About Consumer Voice


The National Consumer Voice for Quality Long-Term Care was formed as NCCNHR (National Citizens' Coalition for Nursing Home Reform) in 1975 because of public concern about substandard care in nursing homes. The Consumer Voice is the outgrowth of work first achieved by advocates working for Ralph Nader and later for the National Gray Panthers. Elma Holder, NCCNHR founder, was working with The Long-Term Care Action Project of the Gray Panthers when she organized a group meeting of advocates from across the country to attend a nursing home industry conference in Washington, DC. At that meeting, representatives of 12 citizen action groups spoke collectively to the industry about the need for serious reform in nursing home conditions. The consumer attendees were inspired to develop a platform of common concerns and motivated to form a new organization to represent the consumer voice at the national level. Most of the original members had witnessed and endured personal experiences with substandard nursing home conditions.

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Our Vision & Mission

View the Executive Summary from the Consumer's Voice business plan.

The Consumer Voice envisions a world in which all consumers of long-term care, services and supports are treated with respect and dignity and have a wide range of affordable, quality options across all settings. These options will make it possible for individuals to receive care and services in the location and manner of their choice and to attain a high quality of life.

The Consumer Voice is the leading national voice representing consumers in issues related to long-term care, helping to ensure that consumers are empowered to advocate for themselves. We are a primary source of information and tools for consumers, families, caregivers, advocates and ombudsmen to help ensure quality care for the individual.  

The Consumer Voice's mission is to represent consumers at the national level for quality long-term care, services and supports.

To carry out our mission, we:

  • Advocate for public policies that support quality care and quality of life responsive to consumers’ needs in all long-term care settings
  • Empower and educate consumers and families with the knowledge and tools they need to advocate for themselves
  • Train and support individuals and groups that empower and advocate for consumers of long-term care
  • Promote the critical role of direct-care workers and best practices in quality-care delivery

Members and subscribers to the Consumer Voice's resources hail from all 50 states and are comprised of a diverse and caring coalition of local citizen action groups, state and local long-term care ombudsmen, legal services programs, religious organizations, professional groups, nursing home employees' unions, concerned providers, national organizations and growing numbers of family and resident councils. The Consumer Voice's grassroots network consists of over 10,000 members.

The Consumer Voice provides information and leadership on federal and state regulatory and legislative policy development and models and strategies to improve care and life for residents of nursing homes and other long-term care facilities. Ongoing work addresses issues such as:

  • Inadequate staffing in nursing homes, particularly all levels of nursing staff;
  • Poor working conditions, salaries and benefits for long-term care workers;
  • Maintenance of residents' rights and empowerment of residents;
  • Support for family members and development of family councils;
  • Resources for and support to Citizen Advocacy Groups (CAGs);
  • Development and support for the long-term care ombudsman program;
  • Minimizing the use of physical and chemical restraints;
  • The high cost of poor care, such as pressure sores, dehydration, incontinence, and contracture of residents' muscles and
  • Accountability to taxpayers for nursing home expenditures and failure to fulfill government contracts.

Elma Holder, Consumer Voice Founder

Elma HolderIn 1975, Elma Holder founded the Consumer Voice and served as Executive Director from its incorporation in 1978 to 1995, working in a staff and advisory capacity until retirement in 2002. She then returned to Oklahoma to become one of her mother’s family caregivers.

After completing studies in the public health program at the University of Oklahoma in 1968, Elma served as the Gerontology Consultant to the Oklahoma State Department of Health, working with the Medicare program and the nursing home survey agency. After advanced studies at the USC Summer Gerontology Institute, she moved to Washington, DC, where she served the National Council on Aging as health consultant. In 1975, Consumer Voice was the outgrowth of Holder’s work with two public interest organizations: Ralph Nader’s Retired Professional Action Group (1971-1973) and the National Gray Panthers (Philadelphia, 1973-1976).

Elma's first exposure to nursing homes was personal: overseeing the care of an elderly grandfather. During her work in Washington, DC, she was in regular contact with residents of nursing homes who became active in Consumer Voice, as well as personal friends experiencing nursing home care.  She initiated the Campaign for Quality Care while at the Consumer Voice and was actively involved in shepherding public advocacy to help achieve the 1987 National Nursing Home Reform Law.  Elma served twice as a delegate to the White House Conference on Aging. Among other awards, in 1998 Contemporary Long Term Care selected Elma as one of  “20 Who Make a Difference.“ In 1999, she was awarded the National Academy of Sciences, Institute of Medicine, Gustave Leinhard Award, supported by the Robert Wood Johnson Foundation for outstanding achievement in improving health care. For her life’s work, Elma was awarded the Chairman’s Medal from the Heinz Family Foundation in 2006. In the fall, 2008, she began work as a volunteer ombudsman in Oklahoma.