Corporate Compliance In Health Care

In accordance with this the hospital makes sure we follow guidelines laid down by Joint commission Standards. The compliance includes four areas…Information management, Infection control, Communication and Medication Management. The Goal here is patient safety and providing patients with safe and effective care of the highest quality and value.

It is often recommended for (HCO)’s to have a corporate compliance plan to be more efficient, reduce errors, and not have small errors turn into large errors. As (OIG) it’s a necessary and fundamental need to incorporate a corporate compliance plan to have for staff and management to stay organized and lessen the chance of fraud, waste, and abuse in the company. Stated by, (Cleverly, Song, & Cleverly, 2011), it is effective only if it includes management support, effective communication, continuous monitoring, and individual accountability. All these aspects are a continual monitoring requirement as long the corporate compliance is in place for the duration.

Effective healthcare organizations routinely monitor and audit compliance performance. The processes ensure that the organization complies with regulations and uncovers compliance risks.

Compliance programs are more focused on risk management. The duties include informing staff about the laws and guidelines regulating the business and monitoring adherence to these policies (Nelson, 2012). (Nelson, 2012) By monitoring compliant behavior the programs reduce the episodes of litigation, negative press, loss of support, and confidence from the public(Nelson, 2012).

Healthcare organizations have a moral and social responsibility to ensure that their communications are conducted using an outlined code of ethics. Whether the communication is an internal message to employees or mission outreach in the community, it must reflect the values and beliefs of the organization. Therefore, in order to establish and maintain the standard of ethical behavior and social responsibility, our organization requires all employees to complete new employee orientation sessions that define the policies and expectations. This orientation introduces our mission and values and it develops the foundation for our success as an organization. Our focus on encouraging and communicating ethical practices helps to reinforce our values to employees and the community. Furthermore, there should be a process in place that monitors and enforces the policies to safeguard against potential errors that would reflect poorly on the organization’s mission.

Hospitals participating in the Medicare Medicaid Program must be in compliance with the standards for Conditions of Participation (CoPs) that are set forth in the federal regulations to receive payment from the Medicare Medicaid programs. One important way to facilitate compliance is through staff training and education. Example of a HIPAA violation further illustrates my point… case involved a Health Plan and a major news broadcasting company. The broadcasting company informed the health plan that it had purchased a photocopier previously leased by the health plan. The hard drive on this copier contained confidential medical information with 344,579 individuals being affected.

Prevailing astuteness supports the fact that working in U.S. health care field in the 21st Century call for familiarity of the countless facets of health laws as they relate to dealing with medical professionals. Further, because U.S. health care administrators have to hypothetically work together with many levels of specialists beyond the medical profession, it is judicious that they are aware of any federal, state, and local laws that may be appropriate to their organizations. Consequently, their manner is also subject to the letter of the law. They must assess the value of their professional collaborations and be watchful of the insinuations and consequences of their choices. As the top health administrator at the proposed Well Care Hospital in Happy Town. Upon being hired, there was a pre-employment screening that involved a background check that was administered to check and see if there were any violations of hospital medical misconduct during the last five years. With the hospital in the last six months being under scrutiny for breach of medical compliance there was some training that had to take place including training in personnel conduct, as well as in inter-employee conduct with medical staff, nurses, and technologists.

Being federally compliant means that you have implemented and practiced the seven components of the OIG’s Compliance Program Guidance. To be compliant with federal standards within the company, the management has designed the following into our policies and practice. Internal auditing will occur on all claims prior to submission. The compliance and practice standards for coding are documented on the company intranet and SharePoint document site. This information is reviewed and updated biannually in December and June.

When conducting business whether it is local and global, big or small organizations have to abide by state and federal laws. Depending on the nature of the business different organization has to comply with certain laws and regulations. For example, retailers like Wal-Mart, Target and Kroger have to comply with the Department of Labor and a manufacturing company like LM Fiberglass and Toyota would have to comply with the Environmental Protection Agency and Occupational Safety and Health Administration (OSHA). When an organization do not comply with the state and federal regulation the company can face fines or become caught up in major

When it comes to a compliance plan program it provider a proactive program that will ensures that you will have full compliance with all the applicable, policies, and the procedures, law and regulations. Compliance officer’s are responsibilities that this will be include in the development and it will also be in the implementation and a good management of this program for action and a designed to make sure that you would want to have3 a ethical behavior that would be in accordance with all the rules of the MUSC’s core values as to expressed in a mission statement and a cord of conduct. In these program it will endeavor to protect. One of the key element this program is the cultivation and to nurturing of an environment committed to the principle

Healthcare organizations are responsible to provide an environment of care with adequate resources, and well-trained staff to support patient safety. Paramount to these responsibilities is having medical staff bylaws that define minimum credentialing and privileging requirements for validating the competency of

This paper explores the importance of professionalism, ethical standards, professional conduct, and the importance of each in the health care system. These roles can have a positive or negative effect, or become determining factors for patients or individuals when choosing a health care facility. As the top administration of Well Care Hospital, it is my duty and role to ensure all staff members are conducting themselves in a professional and ethical manner, and following policy and procedures regarding patient’s and their medical information. The ramification or consequences I will implement if employees or staff members violate our professional code of conduct policy or security policy to prevent another security breach in the near future.

Budgeting and compliance issues are very important to healthcare. Budgeting ensures the quality of care given to patients, what technologies the hospital has available, and how staff gets paid, determining raises and benefits. Waste of time and supplies are damaging to the budget. Compliance issues are what determine the standards of care given to patients. They also set standards for safety of both patients and staff. Non-compliance can cause fines for the facility and loss of accreditation, which in turn causes losses of reimbursements from Medicare, Medicaid, and insurance. Safety issues can cause people to get hurt and, in turn, cause lawsuits for individuals and the organization. The cost of lawsuits and employee injuries can be very damaging to a budget. Healthcare workers also stand the chance of consequences in noncompliance issues. Fines, legal consequences, termination, and lose of professional licenses can occur.

As top administrator of the hospital my responsibility is to make sure professional conduct within the healthcare setting which is very important. The hospital has been under scrutiny for breach of medical compliance for the past six months. This governing board consisted of medical staff, CEO, a system planner, and a compliance officer.

Shared governance is important to compliance in order to keep all staff accountable for compliance measures. Shared governance is an organizational model that gives all management and staff control over their actions and practices and extends the influence of administrative areas (Hess, 2004). Giving all managers a voice can help improve governance compliance and operations by promoting teamwork and accountability among staff throughout the entire organization.