Reporting Errors

As we continue to climb the ROPE Ladder to compliance success, Rung 3 probably inspires the most fear and trepidation. The process of identifying problems and then investigating and correcting them is perceived (often correctly) to involve finger-pointing, blame, punishments and failure. But within the context of the ROPE System, Rung 3 addresses problem-solving.

In this framework, it is essential for a home care company to create a mechanism to identify when things are not operating correctly, and then to fix them. This is just good business.

In reporting errors, both the federal sentencing guidelines and the OIG guidance for DME companies make clear that an effective compliance system must include policies that encourage and process communications from both personnel and customers. Such a reporting system provides the company with a method for self-evaluation. It is essential to enable the company to uncover problems before they become systemic or pervasive.

One key to a successful reporting policy is to obtain employee confidence in the efficacy of the policy. For this reason, senior management must emphasize and demonstrate its commitment to compliance efforts and the importance the organization places on full employee disclosure.

To encourage reporting, management must emphasize clearly that it will not tolerate or engage in retaliation against personnel who report suspected wrongdoing. In some circumstances, a company-wide acknowledgment of an employee's commitment to identifying problems is valuable. In other circumstances, a private “thank-you” from middle or senior management is more appropriate.

Some organizations include financial incentives for reporting suspected problems. Here, though, the company must be careful about encouraging a “bounty hunter” mentality, as this can backfire and result in a paranoid or mercenary atmosphere within the company.

When a home care company first unveils these reporting procedures to employees, it is wise to remind staff that their reporting of improper activity can avoid the serious consequences of a federal investigation or prosecution. Explain that the adverse consequences can include harm to the company's reputation, loss of profits, huge fines, exclusion from the Medicare and Medicaid programs, and even jail.