The Difference Between a Nursing Home Ombudsman and State Inspectors

When it comes to ensuring the well-being of nursing home residents, two key roles often come into play: nursing home ombudsmen and state inspectors. While both work to protect residents' rights and safety, their responsibilities, authority, and approaches differ significantly. 

Understanding these differences can help families and residents advocate more effectively for quality care.

What Is a Nursing Home Ombudsman?

A Long-Term Care Ombudsman is an advocate for residents in nursing homes, assisted living facilities, and other long-term care settings. Their primary role is to:

• Resolve complaints – They address concerns raised by residents or their families, such as issues with care, abuse, neglect, or violations of rights.

• Educate residents and families – They inform residents about their rights and help them navigate the system.

• Mediate conflicts – They work with facility staff to resolve disputes without legal action.

• Advocate for systemic change – They push for policy improvements at local, state, and federal levels.

Ombudsmen are typically volunteers or paid professionals who work independently of the government, though they are federally mandated under the Older Americans Act. They do not have enforcement power but serve as neutral third parties to ensure fair treatment.

Read More: Top 5 Issues the Hawaii Ombudsman Helps Seniors Resolve 

What Do State Inspectors Do?

State surveyors (inspectors) are government employees responsible for ensuring nursing homes comply with federal and state regulations. Their duties include:

• Conducting routine inspections – They evaluate facilities for compliance with health, safety, and care standards.

• Investigating complaints – They look into reports of abuse, neglect, or substandard care.

• Issuing citations and penalties – If violations are found, they can impose fines, require corrective action, or even shut down facilities.

• Enforcing laws – Their findings can lead to legal consequences for non-compliant nursing homes.

State inspectors work under agencies like the Centers for Medicare & Medicaid Services (CMS) or state health departments. Their role is regulatory rather than advocacy-based.

Key Differences Between Ombudsmen and State Inspectors

Aspect	Nursing Home Ombudsman	State Inspector
Primary Role	Advocate for residents	Enforce regulations
Authority	No enforcement power—works through mediation	Can issue citations, fines, and penalties
Focus	Individual resident concerns and rights	Facility-wide compliance with laws
Approach	Mediation, education, and advocacy	Investigation and enforcement
Affiliation	Independent or nonprofit organizations	Government agencies (CMS, state health dept)

When to Contact an Ombudsman vs. a State Inspector

• Contact an Ombudsman if:

  • You have concerns about a resident’s treatment, dignity, or rights.

  • You need help resolving a dispute with facility staff.

  • You want guidance on navigating long-term care options.

• Contact State Inspectors if:

  • You suspect serious violations (e.g., abuse, neglect, unsafe conditions).

  • The facility is failing to meet health and safety standards.

  • You want to trigger an official investigation.

Conclusion

Both nursing home ombudsmen and state inspectors play crucial roles in protecting residents, but they serve different functions. Ombudsman Nursing Homes programs focus on advocacy and conflict resolution, while state inspectors enforce regulations through legal authority. Families and residents should leverage both resources to ensure the highest quality of care.

If you or a loved one is in a nursing home, knowing these differences can empower you to take the right steps when concerns arise.

Would you like help finding your local ombudsman or state inspection agency? Let us know in the comments!