We climb the second rung of the ROPE (Rule Overload Prevention and Elimination) Ladder by teaching our operational systems — and the “Rules” that shape our systems — to our personnel. We have previously identified eight methods that can help convey knowledge, motivation and enthusiasm during the teaching process. Two final training suggestions focus on accountability at both ends of the corporate ladder.
In a healthy organizational culture of compliance, personnel realize that company leadership is ready and willing to help them comply with law, policy and procedure. But there must be clear expectations of compliance, and unambiguous consequences for failures, whether inadvertent, negligent, or intentional. There must be discussions of the company's compliance expectations, with tactful references to other employee policies on topics like progressive discipline.
Employees should be taught to properly respect — not fear — the consequences of non-compliance, but they must appreciate the reality of enforcement. Sometimes the reality is sobering, as with fraud investigations or substantial reimbursement investigations. Other times the reality is more benign, as with HIPAA enforcement.
While staff should be reassured that HHS is not planning any sweeps, dragnets or witch-hunts, they must understand that a complaint by a patient or other affected person can result in serious consequences for both the organization and the employee.
Even more important, personnel must be taught to comply with your policies and procedures simply because they are your policies and procedures — not because the law says so, not because government penalties may follow — but because the policies and procedures were created for good reasons, and because it is better to address policy flaws through official channels than to ignore the policies altogether. Remember our central premise: Teach your compliant internal policies; don't teach the Rules.
When you discuss enforcement issues, include updated enforcement statistics and anecdotes. This will enable your employees to imagine themselves in the place of those who become subjects of enforcement actions, and thus ponder the inherent danger of a casual attitude toward HIPAA compliance.
Finally, remember at all times to integrate enforcement discussions with your own internal needs for compliance. The key is to require compliance because “that's how we do it,” — for reasons that include profitability, efficiency, inventory control, record keeping or anything else — as well as compliance with the Rules.
By offering effective training, home care companies can inoculate their personnel against rule overload. Good training is good leadership, and good leadership in compliance program training will help foster a culture of trust and cooperation where staff and employees strive to do what's right and self-enforce compliance on a daily basis.
Meaningful, ongoing compliance training prevents both foolhardy carelessness and destructive over-compliance, which can erect barriers to efficient health care delivery. Meaningful, ongoing HIPAA training gives staff and employees the tools to carry out their part of your overall compliance program.
During the past several months, “Compliance University” has focused on training techniques to help your employees understand how to utilize the ROPE System as an asset to your success. Together, these techniques teach the following lessons:
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We're all in this together.
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We want to do this the right way, legally and ethically, as well as for competitive success.
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We need the help of our entire workforce to do this correctly.
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Here's how to do it correctly. (Describe your own actual policies.)
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Here's what to do if something does not seem right to you.
Neil Caesar is president of the Health Law Center (Neil B. Caesar Law Associates, PA), a national health law practice in Greenville, S.C. He also is a principal with Caesar Cohen Ltd., which offers compliance training, outsourcing and consulting and the author of the Home Care Compliance Answer Book. He can be reached by e-mail at ncaesar@healthlawcenter.com or by telephone at 864/676-9075.
The ROPE Ladder
Rung 1: Articulate the way you want things to run, and note how they run now. Then, tweak your systems as necessary to comply with “The Rules.”
Rung 2: Teach your operating systems to your employees.
Rung 3: Implement a clear and simple method for dealing with problems — identify them, report them, investigate them and fix them.
Rung 4: Give your compliance staff resources to help them keep up-to-date with internal and external changes that may sometimes require you to refine your operating systems.
Rung 5: Monitor your operating systems to make sure they continue to run as you intended.
Materials in this article have been prepared by the Health Law Center for general informational purposes only. This information does not constitute legal advice. You should not act, or refrain from acting, based upon any information in this presentation. Neither our presentation of such information nor your receipt of it creates nor will create an attorney-client relationship.
