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Real People Real Problems: An Evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act (1995)
Institute of Medicine (IOM)

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. "Conflicts of Interest." Real People Real Problems: An Evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act. Washington, DC: The National Academies Press, 1995.

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Real People Real Problems: An Evaluation of the Long-Term Care Ombudsman Programs of the Older Americans Act
Everyday Ethical Behavior

The ombudsman may engage in behavior either as a professional or in private life that creates a perception that a conflict of interest exists. By acting in an ethical fashion, ombudsmen can eliminate a majority of the causes that give rise to these perceptions. Professional conduct and codes of ethics frequently include provisions that apply to personal behavior.

Public Accountability

Even when the remedies discussed above are sincerely employed, some situations will continue to present conflicts of interest that are not easily or willingly resolved. Indirectly, several functions of the LTC ombudsman program can help to ameliorate conflicts of interest. For example, the LTC ombudsman program is mandated to interact with citizen organizations and the family and resident councils of LTC facilities. In so doing, the program becomes more visible to the public. Consumers who serve on program advisory councils also can help alert officials to situations that might lead to conflicts of interest. Public accountability can help bring balance to the resolution of conflict of interests in one or more government entities. Media exposure of improper conduct can result in changes that remove conflicts of interest.

The effectiveness of the mechanisms to ameliorate conflicts of interest depends, in part, on the willingness of the ombudsman or the ombudsman program to use them. Other measures may better apply, however, to address significant conflicts of interest that are not ameliorated voluntarily. Residents concerned about conflicts of interest within the ombudsman program may seek remedies through the legal system, although to do so may require more financial resources and skills in accessing services outside the LTC facility than some residents may have. Employers may find that significant conflicts of interest hinder the ombudsman’s performance and constitute grounds for dismissal. Both public and private sponsors that provide funds to support ombudsman programs may withhold a portion or all of their support until conflicts of interest are resolved.

CONCLUSIONS AND RECOMMENDATIONS

Determination of actual and potential conflicts of interest in the administration and operation of the LTC ombudsman programs depends primarily on two factors: (1) the definition or parameters describing occurrences of conflicts of interest, and (2) the circumstances of the situation

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