Don’t Lead by Memo

The smart way to train personnel to behave compliantly is not to focus on teaching the laws, regulations and reimbursement policies — the “Rules.” Rather, the second rung of the ROPE Ladder urges you to teach staff how to comply with your company’s day-to-day operational policies and then to make sure that those procedures already address the Rules.

While the government requires that you have compliant policies and procedures, you are not required to teach or learn hundreds of pages of regulatory rules.

To engender trust in your system’s ability to operate compliantly, one of the secrets of effective compliance training is to avoid leading by memo.

Leadership by memo occurs when management sends out memos crafted as orders or ultimatums that warn of severe personal consequences for non-compliance. Employees might even be required to sign a statement confirming that they have read such a memo.

Leadership by memo can be worse than ineffective; it can become downright destructive by breeding suspicion and contempt between management and staff, posing substantial barriers to communication and understanding.

Doing the Right Thing

The rules do require some training, as well as documentation of the training conducted. But it is far more valuable to teach your staff how HIPAA or the anti-fraud rules, as examples, reflect everyone’s ongoing desire to do the right thing than it is to conduct training because the Rules say you must.

This is an important point. Compliance builds on already existing policies and procedures that address invasion of privacy, compromises of care due to conflicts of interest or general unfairness. Long before HIPAA was enacted, your employees already had some idea of what their moral and ethical, if not legal, obligations were regarding patient confidentiality. A good training approach will build on that attitude to foster compliance through cooperation.

Of course I do not suggest your officers and managers never send out another memo. On the contrary, occasional alerts and memos, properly crafted, can build teamwork by keeping staff and employees informed. But memos cannot replace good training programs professionally conducted by organizational leaders.

Good leaders lead from the front, not the rear, and they lead by example. Compliance training should reflect this. When your training sessions do not include organizational leaders who are engaging in the process of learning, you fail to convey fully that your company is serious about compliance and helping personnel to do the right thing.

The leader who joins in training sessions gives the message that proper coding, anti-fraud concerns and privacy and security compliance require a unified effort, and that everyone will work together.

Good compliance training embraces the good work and good attitudes already present in your organization. Leadership by memo tells employees that they are being watched and controlled and that, without coercion, they won’t do what’s right.

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

The ROPE Ladder

Rung 1: Articulate the way you want things to run, and note how they run now. Then, tweak your systems as necessary to comply with “The Rules.”

Rung 2: Teach your operating systems to your employees.

Rung 3: Implement a clear and simple method for dealing with problems — identify them, report them, investigate them and fix them.

Rung 4: Give your compliance staff resources to help them keep up-to-date with internal and external changes that may sometimes require you to refine your operating systems.

Rung 5: Monitor your operating systems to make sure they continue to run as you intended.