Agents of nursing home quality of care: ombudsmen and staff ratios revisited.

Many gerontologists have proposed that ombudsman programs and other forms of community presence should improve nursing home quality of care. This study compared these programs' effects on quality of nursing care on a random sample of 134 Medicare/Medicaid-certified long-term care facilities in Missouri. The presence of an ombudsman program was found to be the most important factor associated with quality for intermediate-care facilities, and it was significantly associated with quality for skilled nursing homes where there was ample staffing of registered nurses.