Mississippi Administrative Code › Title 18 - HUMAN SERVICES › Part 26 - Policies and Procedures Manual for the MS Ombudsman Program › Part II - Administration of the Long-Term Ombudsman Program › Section 18-26-2-D - Conflicts of Interest

Current through June 25, 2024
The organizational placement of the OLTCO and the Office of
				  the State Long-Term Care Ombudsman (OLTCO) and the designated Representatives
				  of the Office of Long-Term Care Ombudsman (LTCO) must be free, and remain free,
				  of any conflicts of interest. A conflict of interest exits when any
				  organizational or supervisory relationship, policy, action or individual
				  relationship or action conflicts with, impairs or threatens to interfere with,
				  or give the appearance of interfering with the ability of a SLTCO or LTCO to
				  investigate, resolve, refer complaints or otherwise advocate on behalf of a
				  long-term care facility resident. A conflict of interest can exist whenever a
				  contracting (or sponsoring) agency does not understand the Ombudsman function.
				  There must be recognition that there are inherent conflicts in the job, and a
				  need to support the role and goals of the Ombudsman through any
				  conflict.
An individual who seeks to be hired as the SLTCO cannot have
				  been employed or participated in the management of a long-term care facility
				  within the previous twelve (12) months. An individual who seeks to be hired as
				  a LTCO cannot have been employed or participated in the management of a
				  long-term care facility within the previous six (6) months.
All LTCO must sign a conflict of interest agreement form upon
				  employment and then annually by Oct. 31st. The State Ombudsman will keep the
				  current signed forms on file (hard copies or electronic copies) for all
				  Representatives of the Office of the State Long-Term Care Ombudsman. In
				  addition, the AAAs or provider agencies must sign an Organizational Conflict of
				  Interest form annually by October 31st.
Identifying a
				  Conflict
Types of conflicts of interest include:
Conflicts of
								Loyalty:
These involve issues of judgment and objectivity.
								An example would be if the ombudsman works as a case manager with the
								responsibility for assisting individuals with moving into long-term care
								facilities. Some are responsible for operation of home- and community-based
								service programs that operate under waivers granted by the federal
								government.
Conflicts of
								Commitment:
These are issues of time and attention. The
								ombudsmen who assume other employment-related responsibilities may experience
								this such as where to direct one's time and energy and the concern about
								adequacy of resources.
Conflicts of
								Control:
These are issues of independence. Do other
								interests or obligations of the agency which houses the ombudsman program
								interfere with the ombudsman's advocacy on behalf of the residents? Do the
								administrative and political forces materially interfere with the professional
								judgment of the ombudsman? Is there fear of retaliation by superiors? Will an
								ombudsman challenge eligibility decisions or speak out publicly about long
								waiting lists?
Organizational
				  Conflicts
:
Conflicts arising from organization location
				  including, but not limited to, LTCOP placement with a service provider
				  that:
1. Is responsible to or reports
				to an agency that has an ownership or investment interest in a long-term care
				facility setting;
2. Provides
				long-term care services, including providing personnel for long-term care
				facilities or the operation of programs, which control access to or services
				for long-term care facilities;
3.
				Operates programs with responsibilities conflicting with LTCOP responsibilities
				such as developing care plans, case management or serving as guardians over
				long-term care residents; or
4.
				Having governing board members with ownership, investment or employment
				interest in long-term care facilities.
Individual Conflicts:
A
				  conflict of interest on the part of the Ombudsman exists whenever:
1. Employment of an individual or member of
				his/her immediate family within the previous year by a long-term care facility
				in the service area or by the owner/operator of any long-term care facility in
				the service area;
2. Participation
				in the management of a long-term care facility by an individual or member of
				his/her immediate family;
3.
				Involvement in the licensing or certifying of long term care facilities by an
				individual or member of his/her immediate family;
4. Ownership or financial interest in an
				existing or proposed long-term care facility;
5. Acceptance of a gift from a long-term care
				facility, resident or resident representative. Note: sample portions of food
				tested as part of an investigation is not a conflict;
6. Receiving, directly or indirectly,
				remuneration (in cash or in kind) under a compensation arrangement with an
				owner or operator of a LTC facility (meaning an immediate family member
				currently employed);
7. Provides
				services with conflicting responsibilities such as adult protective services,
				carrying out care plans and serving as guardians or being a sole witness for a
				DNR order, performing case management or pre-admission screening for residents.
				Possible remedy would be to remove the Ombudsman Program from under the
				supervision of the person who supervises the case management or pre-screening
				program;
8. Serving residents of a
				facility in which an immediate family member resides; or
9. Participation in activities which give the
				appearance that that LTCO's primary interest is something other than being a
				resident advocate.
Removing or Remedying a
				  Conflict
If a conflict is identified, the local LTCOP will:
1) End the application process;
2) Seek a remedy; or
3) Request de-certification.
It is best to avoid rather than remedy conflicts. The State
				  LTC Ombudsman will determine whether any proposed remedies are adequate. If
				  not, he/she will work with the entity operating the LTCOP to devise acceptable
				  remedies.
The SLTCO must be notified of any actual or potential
				  conflict of interest. All agents of the AAAs, other provider agencies and LTCOs
				  have a duty to notify the SLTCO of any actual or potential/perceived conflict
				  of interest of which they have knowledge.
The SLTCO has the authority to decide what actions must take
				  place to remedy the conflict. A conflict may be remedied only if it does not
				  interfere with the duties of the LTCOP or where the conflict is likely not to
				  change the perception of the LTCOP being an independent advocate for the
				  residents of long-term care.
The following steps must be followed in order for an
organizational conflict
to be sufficiently
				  remedied:
* Develop a written remedial plan within 30 days of knowledge
				  of the conflict;
* The remedial plan must include assurances that the LTCOP
				  will investigate complaints in an unbiased manner and independently determine
				  the actions to resolve the situation;
* No agency employee or governing board member with a
				  conflict of interest will be involved with any decision to hire or terminate
				  the employment of a LTCO; and
* The remedial plan must be mutually agreed upon and signed
				  by the agency in which the conflict exits and the State Ombudsman. If either
				  party cannot agree to the plan, then the conflict has not be sufficiently
				  remedied.
The following steps must be followed in order for an
				  individual conflict to be sufficiently remedied:
* No applicant for such a position of a LTCO will be hired if
				  a conflict of interest is identified.
* Volunteers: If a conflict of interest is identified prior
				  to designation/certification, the volunteer will not be designated as a
				  representative of the Office in any facility in which a conflict of interest or
				  an appearance of a conflict of interest could be expected to affect the
				  performance of the ombudsman duties. The District or Local Ombudsman must
				  notify the State Ombudsman immediately. De-certification or reassignment would
				  be possible remedies.
* Directors of AAA: If a conflict of interest is identified,
				  action must be taken within 30 days to remedy the situation. Possible remedies
				  include the withdrawal of designation of the agency as an AAA.