You go to check your email. You see an unread email with the subject line, “compliance investigation”. What are your initial thoughts? Regardless of your level of experience, your seniority, or what you have or have not done, that subject line will likely cause some degree of anxiety. But, should it? If your company has done a proper orientation, then you should know that a compliance investigation is just what it says it is: an investigation.
Imagine this scenario: you have just finished working with a patient. You go to check your email. You see an unread email with the subject line, “compliance investigation”. What are your initial thoughts? Regardless of your level of experience, your seniority, or what you have or have not done, that subject line will likely cause some degree of anxiety. But, should it? If your company has done a proper orientation, then you should know that a compliance investigation is just what it says it is: an investigation.
Patients, family members, and even co-workers can report things to compliance. In fact, most organizations require a compliance report before all of the facts are available. I work in home health, an area ripe for compliance complaints. I remember a situation where a patient called alleging that her clinician, who just left her home, took her 2 roles of quarters that she needed to do her laundry. I sighed to myself, but my position required that I file a compliance report. I initiated the process, which began with documenting the patient’s allegation and obtaining a statement from the clinician. He denied the allegation. He even offered to go buy 2 roles of quarters to avoid the investigation; unfortunately, that was not an option. As I completed the paperwork and was about to send the report, the patient called again. She found her quarters.
What do should you learn from this situation? Hopefully, you learn that you rarely have anything to fear from a compliance investigation. Anecdotally, and in my experience, most compliance investigations end with an unfounded or unconfirmed status. A complaint that is unconfirmed means that there was simply not enough evidence to verify an allegation. When an investigation is unfounded, it means that the investigation has concluded that the claim is false or not supported by facts.
Hopefully you never receive an email from compliance; however, if you practice long enough, chances are you will. So, when and if you do get this dreaded email, what should you do?
My first focus is always on providing quality care. If you focus on quality, you will rarely have to deal with compliance. While my first hope is that you will never deal with a compliance investigation, my experience suggests that many of you will. Knowing what to do can save you a lot of grief.
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