Corporate Compliance 101

What are everyone’s favorite words in health care? Altogether now… Corporate Compliance! Two words that stimulate a variety of emotional reactions. Regardless of how we react, corporate compliance is here to stay, so why not make the best of it and do the best we can? Corporate compliance can be very helpful and keep us out of hot water in so many ways. It can be our friend. Let’s take a closer look…

What is Corporate Compliance?

As I scanned the literature on this topic, I found several explanations for corporate compliance. I like to keep it simple. Corporate compliance is a general oversight system that is both well organized and methodical. It helps to bring together the company’s policies and procedures, training programs, monitoring and auditing systems, reporting methods and improvement efforts. In health care, we have our own brand of compliance – Healthcare Compliance, and it is recognized as a distinct healthcare profession. There are now thousands of healthcare professionals around the country who are certified specifically in healthcare compliance. Their titles range from Compliance Officer to Integrity Specialist and everywhere in between.

A Brief History of Corporate Compliance

Although corporate compliance has a powerful presence in health care now, it has been around for a long time, and officially became a best practice in long term care in the year 2000. This is the year the Department of Health and Human Services Office of the Inspector General (OIG) released compliance guidelines to nursing facilities. Later, in 2008, the Office of the Inspector General released supplemental information concerning areas of risk for being non-compliant in nursing facilities. By implementing effective compliance programs, nursing facilities could reduce their risk. In 2010, the Patient Protection and Affordability Act required all skilled long term care facilities to have a corporate compliance and ethics program in place and operating at full capacity. Whereas compliance programs were voluntary in the past, healthcare reform of 2010 made them mandatory. This act also required not only nursing facilities, but any company participating in Medicare and Medicaid, to have a corporate compliance program.

Compliance Equals Ethical Practice

When you boil it all down, an effective compliance program is really about doing what is ethically right in senior care. I prefer the word “Integrity” over compliance because compliance has a harsher connotation to it. Compliance literally means “obedience”, “submission” and “passivity”. I don’t like those words – too negative for me. I do prefer “Integrity” because it means truthfulness, honesty, honor and reliability. Better, right?

Either way, compliance or integrity is meant to find violations or prevent them in the first place. Any administrative, civil, criminal or financial violation is discovered and properly handled. It also seeks out areas of risks and shores them up. We all know there are numerous areas of risk in long term care, so why not be ahead of the curve on them? A good program also promotes quality of care for residents in nursing facilities. These are all good things.

What Should Your Compliance Program Do?

In the spirit of keeping things simple, an effective corporate compliance program should do the following:

• Demonstrate best efforts to identify, prevent and correct compliance violations
• Be a part of your daily operations
• Drive ethical practice
• Create a culture of integrity
• Protect your residents
• Manager your resources
• Enhance your facility’s reputation

Final Thoughts

Compliance is not our enemy. Rather, it is a helpful friend looking out not only for us, but our residents. It used to be a friend that we would hang around with if we wanted to, but now it is a necessary friend. Compliance can also be thought of as our ethical friend who guides us and strives for integrity. Although some health care professionals see compliance as a necessary evil, we don’t have to. Isn’t this a much better way of viewing our friend, compliance?

More About Healthcare Compliance

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