Jeannine LeCompte, Publishing and Research Coordinator
A Medicare- and Medicaid-approved long-term care (LTC) facility is under a legal obligation to create and maintain a compliance program. Once a written policy and oversight system has been established, the next two core components for a compliance program are the need for effective training and communication.
This means that the facility must establish, implement, and provide effective training and education for its employees, including the CEO, senior administrators or managers, and the governing body members. Training can take place in a classroom environment or online, and documentation of completion should be maintained.
This training must occur on an annual basis—at the very least—and be mandatory orientation for all new employees. The general compliance training should be reviewed on a regular basis, and the material updated whenever there are changes in regulations, policies, or guidance.
Proper training will help ensure compliance with Medicare program requirements, and should cover the process of reporting suspected or detected noncompliance. Examples of reportable noncompliance should be given, along with the disciplinary guidelines for noncompliance or fraudulent behavior. Other topics that should be covered include a review of laws governing gifts and gratuities, conflicts of interest, and the importance of personal health information confidentiality.
The facility must also ensure that effective lines of communication are established which will allow complete confidentiality for the reporting of any alleged or already proven noncompliance. This includes the ability to transmit information throughout the organization, from the lowest level to the highest. Reporting systems must maintain confidentiality to the greatest extent possible and allow anonymity if desired.
Finally, it should be an important part of the training to make sure that staff understand that they are under a legal obligation to report all noncompliance, and that retaliation against anyone for reporting a concern or participating in an investigation is prohibited.
