Complaint Investigation Support
A critical component of a hospice's corporate compliance program is a mechanism for staff to report potential fraud and abuse. An effective reporting mechanism allows staff to raise concerns without fear of retaliation.
When a report of potential fraud is received, the hospice must do whatever possible to ensure that the complaint is thoroughly investigated to determine whether or not the complaint is substantiated. A documented and comprehensive investigation is the hospice's best defense against a possible whistleblower action related to the allegation.
The scope of work for Complaint Investigation Support may include:
Phase I - Investigation
- Review of all documents and data germane to the complaint
- Develop, with input from the hospice, a schedule of on-site and/or telephone interviews with selected employees
- Review additional information, as needed, to aid in evaluating the complaint
- Evaluate the information provided and determine, to the extent possible, whether the complaint is substantiated
- Discuss the outcomes of the independent investigation with designated leaders and plan any required next steps
- Document the independent investigation and recommended next steps, if requested by the hospice
Phase II - Corrective Action
- Develop a comprehensive action plan to address the issues cited in the complaint and/or identified during the investigation. For example:
- Revise policies and procedures, forms and documentation tools
- Ensure that systems and processes support the hospice's compliance plan
- Ensure that professional services are delivered in accordance with acceptable standards of practice
- Assure appropriate internal communication and staff supervision
- Develop and facilitate staff education to address any infrastructure or other changes implemented
Weatherbee's goal is to work with the hospice's leadership to determine how to best approach the matter and ensure that the hospice is in the best position possible to respond accurately to the concerns raised.
Engaging Weatherbee will result in:
- An independent, thorough, and objective evaluation of the cited issues;
- Demonstration to staff that the hospice is proacatively addressing the identified concerns;
- Strengthening the hospice's infrastructure by identifying and addressing areas of concern; and
- Mitigating risk while enhancing staff morale.
Please contact Weatherbee for additional information regarding Compliant Investigation Support.