Corporate compliance is no joke. If push comes to shove, you'll be found to either be in compliance or not. It's better to be in compliance. How to get there from where you are today can be a bewildering question. Our solutions can include quick fixes to get you out of a tight spot or can include a measured, reasonably-paced schedule if your timing allows. Following is a case study that provides one example of how we helped solve a client's corporate compliance problem.

Overview

The Home Health Agency and Hospice of a hospital-based medical center in the western United Sates requested assistance in the development and implementation of a home care and hospice corporate responsibility program and training on the program for their administrative, clinical, financial, and clerical staff.

Objectives

• Increase the level of compliance knowledge and adherence to regulatory requirements for the managerial, patient care, billing, and clerical staff with post-training test scores of 80 percent or greater.
• Train the HHA clinical, financial, and administrative staff in compliance measures and policies resulting in post-training competency test scores of 80 percent and greater
• Redesign key operational processes to improve clinical documentation and billing compliance

What We Did

• Provided the expertise of one executive-level clinician for two months to the home care and hospice agency who performed the following tasks:

• Conducted a liability risk assessment
• Created a standardized code of conduct
• Developed corporate responsibility plans for both home care and hospice
• Reviewed and redesigned policies and processes to promote compliance
• Implemented an agency-specific corporate responsibility program
• Conducted training and testing to ensure staff competency

Results

• Corporate Responsibility program was accepted by the client and successfully implemented
• Corporate Responsibility plans were developed for areas posing greatest risk to agency, eg. Billing, medical records department, clinical documentation
• Determined and reported the agency’s baseline percentage of billing release
• Educated 32 staff members on their role in reimbursement, with 88 percent scoring 80 percent or greater