Effective Discipline

An effective compliance program must have a mechanism for enforcing the rules. During any investigation by the government or DMERC, a home care company's commitment to legal compliance will be evaluated, in large part, by looking at its disciplinary procedures. How severe is the discipline? How effective? How frequent?

If the feds are looking at you, your contention that your compliance program is working must be supported by evidence that you have, in fact, disciplined transgressors. This point is often misunderstood by HME companies. Discipline is not limited to censure, financial penalties or termination. Re-education, notations in personnel files and other forms of minor chits also count as discipline.

Whenever someone violates a policy or protocol, appropriate discipline is required. It is just as important to discipline minor or first-time offenses as major transgressions for two reasons. First, the government wants to see evidence that a company holds its people accountable. Second, repeated mistakes can be just as dangerous as a major error.

Repeated mistakes may indicate a poor attitude or a general unfitness for the job, both of which can lead to major problems. Further, incorrect claims submissions can become “false claims” subject to major fines and penalties when a company submits claims with “reckless disregard” as to their accuracy.

So, it is important to allow and even encourage your compliance system to catch minor errors. It is equally important to discipline the transgressor with admonishment, education, written warnings or, if errors are repeated, more severe discipline.

I strongly recommend that companies consider an employee's failure to report problems or repeated mistakes as a rather severe violation of company rules. Effective reporting is the backbone of effective compliance. Education and re-education is needed to emphasize that a company cannot improve unless the inevitable mistakes that everyone makes are caught and addressed. “Failure to report” must result in some form of discipline.

Similarly, it is important to require supervisors to do their jobs and, as part of their jobs, to catch and address both mistakes and reckless or intentional bad behavior. So a “failure to supervise” should be disciplined at least as severely as is the mistake or wrongdoing.