Chief Compliance and Ethics Officer Health Care

Need to audit internal Complaints and Grievances program

  • 1.  Need to audit internal Complaints and Grievances program

    Posted 04-12-2019 11:20 AM
    Hello!  I have taken over the compliance program,and need to do a audit on our Complaints/Grievance program.  Does anyone have a tool that they currently utilize that can be shared?  Just need a starting point!  Thank you  -Suzannah

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    Suzannah Elsherbini RN CCM
    Director of UM/Compliance Officer
    Alacura
    Dallas,TX
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    2019 HCCA Compliance Institute


  • 2.  RE: Need to audit internal Complaints and Grievances program

    Posted 04-12-2019 11:41 AM

    Suzannah,

    Does the organization have a policy/procedure on complaints/grievances?  I would start with the policy and procedure and determine if it is being followed; does it make sense for the organization; does it line up with any regulations or conditions of participation you have to adhere to?  Just a few thoughts off the top of my head.

     


    Michael Scudillo 
    Chief Compliance Officer/Privacy Officer

    15 Microlab Road
    Suite 101 • Livingston, New Jersey 07039

    P: 1-973-992-8181 X7108 • F: 1-973-992-9797 • C: 1-973-699-4964
    www.uirehab.com

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    2019 HCCA Compliance Institute


  • 3.  RE: Need to audit internal Complaints and Grievances program

    Posted 04-12-2019 09:02 PM
    If you go into the website for the Compliance Institute 2019, there is a handout for Session 309 that could be usable as an auditing tool.

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    Marie Wagner
    Sr. Corp Compliance Coord
    The Queen's Health Systems
    Honolulu,HI
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    2019 HCCA Compliance Institute


  • 4.  RE: Need to audit internal Complaints and Grievances program

    Posted 04-13-2019 08:28 AM
    In addition to what has already been offered you might look at the Medicare Conditions of Participation.  They have requirements for complaints/grievances. You can see if your  policy is up to date by doing this.

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    Lynn Shields
    Director of Clinical & Research Compliance
    Cape Cod Healthcare, Inc
    West Yarmouth,MA
    lshields@capecodhealth.org (508) 862-5812
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    2019 HCCA Compliance Institute