Building Your ROPE Ladder

Welcome back to Compliance University. Class is now in session! Let’s explore solutions to the problem of “Rule Overload,” which we defined last time. Rule Overload afflicts the majority of health care providers who approach compliance from a “learning the rules” perspective.

Instead of keeping track of all the rules, the ROPE System is a new method for achieving Rule Overload Prevention and Elimination that incorporates rule-compliant behavior into your existing operational systems — billing, warehousing and maintenance, delivery and set-up, medical records, contracting and marketing, and so forth.

This is a new way to view compliance. Forget the “rules.” Just make sure your own systems run as you intend them to run! So, how can you subsume the concept of “compliance” into your own operational systems? By using the ROPE System, summarized as follows:

• Make sure your operating systems comply with whatever rules are out there.
• Be sure you have a way to teach your operating systems to your personnel.
• Implement an effective way to identify, report, investigate and fix problems.
• Use outside resources to make sure your internal systems stay compliant.
• Make sure all of your operating systems, including your monitoring system, continue to operate as you intend.

I don’t pretend that the ROPE System is quick or easy. However, the initial effort required to set it up provides substantial and ongoing dividends. Stress is reduced because you monitor your own internal systems, which are designed to make money for you. The system makes it easier to monitor and fine-tune compliance, because your internal systems are designed to reflect your actual strengths and weaknesses, as well as your needs and opportunities.

Perhaps most important, by using this system to integrate “the rules” into your existing operating systems, you will identify how you actually run your company. You may then use this knowledge for many other purposes. Want to identify why your costs are too high? Want to identify areas of personnel dissatisfaction or inefficiency? Want to identify a better way to respond to growth opportunities or to respond to problems more efficiently? The ROPE System can help.

The ROPE System then helps you lay out a path, steer clear of problems and monitor your progress. Compliant behavior can also be behavior that helps you increase profitability, employee satisfaction and your ability to respond to opportunities. Not a bad solution!

The tools you will use to apply the ROPE System to your company are customized variations of the Systems Management and Total Quality Improvement initiatives. These initiatives, which have been used for years by non-health care companies, are formal systems designed to gather facts, solve problems and improve quality within an organization. These tools include the ISO series of standards, the Baldridge Healthcare Criteria for Performance Excellence and the Six Sigma process improvement theories. We will explore all of these in future sessions of Compliance University.

However, these Systems Management and TQI initiatives are only the tools we use in the ROPE System. Tools do not get us where we need to go. To show us how to climb out of the Rule Overload pit, we use the metaphor of a ROPE Ladder, which has five rungs. Next time, we will discuss Rungs 1 and 2.

There’s the bell — Class Dismissed!

Neil Caesar is president of the Health Law Center (Neil B. Caesar Law Associates, PA), a national health law practice in Greenville, S.C. (www.healthlawcenter.com). He also is a principal with Caesar Cohen Ltd., which offers compliance training, outsourcing and consulting. A frequent author and speaker, Caesar is the author and editor-in-chief of the Home Care Compliance Answer Book. He can be reached by e-mail at [email protected] or by telephone at 864/676-9075.