Home Health Hospice Team Lead – Timothy E. Allen | Former Special Agent (U.S. Secret Service & DOJ-OIG)
Internal audits in the home health/hospice industry establish if providers have internal controls in place in all aspects, from accounting processes to corporate governance. The audits also ensure home health and hospice providers comply with regulations governing them.
Corporate Investigation Consulting can conduct internal audits or facilitate them for providers wishing to establish internal controls and comply with applicable home health/hospice regulations nationwide.
The OIG (Office of Inspector General) has guidelines on hospice compliance. However, many hospices are still unfamiliar with these guidelines or have over complied. Our internal audits can reveal the extent of compliance and the need for new internal controls. One of the critical issues assessed through internal audit processes is the presence of compliance programs. Hospices and related providers like home health providers need compliance programs.
Corporate Investigation Consulting can assess internal processes and set up compliance programs to help home health and hospice providers avoid common non-compliance problems like penalties and lawsuits. Our compliance programs include everything from audits to monitoring operations like billing, care provision, etc., to ensure they are at par with regulations.
Put our highly experienced team on your side
Roger Bach
Former Special Agent (OIG)
Timothy E. Allen
Former Senior Special Agent U.S. Secret Service
Chris J. Quick
Former Special Agent (FBI & IRS-CI)
Maura Kelley
Former Special Agent (FBI)
Ray Yuen
Former Supervisory Special Agent (FBI)
Michael S. Koslow
Former Supervisory Special Agent (DOD-OIG)
Marquis D. Pickett
Special Agent U.S. Secret Service (ret.)
What We Do For Home Health/Hospice Providers
Our internal audits include, but aren’t limited to:
Internal Monitoring
Home health/hospices should determine operational areas that need monitoring and determine how audits should be done. While most hospices monitor internal controls internally, a professional third party such as Corporate Investigation Consulting is best suited for obvious reasons. Audits need to be conducted without bias otherwise, they won’t be effective.
Our internal audits/monitoring focuses on many areas the most notable being OIG’s risk areas, patient admission, compliance with Medicare, and substandard care areas.
We can ensure your establishment never admits patients that don’t meet the patient admission guidelines or bill for the wrong level of care. This alone minimizes incidences of claim denial or focused medical reviews conducted by fiscal intermediaries. Our internal audit experts ensure providers have everything needed, including the right documentation processes to eliminate such risks.
Standards of Conduct
Our internal audits focus on important risk areas as well as the effectiveness of compliance programs in place. In doing so, our focus is on standards of conduct, emphasizing how providers are committed to ethics.
Our clients get recommendations on the best code of ethics to adopt i.e., NHPCO, and ways of making such codes visible on all a provider’s channels and staff training material.
Policies and Procedures
We assess as well as develop internal policies and procedures for providers that need them. We have home health/hospice policy experts with vast expertise in handling all aspects of a hospice or home health provider’s compliance program and risk areas.
Establishing Reporting Mechanisms
Providers need reporting mechanisms in cases of compliance concerns. We can establish such procedures for disgruntled employees and third parties known to bring lawsuits against home health and hospice providers.
Our internal audits assess the existence and effectiveness of reporting mechanisms. There should be a way for anyone to report potential abuse, fraud, or other bad practices or occurrence without fear of retaliation. Our experts can review and establish new reporting mechanisms ranging from toll-free reporting numbers to suggestion boxes.
Establishing Corrective Actions
Internal audits that yield unfavorable results need corrective actions. Non-compliance issues uncovered by audits should be addressed immediately.
Home care/hospice providers need policies and procedures for disciplining employee-related non-compliance with standards of conduct, regulations, and code of ethics. Part of our service is ensuring staff in-home care/hospice understand the seriousness of following internal procedures and policies.
Audits that find problems within a hospice or home health provider must be followed with corrective actions that include what management is willing to do. For instance, overpayments must be refunded immediately. If internal audits uncover legal problems that require hiring legal experts, providers should be willing to do so.
We can also help providers find compliance officers internally whose work is continuously monitoring internal controls. Large hospice chains have the resources to designate compliance officer roles. We can help small hospices find internal employees that fit this role perfectly. Such persons should have an in-depth understanding of internal processes i.e., a nurse manager, clinical director.
Staff Education/Training
Compliance programs can’t be effective if staff are oblivious of internal controls. Since internal audits assess compliance programs, the importance of having trained staff can’t be overlooked.
Corporate Investigation Consulting can facilitate home health/hospice staff on the existence of compliance programs and how to comply. We facilitate training that includes an introduction to compliance and other information needed for internal processes to work.
Custom Compliance Manuals
Since different home health providers and hospices differ in many ways, we can assist in preparing custom compliance manuals that work perfectly for an organization.
Corporate Investigation Consulting prides itself in offering practical solutions to internal process problems. We don’t “copy-paste” solutions from one provider to the other. We understand the uniqueness of all our customers and strive to create compliance manuals that recognize this fact.
After internal auditing, our dedicated staff work on custom compliance manuals, find a suitable compliance officer within or outside an organization, and establish a compliance committee responsible for ensuring internal processes and policies are followed to the letter.
We offer much more. Call Corporate Investigation Consulting now on 866-352-9324 on all matters regarding and related to home care/hospice internal audits.
Important: Home health providers and hospices are guilty of trying too hard to comply with regulations and guidelines. Since risks originating from internal processes are many, it helps to shift some focus on legal safeguards.
Internal audits can reveal non-compliance issues even in the most seemingly compliant home health and hospice providers. Legal experts are important in ensuring auditors follow recommended guidelines and challenging unfair audit processes and outcomes.
We have legal experts specialized in audits. Their understanding of what the law says on hospices and home health providers across all states can support providers through legal representation and training staff on compliance issues such as complacency.
Get a free-confidential consultation on internal audits now; contact us today.