need of greatest 

technical assistance, one program made several 

changes to its training. These include increasing the 

number of training hours and delivering the training 

through a mix of formats, including independent study, 

mentoring/shadowing, classroom instruction, and inperson training. Other changes included sending more 

reminders and reinforcements to volunteers about the 

value they bring to the program. To better accommodate 

the schedule of retired volunteers, the program also

moved to extend the training over a longer period of 

time.

One State Ombudsman hired a consultant and retired 

state employee to modernize their program’s recruitment 

methods and training materials, including enhancing the 

program’s website and offering more web-based 

instruction. Some of these changes were informed by 

feedback from current volunteers about the training and 

support that they received. 

Another State Ombudsman recently instituted a process 

of administering surveys to prospective volunteers who 

undergo initial training, regardless of whether they 

ultimately join the program. The feedback offers an 

opportunity for the program to obtain insights on how to 

improve training delivery as well as the changing 

landscape of volunteerism. 

Involvement in task forces and newsletters. State 

Ombudsmen reported developing volunteer task forces 

to help support retention. In these efforts, participating 

volunteers are responsible for drafting newsletters that 

showcase their contributions. In another approach to 

volunteer task forces, the local volunteer coordinator and 

local Ombudsman coordinators throughout the state 

work together to identify and share successful practices. 

The intent of these collaborations is to build on the 

successes of local programs so that Ombudsmen are 

not continually developing solutions on their own.

Flexibility in facility assignments and volunteer 

periods, locations, and roles. Whenever possible, 

State Ombudsmen reported making an effort to assign 

volunteers to facilities close to their homes to reduce 

travel distances, thereby promoting volunteer retention. 

Accommodating to volunteers’ travel schedules has also 

proven to be a successful retention strategy. After 

identifying seasonal patterns in volunteer attrition, one 

program addressed the needs of “snow birds” in their 

volunteer workforce. Allowing these volunteers to return 

to their Ombudsman duties during winter months without 

losing their certification has aided retention. Another 

State Ombudsman allows volunteers to serve more than 

one local entity if their time is routinely split between two 

residences during the year. 

Other adaptations aimed at promoting retention relate to 

volunteers’ health needs or comfort with handling 

complaints. Given the large number of older adult 

volunteers in the program, one State Ombudsman 

reported identifying ways to support volunteers’ interest 

NORC at the University of Chicago Research Brief | 14 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

in serving despite declining health. These volunteers 

may be paired with another volunteer who accompanies 

them on facility visits who also serves as a resource for 

questions or brainstorming. 

Creating tiers for various volunteer Ombudsman roles 

was also reported to help with retention. As described 

earlier, some programs have volunteers who handle a 

limited number of complaints or all types of complaints. 

According to one State Ombudsman, offering volunteers 

a choice among these two roles or allowing them to 

transition into more demanding roles once they have 

gained confidence and feel empowered have been 

important strategies for limiting turnover.

Compensation. One State Ombudsman reported that 

offering a stipend to volunteers has been attractive for 

recruitment and retention, particularly in tough economic 

times. A small number of states are also able to offer 

mileage reimbursement, a factor that is especially 

important for volunteers who cover rural areas and can 

drive 50 to 100 miles to visit a facility. These options, 

however, are often unavailable to resource-constrained 

programs. One State Ombudsman reported attempting 

to address this issue with creating a 501(c)(3) nonprofit 

organization so that donations could be used for mileage 

reimbursement. 

Recognition and appreciation. A clear priority for 

Ombudsman programs is to recognize volunteer 

contributions so that volunteers feel their efforts are 

appreciated. These feelings of appreciation translate into 

volunteers who continue to have fulfilling experiences 

with the program. Hosting recognition events honoring 

volunteers, such as luncheons and banquets, offers a 

formal occasion to acknowledge their individual and 

collective contributions and to publicly reflect of the value 

that they bring to the Ombudsman program. State 

Ombudsmen reported that these gatherings also help 

foster a sense of community and comradery where 

success stories are shared and volunteers can connect 

with other advocates. 

Volunteer recognition events may take place annually, 

and sometimes more frequently, depending on the 

program. In recognition of their service, Ombudsman 

programs bestow awards, plaques, pins, certificates, or 

other tokens of appreciation on volunteers. They also 

celebrate volunteers’ anniversaries and key milestones, 

such as number of donated volunteer hours. Some 

programs also bring in speakers or involve public 

officials in these events, including the governor, 

lieutenant governor, commissioner of health and human 

services, mayor, legislators and states’ congressional 

delegations, some of whom will draft letters or present 

awards to volunteers. One State Ombudsman noted that 

volunteer recognition events also serve to raise the 

general assembly’s awareness of the program in the 

state. Given that the program assists legislators and 

addresses their constituent concerns, the recognition 

events help improve the program’s relationship with the 

general assembly. 

State Ombudsmen also reported that when volunteers 

consented, their achievements were highlighted through 

Facebook, newsletters, and articles. Whenever possible, 

State Ombudsmen reported identifying opportunities to 

nominate volunteers for awards that are available 

through state or local host agencies or the governor’s 

office, and ensuring that outstanding performance by 

volunteers is praised and shared with their agency 

leadership and in some instances, the governor. 

State Ombudsmen also stressed the importance of 

ongoing, informal validation. Small, everyday gestures 

expressing gratitude for volunteers’ commitment helps 

them know that the program values and needs 

them. State Ombudsmen or other paid staff often reach 

out to volunteers by phone or text to ask how they are 

doing or send out birthday cards, get well cards, 

condolence cards, and thank you notes on anniversaries 

to thank them for their service. Together, the large and

small personal gestures help volunteers remain 

committed to the Ombudsman program. 

SUMMARY

Since the Ombudsman program’s inception, volunteers 

have played a critical role in strengthening the program’s 

ability to advocate on behalf of long-term care residents. 

Without volunteers, many State Ombudsmen reported 

that programs would struggle to ensure an ongoing 

presence in long-term care facilities and to make 

advocacy services accessible to residents. In 2017, 

volunteers contributed 591,362 hours of service to 

Ombudsman programs. For that year, the Independent 

Sector estimated the value of volunteer time at 

NORC at the University of Chicago Research Brief | 15 
Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

$24.69/hour, suggesting that volunteers provide over 

$14.6 million in additional labor assets to the program.7

In our sample, volunteers tended to be highly educated 

older adults who often bring relevant professional 

experiences to their volunteer roles. They also tend to 

donate a significant number of hours to the program and 

they often have long tenures as volunteers. 

In their primary role, 93% of volunteers in our sample

reported making at least quarterly visits to nursing 

homes and board and care homes and 87% investigated 

or assisted other Ombudsmen with handling resident 

complaints. Regular visitation to the same facilities offers 

the opportunity for volunteers to build relationships with 

residents and raise residents’ comfort level in expressing 

concerns. 

Some programs have also involved a smaller number of 

volunteers in responsibilities that expand beyond facility 

visitation to include systems advocacy work. Given 

volunteers’ relatively high education levels and their

desire for challenging work, there may be additional 

opportunities to leverage volunteers’ interests, skills, and 

knowledge to further support the program’s systems 

advocacy efforts to improve the long-term care system. 

Volunteers were overwhelmingly positive about, and 

satisfied with their experiences with the Ombudsman 

program. A majority of volunteers reported that their 

work was rewarding and that they were positively 

influencing other people’s lives. The Ombudsman 

program’s mission and the desire for personal fulfillment 

are key motivators for new volunteers, as well as 

reasons for staying committed to the program. 

Although a majority of volunteers reported that the 

training and support they received had prepared them 

for their roles as Ombudsmen, these data reflect the 

perspective of volunteers who continued with the 

program. When asked about areas where additional 

support would be useful, volunteers reported wanting to 

have more opportunities to discuss challenges with other 

7 https://independentsector.org/news-post/value-of-volunteer-time-release/

Ombudsmen. Our data, however, also showed that 

volunteers are not fully utilizing available resources to 

support their work. A majority was not familiar with key 

resources, including the National Association of Local 

Long-Term Care Ombudsmen and the National 

Ombudsman Resource Center. 

For many Ombudsman programs, volunteers are 

essential for meeting program mandates, particularly 

when programs have insufficient staff and funding. The 

same resource constraints, however, also present 

challenges for programs that wish to build volunteer 

management capacity to optimize volunteers’ 

contributions. State Ombudsmen reported using a wide 

variety of strategies to recruit and retain volunteers. 

These included ensuring that prospective volunteers 

have a clear understanding of the Ombudsman role, 

hiring a dedicated volunteer coordinator to grow 

volunteer programs when resources permit; providing 

opportunities for regular communication, training and 

support; offering flexibility in assignments as well as 

volunteer periods, locations, and roles; providing 

compensation, including stipends and mileage 

reimbursement; and formally and informally recognizing 

volunteers’ contributions. 

Although the Ombudsman program has evolved in 

scope and implementation over the last four decades, 

the program’s reliance on volunteers has endured. 

Moving forward, programs will need more support to 

strengthen this critical resource. Findings suggest that 

volunteers, when effectively mobilized and efficiently 

trained and coordinated, are central to adding needed 

capacity to Ombudsman programs. Given the 

responsibility entrusted to volunteers to advocate on 

behalf of as well as empower long-term care residents, 

the Ombudsman role is arguably among the most 

challenging roles that a volunteer can assume. Indeed, 

volunteer Ombudsmen’s authority to represent the 

interest of residents is a notable feature of the program 

and one that is linked to the program’s ability to carry out 

its basic legislative mandate to advocate on their behalf. 

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Strengthening the Aging and Disability Networks: Use of Volunteers in Long-Term Care Ombudsman Programs 

NORC at the University of Chicago Research Brief | 17

ABOUT NORC

NORC at the University of Chicago is an independent research organization headquartered in downtown Chicago with additional offices 

on the University of Chicago’s campus, the DC Metro area, Atlanta, Boston, and San Francisco. NORC also supports a nationwide field 

staff as well as international research operations. With clients throughout the world, NORC collaborates with government agencies, 

foundations, educational institutions, nonprofit organizations, and businesses to provide data and analysis that support informed 

decision-making in key areas, including health care, education, economics, crime, justice, and energy. NORC’s decades of leadership 

and experience in data collection, analysis, and dissemination—coupled with deep subject matter expertise—provide the foundation for 

effective solutions.

NORC at the University of Chicago Research Brief | 17