Setting Compliance Goals Today Keeps the HEAT Away


HEAT, also known as the Health Care Fraud Prevention & Enforcement Action Team, is an unwelcome visitor. That said, its services are of vital necessity to end the practices of billing for services that were not rendered, backdating visit notes and lacking documentation. While you do not engage in fraudulent activities, the failure of setting compliance goals may inadvertently put you in the crosshairs of HEAT.

There are five compliance goals that home healthcare agencies of all sizes can set. You do not have to be a major player in the niche to set goals for achieving regulatory compliance today.

    1. Appoint a compliance officer.  
    2. This professional is in charge of goal setting, goal implementation and follow-up. It is tempting to add this task to the job description of a senior nurse or other employee.  Resist this temptation! Ensuring compliance quickly becomes a full-time task on its own.
    1. Establish written compliance standards.
    2. Each agency employee must follow these rules. There will be additional standards for nurses, CNAs and other professionals in the field.
    1. Schedule training sessions.
    2. T
    3. he best set of standards will amount to very little if your workers are not trained on the details. While it should be as simple as suggesting that each employee should read the compliance standards, hands-on training with Q&A sessions ensure that everyone is on the same page.
    1. Monitor compliance.
    2. Y
    3. ou have spelled out the rules, and you have trained your employees. Now is the time to monitor patient charts to ensure that proper codes are used, detailed notes are entered during the visit and patient care follows the protocol set forth by the referring physician.
    1. Handle disciplinary actions.
    2. First-time offenders may make a simple mistake that nevertheless can look bad on your records. Work with employees to ensure that no further mistakes occur. If needed, re-train, add in-house training for all or re-write your compliance standards with an eye on enhanced clarity. Repeat offenders may have to undergo disciplinary actions as set forth by the human resources department.

Setting these compliance goals prevents your home healthcare agency from making errors that could bring on the HEAT.