---
kind: "section"
citation: "42 U.S.C. § 3058g"
title: "42"
title_heading: "The Public Health and Welfare"
number: "3058g"
heading: "State Long-Term Care Ombudsman program"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/3058g"
units:
  - "Chapter 35 — Programs for Older Americans"
  - "Subchapter XI — Allotments for Vulnerable Elder Rights Protection Activities"
  - "Part A — State Provisions"
  - "Subpart ii — ombudsman programs"
---

# §3058g. State Long-Term Care Ombudsman program

- (a) **Establishment—**
  - (1) **In general—** In order to be eligible to receive an allotment under [section 3058b of this title](/usc/42/3058b.md) from funds appropriated under [section 3058a of this title](/usc/42/3058a.md) and made available to carry out this subpart, a [State agency](/usc/42/3002.md?p=52) shall, in accordance with this section—
    - (A) establish and operate an [Office](/usc/42/3058f.md?p=1) of the [State](/usc/42/3002.md?p=51) [Long-Term Care](/usc/42/3002.md?p=34) [Ombudsman](/usc/42/3058f.md?p=2); and
    - (B) carry out through the [Office](/usc/42/3058f.md?p=1) a [State](/usc/42/3002.md?p=51) [Long-Term Care](/usc/42/3002.md?p=34) [Ombudsman](/usc/42/3058f.md?p=2) [program](/usc/42/3058f.md?p=4).
  - (2) **Ombudsman—** The [Office](/usc/42/3058f.md?p=1) shall be headed by an individual, to be known as the [State](/usc/42/3002.md?p=51) [Long-Term Care](/usc/42/3002.md?p=34) [Ombudsman](/usc/42/3058f.md?p=2), who shall be selected from among individuals with expertise and experience in the fields of [long-term care](/usc/42/3002.md?p=34) and advocacy. The [Ombudsman](/usc/42/3058f.md?p=2) shall be responsible for the management, including the fiscal management, of the [Office](/usc/42/3058f.md?p=1).
  - (3) **Functions—** The [Ombudsman](/usc/42/3058f.md?p=2) shall serve on a full-time basis, and shall, personally or through [representatives](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1)—
    - (A) identify, investigate, and resolve complaints that—
      - (i) are made by, or on behalf of, [residents](/usc/42/3058f.md?p=6), including [residents](/usc/42/3058f.md?p=6) with limited or no decisionmaking capacity and who have no known legal [representative](/usc/42/3058f.md?p=5), and if such a [resident](/usc/42/3058f.md?p=6) is unable to communicate consent for an [Ombudsman](/usc/42/3058f.md?p=2) to work on a complaint directly involving the [resident](/usc/42/3058f.md?p=6), the [Ombudsman](/usc/42/3058f.md?p=2) shall seek evidence to indicate what outcome the [resident](/usc/42/3058f.md?p=6) would have communicated (and, in the absence of evidence to the contrary, shall assume that the [resident](/usc/42/3058f.md?p=6) wishes to have the [resident](/usc/42/3058f.md?p=6)’s health, safety, welfare, and rights protected) and shall work to accomplish that outcome; and
      - (ii) relate to action, inaction, or decisions, that may adversely affect the health, safety, welfare, or rights of the [residents](/usc/42/3058f.md?p=6) (including the welfare and rights of the [residents](/usc/42/3058f.md?p=6) with respect to the appointment and activities of guardians and [representative payees](/usc/42/3002.md?p=45)), of—
        - (I) providers, or [representatives](/usc/42/3058f.md?p=5) of providers, of [long-term care](/usc/42/3002.md?p=34) services;
        - (II) [public agencies](/usc/42/11851.md?p=8); or
        - (III) health and social service [agencies](/usc/42/8262.md?p=1);
    - (B) provide services to assist the [residents](/usc/42/3058f.md?p=6) in protecting the health, safety, welfare, and rights of the [residents](/usc/42/3058f.md?p=6);
    - (C) inform the [residents](/usc/42/3058f.md?p=6) about means of obtaining services provided by providers or [agencies](/usc/42/8262.md?p=1) described in [subparagraph (A)(ii)](#a-3-A-ii) or services described in [subparagraph (B)](#a-3-B);
    - (D) ensure that the [residents](/usc/42/3058f.md?p=6) have regular, timely, private, and unimpeded access to the services provided through the [Office](/usc/42/3058f.md?p=1) and that the [residents](/usc/42/3058f.md?p=6) and complainants receive timely responses from [representatives](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) to complaints;
    - (E) represent the interests of the [residents](/usc/42/3058f.md?p=6) before governmental [agencies](/usc/42/8262.md?p=1) and seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of the [residents](/usc/42/3058f.md?p=6);
    - (F) provide administrative and technical assistance to entities designated under [paragraph (5)](#a-5) to assist the entities in participating in the [program](/usc/42/3058f.md?p=4);
    - (G)
      - (i) analyze, comment on, and monitor the development and implementation of Federal, [State](/usc/42/3002.md?p=51), and local laws, regulations, and other governmental policies and actions, that pertain to the health, safety, welfare, and rights of the [residents](/usc/42/3058f.md?p=6), with respect to the adequacy of [long-term care facilities](/usc/42/3002.md?p=35) and services in the [State](/usc/42/3002.md?p=51);
      - (ii) recommend any changes in such laws, regulations, policies, and actions as the [Office](/usc/42/3058f.md?p=1) determines to be appropriate; and
      - (iii) facilitate public comment on the laws, regulations, policies, and actions;
    - (H)
      - (i) provide for training [representatives](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1);
      - (ii) promote the development of citizen organizations, to participate in the [program](/usc/42/3058f.md?p=4); and
      - (iii) provide technical support for, actively encourage, and assist in the development of [resident](/usc/42/3058f.md?p=6) and family councils to protect the well-being and rights of [residents](/usc/42/3058f.md?p=6);
    - (I) when feasible, continue to carry out the functions described in this section on behalf of [residents](/usc/42/3058f.md?p=6) transitioning from a [long-term care facility](/usc/42/3002.md?p=35) to a home care setting; and
    - (J) carry out such other activities as the [Assistant Secretary](/usc/42/3002.md?p=7) determines to be appropriate.
  - (4) **Contracts and arrangements—**
    - (A) **In general—** Except as provided in [subparagraph (B)](#a-4-B), the [State agency](/usc/42/3002.md?p=52) may establish and operate the [Office](/usc/42/3058f.md?p=1), and carry out the [program](/usc/42/3058f.md?p=4), directly, or by contract or other arrangement with any [public agency](/usc/42/11851.md?p=8) or [nonprofit](/usc/42/3002.md?p=39) private organization.
    - (B) **Licensing and certification organizations; associations—** The [State agency](/usc/42/3002.md?p=52) may not enter into the contract or other arrangement described in [subparagraph (A)](#a-4-A) with—
      - (i) an [agency](/usc/42/8262.md?p=1) or organization that is responsible for licensing or certifying [long-term care](/usc/42/3002.md?p=34) services in the [State](/usc/42/3002.md?p=51); or
      - (ii) an association (or an affiliate of such an association) of [long-term care facilities](/usc/42/3002.md?p=35), or of any other residential facilities for [older individuals](/usc/42/3002.md?p=40).
  - (5) **Designation of local Ombudsman entities and representatives—**
    - (A) **Designation—** In carrying out the duties of the [Office](/usc/42/3058f.md?p=1), the [Ombudsman](/usc/42/3058f.md?p=2) may designate an entity as a [local Ombudsman entity](/usc/42/3058f.md?p=3), and may designate an employee or volunteer to represent the entity.
    - (B) **Duties—** An individual so designated shall, in accordance with the policies and procedures established by the [Office](/usc/42/3058f.md?p=1) and the [State agency](/usc/42/3002.md?p=52)—
      - (i) provide services to protect the health, safety, welfare[^1] and rights of [residents](/usc/42/3058f.md?p=6);
      - (ii) ensure that [residents](/usc/42/3058f.md?p=6) in the service area of the entity have regular, timely access to [representatives](/usc/42/3058f.md?p=5) of the [program](/usc/42/3058f.md?p=4) and timely responses to complaints and requests for assistance;
      - (iii) identify, investigate, and resolve complaints made by or on behalf of [residents](/usc/42/3058f.md?p=6) that relate to action, inaction, or decisions, that may adversely affect the health, safety, welfare, or rights of the [residents](/usc/42/3058f.md?p=6);
      - (iv) represent the interests of [residents](/usc/42/3058f.md?p=6) before government [agencies](/usc/42/8262.md?p=1) and seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of the [residents](/usc/42/3058f.md?p=6);
      - (v)
        - (I) review, and if necessary, comment on any existing and proposed laws, regulations, and other government policies and actions, that pertain to the rights and well-being of [residents](/usc/42/3058f.md?p=6); and
        - (II) facilitate the ability of the public to comment on the laws, regulations, policies, and actions;
      - (vi) support, actively encourage, and assist in the development of [resident](/usc/42/3058f.md?p=6) and family councils;
      - (vii) identify, investigate, and resolve complaints described in [clause (iii)](#a-5-B-iii) that are made by or on behalf of [residents](/usc/42/3058f.md?p=6) with limited or no decisionmaking capacity and who have no known legal [representative](/usc/42/3058f.md?p=5), and if such a [resident](/usc/42/3058f.md?p=6) is unable to communicate consent for an [Ombudsman](/usc/42/3058f.md?p=2) to work on a complaint directly involving the [resident](/usc/42/3058f.md?p=6), the [Ombudsman](/usc/42/3058f.md?p=2) shall seek evidence to indicate what outcome the [resident](/usc/42/3058f.md?p=6) would have communicated (and, in the absence of evidence to the contrary, shall assume that the [resident](/usc/42/3058f.md?p=6) wishes to have the [resident](/usc/42/3058f.md?p=6)’s health, safety, welfare, and rights protected) and shall work to accomplish that outcome; and
      - (viii) carry out other activities that the [Ombudsman](/usc/42/3058f.md?p=2) determines to be appropriate.
    - (C) **Eligibility for designation—** Entities eligible to be designated as [local Ombudsman entities](/usc/42/3058f.md?p=3), and individuals eligible to be designated as [representatives](/usc/42/3058f.md?p=5) of such entities, shall—
      - (i) have demonstrated capability to carry out the responsibilities of the [Office](/usc/42/3058f.md?p=1);
      - (ii) be free of conflicts of interest and not stand to gain financially through an action or potential action brought on behalf of individuals the [Ombudsman](/usc/42/3058f.md?p=2) serves;
      - (iii) in the case of the entities, be public or [nonprofit](/usc/42/3002.md?p=39) private entities; and
      - (iv) meet such additional requirements as the [Ombudsman](/usc/42/3058f.md?p=2) may specify.
    - (D) **Policies and procedures—**
      - (i) **In general—** The [State agency](/usc/42/3002.md?p=52) shall establish, in accordance with the [Office](/usc/42/3058f.md?p=1), policies and procedures for monitoring [local Ombudsman entities](/usc/42/3058f.md?p=3) designated to carry out the duties of the [Office](/usc/42/3058f.md?p=1).
      - (ii) **Policies—** In a case in which the entities are grantees, or the [representatives](/usc/42/3058f.md?p=5) are employees, of area [agencies](/usc/42/8262.md?p=1) on aging, the [State agency](/usc/42/3002.md?p=52) shall develop the policies in consultation with the area [agencies](/usc/42/8262.md?p=1) on aging. The policies shall provide for participation and comment by the [agencies](/usc/42/8262.md?p=1) and for resolution of concerns with respect to case activity.
      - (iii) **Confidentiality and disclosure—** The [State agency](/usc/42/3002.md?p=52) shall develop the policies and procedures in accordance with all provisions of this part regarding confidentiality and conflict of interest.
    - (E) **Rule of construction for volunteer Ombudsman representatives—** Nothing in this paragraph shall be construed as prohibiting the [program](/usc/42/3058f.md?p=4) from providing and financially supporting recognition for an individual designated under [subparagraph (A)](#a-5-A) as a volunteer to represent the [Ombudsman](/usc/42/3058f.md?p=2) [program](/usc/42/3058f.md?p=4), or from reimbursing or otherwise providing financial support to such an individual for any costs, such as transportation costs, incurred by the individual in serving as such volunteer.
- (b) **Procedures for access—**
  - (1) **In general—** The [State](/usc/42/3002.md?p=51) shall ensure that [representatives](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) shall have—
    - (A) private and unimpeded access to [long-term care facilities](/usc/42/3002.md?p=35) and [residents](/usc/42/3058f.md?p=6);
    - (B)
      - (i) appropriate access to review all files, records, and other information concerning a [resident](/usc/42/3058f.md?p=6), if—
        - (I) the [representative](/usc/42/3058f.md?p=5) has the permission of the [resident](/usc/42/3058f.md?p=6), or the legal [representative](/usc/42/3058f.md?p=5) of the [resident](/usc/42/3058f.md?p=6); or
        - (II) the [resident](/usc/42/3058f.md?p=6) is unable to communicate consent to the review and has no legal [representative](/usc/42/3058f.md?p=5); or
      - (ii) access to the files, records, and information as is necessary to investigate a complaint if—
        - (I) a legal guardian of the [resident](/usc/42/3058f.md?p=6) refuses to give the permission;
        - (II) a [representative](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) has reasonable cause to believe that the guardian is not acting in the best interests of the [resident](/usc/42/3058f.md?p=6); and
        - (III) the [representative](/usc/42/3058f.md?p=5) obtains the approval of the [Ombudsman](/usc/42/3058f.md?p=2);
    - (C) access to the administrative records, policies, and documents, to which the [residents](/usc/42/3058f.md?p=6) have, or the general public has access, of [long-term care facilities](/usc/42/3002.md?p=35); and
    - (D) access to and, on request, copies of all licensing and certification records maintained by the [State](/usc/42/3002.md?p=51) with respect to [long-term care facilities](/usc/42/3002.md?p=35).
  - (2) **Procedures—** The [State agency](/usc/42/3002.md?p=52) shall establish procedures to ensure the access described in [paragraph (1)](#b-1).
  - (3) **Health oversight agency—** For purposes of [section 264(c)](/usc/42/264.md?p=c) of the Health Insurance Portability and Accountability Act of 1996 (including regulations issued under that section) ([42 U.S.C. 1320d–2](/usc/42/1320d–2.md) note), the [Ombudsman](/usc/42/3058f.md?p=2) and a [representative](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) shall be considered a “health oversight [agency](/usc/42/8262.md?p=1),” so that release of [residents](/usc/42/3058f.md?p=6)’ individually identifiable health information to the [Ombudsman](/usc/42/3058f.md?p=2) or [representative](/usc/42/3058f.md?p=5) is not precluded in cases in which the requirements of clause [(i)](#b-1-B-i) or [(ii)](#b-1-B-ii) of paragraph (1)(B), or the requirements of [paragraph (1)(D)](#b-1-D), are otherwise met.
- (c) **Reporting system—** The [State agency](/usc/42/3002.md?p=52) shall establish a statewide uniform reporting system to—
  - (1) collect and analyze data relating to complaints and conditions in [long-term care facilities](/usc/42/3002.md?p=35) and to [residents](/usc/42/3058f.md?p=6) for the purpose of identifying and resolving significant problems; and
  - (2) submit the data, on a regular basis, to—
    - (A) the [agency](/usc/42/8262.md?p=1) of the [State](/usc/42/3002.md?p=51) responsible for licensing or certifying [long-term care facilities](/usc/42/3002.md?p=35) in the [State](/usc/42/3002.md?p=51);
    - (B) other [State](/usc/42/3002.md?p=51) and Federal entities that the [Ombudsman](/usc/42/3058f.md?p=2) determines to be appropriate;
    - (C) the [Assistant Secretary](/usc/42/3002.md?p=7); and
    - (D) the National [Ombudsman](/usc/42/3058f.md?p=2) Resource Center established in [section 3012(a)(18) of this title](/usc/42/3012.md?p=a-18).
- (d) **Disclosure—**
  - (1) **In general—** The [State agency](/usc/42/3002.md?p=52) shall establish procedures for the disclosure by the [Ombudsman](/usc/42/3058f.md?p=2) or [local Ombudsman entities](/usc/42/3058f.md?p=3) of files, records, and other information maintained by the [program](/usc/42/3058f.md?p=4), including records described in subsection [(b)(1)](#b-1) or [(c)](#c).
  - (2) **Identity of complainant or resident—** The procedures described in [paragraph (1)](#d-1) shall—
    - (A) provide that, subject to [subparagraph (B)](#d-2-B), the files, records, and other information described in [paragraph (1)](#d-1) may be disclosed only at the discretion of the [Ombudsman](/usc/42/3058f.md?p=2) (or the person designated by the [Ombudsman](/usc/42/3058f.md?p=2) to disclose the files, records, and other information);
    - (B) prohibit the disclosure of the identity of any complainant or [resident](/usc/42/3058f.md?p=6) with respect to whom the [Office](/usc/42/3058f.md?p=1) maintains such files, records, or other information unless—
      - (i) the complainant or [resident](/usc/42/3058f.md?p=6), or the legal [representative](/usc/42/3058f.md?p=5) of the complainant or [resident](/usc/42/3058f.md?p=6), consents to the disclosure and the consent is given in writing;
      - (ii)
        - (I) the complainant or [resident](/usc/42/3058f.md?p=6) gives consent orally; and
        - (II) the consent is documented contemporaneously in a writing made by a [representative](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) in accordance with such requirements as the [State agency](/usc/42/3002.md?p=52) shall establish; or
      - (iii) the disclosure is required by court order; and
    - (C) notwithstanding [subparagraph (B)](#d-2-B), ensure that the [Ombudsman](/usc/42/3058f.md?p=2) may disclose information as needed in order to best serve [residents](/usc/42/3058f.md?p=6) with limited or no decisionmaking capacity who have no known legal [representative](/usc/42/3058f.md?p=5) and are unable to communicate consent, in order for the [Ombudsman](/usc/42/3058f.md?p=2) to carry out the functions and duties described in paragraphs [(3)(A)](#a-3-A) and [(5)(B)](#a-5-B) of subsection (a).
- (e) **Consultation—** In planning and operating the [program](/usc/42/3058f.md?p=4), the [State agency](/usc/42/3002.md?p=52) shall consider the views of area [agencies](/usc/42/8262.md?p=1) on aging, [older individuals](/usc/42/3002.md?p=40), and providers of [long-term care](/usc/42/3002.md?p=34).
- (f) **Conflict of interest—**
  - (1) **Individual conflict of interest—** The [State agency](/usc/42/3002.md?p=52) shall—
    - (A) ensure that no individual, or member of the immediate family of an individual, involved in the designation of the [Ombudsman](/usc/42/3058f.md?p=2) (whether by appointment or otherwise) or the designation of an entity designated under [subsection (a)(5)](#a-5), is subject to a conflict of interest;
    - (B) ensure that no officer or employee of the [Office](/usc/42/3058f.md?p=1), [representative](/usc/42/3058f.md?p=5) of a [local Ombudsman entity](/usc/42/3058f.md?p=3), or member of the immediate family of the officer, employee, or [representative](/usc/42/3058f.md?p=5), is subject to a conflict of interest; and
    - (C) ensure that the [Ombudsman](/usc/42/3058f.md?p=2)—
      - (i) does not have a direct involvement in the licensing or certification of a [long-term care facility](/usc/42/3002.md?p=35) or of a provider of a [long-term care](/usc/42/3002.md?p=34) service;
      - (ii) does not have an ownership or investment interest (represented by equity, debt, or other financial relationship) in a [long-term care facility](/usc/42/3002.md?p=35) or a [long-term care](/usc/42/3002.md?p=34) service;
      - (iii) is not employed by, or participating in the management of, a [long-term care facility](/usc/42/3002.md?p=35) or a related organization, and has not been employed by such a facility or organization within 1 year before the date of the determination involved;
      - (iv) does not receive, or have the right to receive, directly or indirectly, remuneration (in cash or in kind) under a compensation arrangement with an [owner](/usc/42/13641.md?p=4) or operator of a [long-term care facility](/usc/42/3002.md?p=35);
      - (v) does not have management responsibility for, or operate under the supervision of an individual with management responsibility for, [adult protective services](/usc/42/3002.md?p=3); and
      - (vi) does not serve as a guardian or in another [fiduciary](/usc/42/3002.md?p=20) capacity for [residents](/usc/42/3058f.md?p=6) of [long-term care facilities](/usc/42/3002.md?p=35) in an official capacity (as opposed to serving as a guardian or [fiduciary](/usc/42/3002.md?p=20) for a family member, in a personal capacity).
  - (2) **Organizational conflict of interest—**
    - (A) **In general—** The [State agency](/usc/42/3002.md?p=52) shall comply with [subparagraph (B)(i)](#f-2-B-i) in a case in which the [Office](/usc/42/3058f.md?p=1) poses an organizational conflict of interest, including a situation in which the [Office](/usc/42/3058f.md?p=1) is placed in an organization that—
      - (i) is responsible for licensing, certifying, or surveying [long-term care](/usc/42/3002.md?p=34) services in the [State](/usc/42/3002.md?p=51);
      - (ii) is an association (or an affiliate of such an association) of [long-term care facilities](/usc/42/3002.md?p=35), or of any other residential facilities for [older individuals](/usc/42/3002.md?p=40);
      - (iii) provides [long-term care](/usc/42/3002.md?p=34) services, including [programs](/usc/42/3058f.md?p=4) carried out under a Medicaid waiver approved under section 1115 of the Social Security Act ([42 U.S.C. 1315](/usc/42/1315.md)) or under subsection (b) or (c) of section 1915 of the Social Security Act ([42 U.S.C. 1396n](/usc/42/1396n.md)), or under a Medicaid [State](/usc/42/3002.md?p=51) plan amendment under subsection (i), (j), or (k) of section 1915 of the Social Security Act ([42 U.S.C. 1396n](/usc/42/1396n.md));
      - (iv) provides [long-term care](/usc/42/3002.md?p=34) case management;
      - (v) sets rates for [long-term care](/usc/42/3002.md?p=34) services;
      - (vi) provides [adult protective services](/usc/42/3002.md?p=3);
      - (vii) is responsible for eligibility determinations for the Medicaid [program](/usc/42/3058f.md?p=4) carried out under title XIX of the Social Security Act ([42 U.S.C. 1396](/usc/42/1396.md) et seq.);
      - (viii) conducts preadmission screening for placements in facilities described in [clause (ii)](#f-2-A-ii); or
      - (ix) makes decisions regarding admission or discharge of individuals to or from such facilities.
    - (B) **Identifying, removing, and remedying organizational conflict—**
      - (i) **In general—** The [State agency](/usc/42/3002.md?p=52) may not operate the [Office](/usc/42/3058f.md?p=1) or carry out the [program](/usc/42/3058f.md?p=4), directly, or by contract or other arrangement with any [public agency](/usc/42/11851.md?p=8) or [nonprofit](/usc/42/3002.md?p=39) private organization, in a case in which there is an organizational conflict of interest (within the meaning of [subparagraph (A)](#f-2-A)) unless such conflict of interest has been—
        - (I) identified by the [State agency](/usc/42/3002.md?p=52);
        - (II) disclosed by the [State agency](/usc/42/3002.md?p=52) to the [Assistant Secretary](/usc/42/3002.md?p=7) in writing; and
        - (III) remedied in accordance with this subparagraph.
      - (ii) **Action by Assistant Secretary—** In a case in which a potential or actual organizational conflict of interest (within the meaning of [subparagraph (A)](#f-2-A)) involving the [Office](/usc/42/3058f.md?p=1) is disclosed or reported to the [Assistant Secretary](/usc/42/3002.md?p=7) by any person or entity, the [Assistant Secretary](/usc/42/3002.md?p=7) shall require that the [State agency](/usc/42/3002.md?p=52), in accordance with the policies and procedures established by the [State agency](/usc/42/3002.md?p=52) under [subsection (a)(5)(D)(iii)](#a-5-D-iii)—
        - (I) remove the conflict; or
        - (II) submit, and obtain the approval of the [Assistant Secretary](/usc/42/3002.md?p=7) for, an adequate remedial plan that indicates how the [Ombudsman](/usc/42/3058f.md?p=2) will be unencumbered in fulfilling all of the functions specified in [subsection (a)(3)](#a-3).
- (g) **Legal counsel—** The [State agency](/usc/42/3002.md?p=52) shall ensure that—
  - (1)
    - (A) adequate legal counsel is available, and is able, without conflict of interest, to—
      - (i) provide advice and consultation needed to protect the health, safety, welfare, and rights of [residents](/usc/42/3058f.md?p=6); and
      - (ii) assist the [Ombudsman](/usc/42/3058f.md?p=2) and [representatives](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) in the performance of the official duties of the [Ombudsman](/usc/42/3058f.md?p=2) and [representatives](/usc/42/3058f.md?p=5); and
    - (B) legal representation is provided to any [representative](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) against whom suit or other legal action is brought or threatened to be brought in connection with the performance of the official duties of the [Ombudsman](/usc/42/3058f.md?p=2) or such a [representative](/usc/42/3058f.md?p=5); and
  - (2) the [Office](/usc/42/3058f.md?p=1) pursues administrative, legal, and other appropriate remedies on behalf of [residents](/usc/42/3058f.md?p=6).
- (h) **Administration—** The [State agency](/usc/42/3002.md?p=52) shall require the [Office](/usc/42/3058f.md?p=1) to—
  - (1) prepare an annual report—
    - (A) describing the activities carried out by the [Office](/usc/42/3058f.md?p=1) in the year for which the report is prepared;
    - (B) containing and analyzing the data collected under [subsection (c)](#c);
    - (C) evaluating the problems experienced by, and the complaints made by or on behalf of, [residents](/usc/42/3058f.md?p=6);
    - (D) containing recommendations for—
      - (i) improving quality of the care and life of the [residents](/usc/42/3058f.md?p=6); and
      - (ii) protecting the health, safety, welfare, and rights of the [residents](/usc/42/3058f.md?p=6);
    - (E)
      - (i) analyzing the success of the [program](/usc/42/3058f.md?p=4) including success in providing services to [residents](/usc/42/3058f.md?p=6) of [board and care facilities](/usc/42/3002.md?p=10) and other similar adult care facilities; and
      - (ii) identifying barriers that prevent the optimal operation of the [program](/usc/42/3058f.md?p=4); and
    - (F) providing policy, regulatory, and legislative recommendations to solve identified problems, to resolve the complaints, to improve the quality of care and life of [residents](/usc/42/3058f.md?p=6), to protect the health, safety, welfare, and rights of [residents](/usc/42/3058f.md?p=6), and to remove the barriers;
  - (2) analyze, comment on, and monitor the development and implementation of Federal, [State](/usc/42/3002.md?p=51), and local laws, regulations, and other government policies and actions that pertain to [long-term care facilities](/usc/42/3002.md?p=35) and services, and to the health, safety, welfare, and rights of [residents](/usc/42/3058f.md?p=6), in the [State](/usc/42/3002.md?p=51), and recommend any changes in such laws, regulations, and policies as the [Office](/usc/42/3058f.md?p=1) determines to be appropriate;
  - (3)
    - (A) provide such information as the [Office](/usc/42/3058f.md?p=1) determines to be necessary to public and private [agencies](/usc/42/8262.md?p=1), legislators, and other persons, regarding—
      - (i) the problems and concerns of individuals residing in [long-term care facilities](/usc/42/3002.md?p=35); and
      - (ii) recommendations related to the problems and concerns; and
    - (B) make available to the public, and submit to the [Assistant Secretary](/usc/42/3002.md?p=7), the chief executive officer of the [State](/usc/42/3002.md?p=51), the [State](/usc/42/3002.md?p=51) legislature, the [State agency](/usc/42/3002.md?p=52) responsible for licensing or certifying [long-term care facilities](/usc/42/3002.md?p=35), and other appropriate governmental entities, each report prepared under [paragraph (1)](#h-1);
  - (4) ensure that the [Ombudsman](/usc/42/3058f.md?p=2) or a designee participates in training provided by the National [Ombudsman](/usc/42/3058f.md?p=2) Resource Center established in [section 3012(a)(18) of this title](/usc/42/3012.md?p=a-18);
  - (5) strengthen and update procedures for the training of the [representatives](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1), including unpaid volunteers, based on model standards established by the [Director](/usc/42/11851.md?p=5) of the [Office](/usc/42/3058f.md?p=1) of [Long-Term Care](/usc/42/3002.md?p=34) [Ombudsman](/usc/42/3058f.md?p=2) [Programs](/usc/42/3058f.md?p=4), in consultation with [representatives](/usc/42/3058f.md?p=5) of citizen groups, [long-term care](/usc/42/3002.md?p=34) providers, and the [Office](/usc/42/3058f.md?p=1), that—
    - (A) specify a minimum number of hours of initial training;
    - (B) specify the content of the training, including training relating to—
      - (i) Federal, [State](/usc/42/3002.md?p=51), and local laws, regulations, and policies, with respect to [long-term care facilities](/usc/42/3002.md?p=35) in the [State](/usc/42/3002.md?p=51);
      - (ii) investigative techniques; and
      - (iii) such other matters as the [State](/usc/42/3002.md?p=51) determines to be appropriate; and
    - (C) specify an annual number of hours of in-service training for all designated [representatives](/usc/42/3058f.md?p=5);
  - (6) prohibit any [representative](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) (other than the [Ombudsman](/usc/42/3058f.md?p=2)) from carrying out any activity described in subparagraphs [(A)](#a-3-A) through [(G)](#a-3-G) of subsection (a)(3) unless the [representative](/usc/42/3058f.md?p=5)—
    - (A) has received the training required under [paragraph (5)](#h-5); and
    - (B) has been approved by the [Ombudsman](/usc/42/3058f.md?p=2) as qualified to carry out the activity on behalf of the [Office](/usc/42/3058f.md?p=1);
  - (7) coordinate [ombudsman](/usc/42/3058f.md?p=2) services with the protection and advocacy systems for individuals with [developmental disabilities](/usc/42/3002.md?p=13) and mental illnesses established under—
    - (A) subtitle C of title I of the [Developmental Disabilities](/usc/42/3002.md?p=13) Assistance and Bill of Rights Act of 2000 [[42 U.S.C. 15041](/usc/42/15041.md) et seq.]; and
    - (B) the Protection and Advocacy for Mentally Ill Individuals Act of 1986[^2] ([42 U.S.C. 10801](/usc/42/10801.md) et seq.);
  - (8) coordinate, to the greatest extent possible, [ombudsman](/usc/42/3058f.md?p=2) services with [legal assistance](/usc/42/3002.md?p=33) provided under [section 3026(a)(2)(C) of this title](/usc/42/3026.md?p=a-2-C), through adoption of memoranda of understanding and other means;
  - (9) coordinate services with [State](/usc/42/3002.md?p=51) and local law enforcement [agencies](/usc/42/8262.md?p=1) and courts of competent jurisdiction; and
  - (10) permit any [local Ombudsman entity](/usc/42/3058f.md?p=3) to carry out the responsibilities described in paragraph [(1)](#h-1), [(2)](#h-2), [(3)](#h-3), [(7)](#h-7), or [(8)](#h-8).
- (i) **Liability—** The [State](/usc/42/3002.md?p=51) shall ensure that no [representative](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) will be liable under [State](/usc/42/3002.md?p=51) law for the good faith performance of official duties.
- (j) **Noninterference—** The [State](/usc/42/3002.md?p=51) shall—
  - (1) ensure that willful interference with [representatives](/usc/42/3058f.md?p=5) of the [Office](/usc/42/3058f.md?p=1) in the performance of the official duties of the [representatives](/usc/42/3058f.md?p=5) (as defined by the [Assistant Secretary](/usc/42/3002.md?p=7)) shall be unlawful;
  - (2) prohibit retaliation and reprisals by a [long-term care facility](/usc/42/3002.md?p=35) or other entity with respect to any [resident](/usc/42/3058f.md?p=6), employee, or other person for filing a complaint with, providing information to, or otherwise cooperating with any [representative](/usc/42/3058f.md?p=5) of, the [Office](/usc/42/3058f.md?p=1); and
  - (3) provide for appropriate sanctions with respect to the interference, retaliation, and reprisals.

## Footnotes

[^1]: So in original. Probably should be followed by a comma.
[^2]: See References in Text note below.

## Source credit

(Pub. L. 89–73, title VII, § 712, as added Pub. L. 102–375, title VII, § 702, Sept. 30, 1992, 106 Stat. 1276; amended Pub. L. 103–171, § 3(a)(9), Dec. 2, 1993, 107 Stat. 1990; Pub. L. 106–402, title IV, § 401(b)(9)(D), Oct. 30, 2000, 114 Stat. 1739; Pub. L. 106–501, title VII, § 704, title VIII, § 801(e)(2), Nov. 13, 2000, 114 Stat. 2289, 2293; Pub. L. 114–144, § 8(c), Apr. 19, 2016, 130 Stat. 347; Pub. L. 116–131, title VI, § 602, Mar. 25, 2020, 134 Stat. 268.)

## Notes

### Editorial Notes

### References in Text

Section 264(c) of the Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (b)(3), is section 264(c) of Pub. L. 104–191, which is set out as a note under section 1320d–2 of this title.

The Social Security Act, referred to in subsec. (f)(2)(A)(vii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.

The Developmental Disabilities Assistance and Bill of Rights Act of 2000, referred to in subsec. (h)(7)(A), is Pub. L. 106–402, Oct. 30, 2000, 114 Stat. 1677. Subtitle C of title I of the Act is classified generally to part C (§ 15041 et seq.) of subchapter I of chapter 144 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 15001 of this title and Tables.

The Protection and Advocacy for Mentally Ill Individuals Act of 1986, referred to in subsec. (h)(7)(B), was Pub. L. 99–319, May 23, 1986, 100 Stat. 478. Pub. L. 99–319 was renamed the Protection and Advocacy for Individuals with Mental Illness Act by Pub. L. 106–310, div. B, title XXXII, § 3206(a), Oct. 17, 2000, 114 Stat. 1193, and is classified generally to chapter 114 (§ 10801 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 10801 of this title and Tables.

### Amendments

2020—Subsec. (a)(5)(E). Pub. L. 116–131 added subpar. (E).

2016—Subsec. (a)(2). Pub. L. 114–144, § 8(c)(1)(A), inserted at end “The Ombudsman shall be responsible for the management, including the fiscal management, of the Office.”

Subsec. (a)(3)(A)(i). Pub. L. 114–144, § 8(c)(1)(B)(i), added cl. (i) and struck out former cl. (i) which read as follows: “are made by, or on behalf of, residents; and”.

Subsec. (a)(3)(D). Pub. L. 114–144, § 8(c)(1)(B)(ii), substituted “regular, timely, private, and unimpeded” for “regular and timely”.

Subsec. (a)(3)(H)(iii). Pub. L. 114–144, § 8(c)(1)(B)(iii), inserted “, actively encourage, and assist in” after “provide technical support for” and struck out “and” after semicolon at end.

Subsec. (a)(3)(I), (J). Pub. L. 114–144, § 8(c)(1)(B)(iv), (v), added subpar. (I) and redesignated former subpar. (I) as (J).

Subsec. (a)(5)(B)(vi). Pub. L. 114–144, § 8(c)(1)(C)(i), inserted “, actively encourage, and assist in” after “support” and struck out “and” after semicolon at end.

Subsec. (a)(5)(B)(vii), (viii). Pub. L. 114–144, § 8(c)(1)(C)(ii), (iii), added cl. (vii) and redesignated former cl. (vii) as (viii).

Subsec. (b)(1)(A). Pub. L. 114–144, § 8(c)(2)(A)(i), substituted “private and unimpeded access” for “access”.

Subsec. (b)(1)(B)(i). Pub. L. 114–144, § 8(c)(2)(A)(ii)(I)(aa), substituted “all files, records, and other information concerning” for “the medical and social records of” in introductory provisions.

Subsec. (b)(1)(B)(i)(II). Pub. L. 114–144, § 8(c)(2)(A)(ii)(I)(bb), substituted “to communicate consent” for “to consent”.

Subsec. (b)(1)(B)(ii). Pub. L. 114–144, § 8(c)(2)(A)(ii)(II), substituted “the files, records, and information” for “the records” in introductory provisions.

Subsec. (b)(3). Pub. L. 114–144, § 8(c)(2)(B), added par. (3).

Subsec. (c)(2)(D). Pub. L. 114–144, § 8(c)(3), substituted “3012(a)(18)” for “3012(a)(21)”.

Subsec. (d)(1). Pub. L. 114–144, § 8(c)(4)(A), substituted “files, records, and other information” for “files”.

Subsec. (d)(2)(A). Pub. L. 114–144, § 8(c)(4)(B)(i), substituted “files, records, and other information” for “files and records” in two places and struck out “and” after semicolon at end.

Subsec. (d)(2)(B). Pub. L. 114–144, § 8(c)(4)(B)(ii)(I), substituted “files, records, or other information” for “files or records” in introductory provisions.

Subsec. (d)(2)(C). Pub. L. 114–144, § 8(c)(4)(B)(ii)(II), (iii), added subpar. (C).

Subsec. (f). Pub. L. 114–144, § 8(c)(5), added subsec. (f) and struck out former subsec. (f) which related to conflict of interest.

Subsec. (h)(3)(A)(i). Pub. L. 114–144, § 8(c)(6)(A), struck out “older” before “individuals”.

Subsec. (h)(4). Pub. L. 114–144, § 8(c)(6)(D), added par. (4). Former par. (4) redesignated (5).

Pub. L. 114–144, § 8(c)(6)(B), substituted “(4) strengthen and update” for text that had been amended by Pub. L. 106–501, § 704(2)(A), which was executed to read “(4) strengthen and update”. See 2000 Amendment note below.

Subsec. (h)(5), (6). Pub. L. 114–144, § 8(c)(6)(C), redesignated pars. (4) and (5) as (5) and (6), respectively. Former par. (6) redesignated (7).

Subsec. (h)(6)(A). Pub. L. 114–144, § 8(c)(6)(E), substituted “paragraph (5)” for “paragraph (4)”.

Subsec. (h)(7). Pub. L. 114–144, § 8(c)(6)(C), redesignated par. (6) as (7). Former par. (7) redesignated (8).

Subsec. (h)(7)(A). Pub. L. 114–144, § 8(c)(6)(F), substituted “subtitle C of title I of the” for “subtitle C of the”.

Subsec. (h)(8), (9). Pub. L. 114–144, § 8(c)(6)(C), redesignated pars. (7) and (8) as (8) and (9), respectively. Former par. (9) redesignated (10).

Subsec. (h)(10). Pub. L. 114–144, § 8(c)(6)(G), substituted “(7), or (8)” for “(6), or (7)”.

Pub. L. 114–144, § 8(c)(6)(C), redesignated par. (9) as (10).

2000—Subsec. (a)(1). Pub. L. 106–501, § 801(e)(2), substituted “section 3058a of this title and made available to carry out this subpart” for “section 3058a(a) of this title” in introductory provisions.

Subsec. (a)(5)(C)(ii). Pub. L. 106–501, § 704(1), inserted “and not stand to gain financially through an action or potential action brought on behalf of individuals the Ombudsman serves” after “interest”.

Subsec. (h)(4). Pub. L. 106–501, § 704(2)(A), substituted “strengthen and update” for “(A) not later than 1 year after September 30, 1992, establish” in introductory provisions, redesignated cls. (i) and (ii) of former subpar. (A) as subpars. (A) and (B), respectively, redesignated subcls. (I) to (III) of former subpar. (A)(ii) as cls. (i) to (iii), respectively, of subpar. (B), redesignated cl. (iii) of former subpar. (A) as subpar. (C) and struck out “and” at end, and struck out former subpar. (B) which read as follows: “require implementation of the procedures not later than 21 months after September 30, 1992;”. Amendment was executed to reflect the probable intent of Congress notwithstanding error in directory language misquoting original text to be struck out, which had been translated as reference to September 30, 1992.

Subsec. (h)(6)(A). Pub. L. 106–402 substituted “subtitle C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000” for “part A of the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6001 et seq.)”.

Subsec. (h)(8), (9). Pub. L. 106–501, § 704(2)(B)–(D), added par. (8) and redesignated former par. (8) as (9).

1993—Subsecs. (a)(3)(I), (c)(2)(C), (h)(3)(B). Pub. L. 103–171, § 3(a)(9)(B), substituted “Assistant Secretary” for “Commissioner”.

Subsec. (h)(4)(A). Pub. L. 103–171, § 3(a)(9)(A), substituted “Director of the Office of Long-Term Care Ombudsman Programs” for “Associate Commissioner for Ombudsman Programs”.

Subsec. (j)(1). Pub. L. 103–171, § 3(a)(9)(B), substituted “Assistant Secretary” for “Commissioner”.

### Statutory Notes and Related Subsidiaries

### Effective Date

Section inapplicable with respect to fiscal year 1993, see section 4(b) of Pub. L. 103–171, set out as an Effective Date of 1992 Amendment note under section 3001 of this title.

Section inapplicable with respect to fiscal year 1992, see section 905(b)(6) of Pub. L. 102–375, set out as an Effective Date of 1992 Amendment note under section 3001 of this title.