Community presence and nursing home quality of care: the ombudsman as a complementary role.

Nursing home ombudsmen represent a community presence in long-term care facilities. This study examines ombudsmen in the context of Litwak's theory of complementary roles in order to assess the theory's association with quality of care. A multivariate analysis of a random sample of 210 Missouri nursing homes revealed that the presence of an ombudsman in intermediate care facilities is significantly related to both process and outcome measures of quality of nursing care. The implication is that conceptualizations of complementary roles should include the quality assurance functions illustrated by ombudsmen.