Guide to Maintain Compliance in Your Home Health Care Policies and Procedures It is a significant burden on home health agencies to maintain compliance in your home health care policies and procedures. There are several essential elements in this field. Here are the vital actions to ensure successful compliance.
Develop Written Standards of Conduct, Procedures, and Policies
The purpose of the standard procedure is to standardize daily operational activities. It will help if you have clarity in dealing with issues and activities related to safety and health. You should also be aware of regulatory requirements and legal liabilities. The importance of health care policy and the procedure cannot be disputed.
Documentation of the policy and procedures gives us clarity when performing actions. It also allows you to share knowledge in the matter. You need to ensure no regulations are breached. Written standards of conduct, procedures, and policies will enable the identification of problem areas. It also allows you to detect areas of potential fraud. Employees must agree to the adherence to the standards and performance evaluations.
Appoint a Compliance Officer or Compliance Committee
A practical and empowered compliance office is a principle element of the compliance program. If there is a compliance committee, the compliance officer would be the chairperson. The compliance officer has to co-ordinate responsibilities between the members. They have two primary responsibilities, viz. development and implementation of a compliance program.
The compliance program should cover regulations pertaining to healthcare policies. Many practices address HIPAA compliance and cover billing and reimbursement. The compliance officer/committee should be updated about compliance laws. They should also ensure policies and procedures followed.
Develop and Implement Effective Education and Training Programs
Education and training programs should be mandatory. Regular training programs instill a better understanding of compliance in employees. The training program should focus on educating employees on the law, organization policies, and regulations. Through education and training programs, employees learn how compliance is related to their day-to-day activities. The compliance program structure should discuss pertinent laws and regulations.
The education and training program should place a strong emphasis on the importance of regulatory compliance across departments. You need not communicate all compliance standards, policies, and procedures to employees. However, you must include the standards related to abuse of laws and complying with fraud as part of all training programs.
Develop and Maintain a Standardized Reporting System for Complaints
Effective and efficient reporting systems are critical in creating standard practice and procedures in a healthcare system. There is no agreement on a standard set of data elements related to patient safety and clinical procedures. Each healthcare facility designs its reporting system and the content of the reports.
The healthcare organization should have a standardized reporting system for complaints that supports the agency’s regulatory obligations. The reporting system should be able to share and compare data with integrated systems.
The agency should create a reporting system that allows the submission of breaches to the compliance committee or compliance officer. There can be a suggestion or complaint box, third party hotline, or other forms of safeguarded communication. The complaint submission method should protect the identity of the complainant.
Develop Disciplinary Guidelines and Enforce Them to Achieve Service Standards
The compliance officer should develop disciplinary guidelines and also formulate disciplinary action to staff that does not follow the home health care policies and procedures.
The compliance program should have a written policy that identifies various disciplinary actions for breaking the code of conduct. The disciplinary guidelines should be strictly imposed on non-compliant employees.
The compliance officer should employ internal or external audits or use other evaluation techniques to identify problem areas and monitor compliance. The inspection should focus on compliance laws related to cost reporting, physician self-referral prohibition, kickback arrangements, claim development and submission, and marketing.
Develop Corrective Plans and Respond to Detected Offenses
Detected but uncorrected offenses threaten the reputation of the organization, licensure, and reimbursements. The home health agencies should have a system and policy in place to investigate alleged misconduct.
Encourage High-Level Involvement in Compliance
Though the organization designates the compliance committee to maintain compliance, the compliance authority should encourage the agency’s governing body, chief operating officer, chief executive officer, chief financial officer, and general counsel to involve in the development of appropriate standards of conduct. An all-organization involvement helps communicate an explicit and robust statement of compliance standards and goals.
The above-given guidelines would help the home health agencies in maintaining compliance in their home health care policies and procedures.
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Guide to Maintain Compliance in Your Home Health Care Policies and Procedures