INVESTIGATIONS

Once a possible incident of non-compliance is reported, an investigation ensues. The Compliance Officer determines the level and manner of investigations.

The Compliance Officer also keeps record of the investigation and outcome in a Compliance Issue Report form and maintains copies of evidence. The Issue Report form and evidence may be shared with the Company’s legal counsel.

Investigations may include:

  • Parent Surveys
  • Review of Progress/Evaluation Reports, Session Notes, Service Coordination notes, Intake Documentation, Database Notes, Billing Data, Provider Files, HR Files, etc
  • Interviews with Office Staff, Service Providers, Service Coordinators, Parents, Gov’t Officials/Regulators

In Reports of Patient Neglect/Abuse, the witness is immediately referred to contact their local Child Protective Agency.

Upon conclusion of an investigation, the Compliance Officer ensures that appropriate remediation and corrective action is undertaken.

Possible Remediation and Corrective Action include:

  • Refund of Payment
  • Restaff of Cases
  • Individual Performance Improvement Plan
  • Termination of Employee or Contractor
  • Change in Policy & Procedure
  • Staff/Provider Training or Re-Training
  • Submission of Documentation to Regulator or Payer
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