Alice in the land of wonders, temptations, risk and compliance [Compliance’s Once-A-Upon-Time Story Series]


By J. Veronica Xu, Esq., CHC, CHPC, CCEP, Chief Compliance Officer for Saber Healthcare Group headquartered in Cleveland, Ohio

Once upon a time, there was a little girl who fell asleep under a tree on a warm day when she was supposed to be reading.  Well, who can blame her?  An afternoon nap on a warm day sounds nice and relaxing, doesn’t it?  It wasn’t an ordinary nap because she had a wild and adventurous dream…  Yes, you’ve guessed it.  It’s Alice.  Who can forget that adorable little girl who “fell down” a rabbit hole?  Little did Alice know that her absurd yet exciting dream would make her a well-known figure worldwide.

In a blink of an eye, time flies by.  Whether willingly or not, we all grow up; so does Alice.  After all, not many people have been invited to Peter Pan’s Neverland; not to even mention staying there forever.  But the world that Alice (as well as all of us) lives in isn’t so bad.  For example, we have i-Phones, i-Pads, smart TVs, Netflix, Peacock, driverless vehicles, drones, anything and everything you can ever imagine.  So she is not really missing out.  Alice now works in healthcare and has a bright and promising future ahead of her.

Working in the healthcare industry isn’t as simple as Alice originally thought, as she needs to interact with vendors, patients, and co-workers, and they are full of questions, dilemmas, challenges, and conundrums.  For example, this morning, Vendor Ursula (who previously turned the little mermaid Ariel into a human) approached Alice and asked her to promote a potent medicine she developed that allegedly can cure all diseases.  In return, Ursula promised Alice that she would receive a ticket to a magical kingdom where Alice could take a magic carpet ride, meet Genie, and be granted 3 wishes.  How cool is that?!  How can anyone resist that?  Plus, nobody will know, at least she thinks.

While she is considering Ursula’s proposal, Alice is doing rounds in the building.  This is a fun time of the year, because everyone – including patients – is preparing for Halloween.  As she passed a patient’s room, she saw the patient dressed as the Queen of Hearts.  Just as she is about to take out her indispensable do-it-all cell phone to snap a picture and share with all her friends on social media, Dr. Rabbit comes running, pointing at his pocket watch while shouting, “I am late.  I can’t wait.  I’ve got an important date.  But these must be done today.”  On his way out, Dr. Rabbit asked Alice (who is NOT a licensed physician, NP or PA) to use his login credentials to sign all his physician orders, certifications and re-certifications by 3pm TODAY.  Otherwise, the building will not get paid.

Feeling pressured, confused, tempted and conflicted, Alice doesn’t know what to do.  Luckily, she remembers the mandatory training she received and she knows whom to contact.  Of course, Compliance!!!   Compliance commended Alice for reaching out to seek guidance and shared the following with her: “Our world is not that different from the wonderland you dreamed of.  We live in a special place where there is great joy, fun, happiness and kindness, but there is also deceit, deception, temptations and desires.  Oftentimes, decisions are made in a split second and they can have profound impacts on all parties involved; every action leads to a consequence.  Unfortunately, in reality, there is no magic potion that can undo every mistake or misstep.  Regardless of the excuses that a person may come up with to justify the action, it doesn’t change the nature of the conduct.  A wrong decision could cost your livelihood and future, so make your choices wisely.  But keep in mind, you’re not alone in figuring everything out.  We’re here to help.  Just like the little things in life can make a big difference, small steps you take, such as consulting Compliance, can help you feel more confident about your decisions and actions.  That’s why we are here to assist and protect.  Compliance is your North Star and moral compass that will guide you and point you in the right direction.”

Compliance encouraged Alice to use her judgment and not to blindly follow what others or her own desires are telling her to do.  She has also learned:

  • Accepting valuable gifts from vendors is prohibited by law and company policies;
  • Taking pictures of patients without their explicit prior written consent is a violation of federal and state regulations;
  • Using someone else’s login credentials, with or without that person’s knowledge, could be a potential HIPAA violation; and
  • Signing medical documents without proper credentials, qualifications, and licensures is against the law.

“What a day!  Compliance saved the day.  The Compliance people are so helpful because a simple conversation with them has saved me and my team a bunch of headaches that would have likely turned into nightmares.  I am glad I checked with them before any disaster could take place.  Compliance keeps us safe.” Alice thought to herself, “Now, it’s time to go home and take a nap.”

Key Takeaways

  • Compliance is just one call/email away.  Your employees don’t need to be a compliance expert.  They have you – their compliance team.  Compliance is here to protect, help, support and guide.
  • Whenever in doubt, please don’t hesitate to contact your compliance team or call the compliance hotline (which provides anonymity protection).
  • The easy way may not be the right way.  Always do the right thing.

Questions for your employees to ponder

  • Have you ever been approached by any vendors who offered to send you a gift?  Do you know what to do?
  • Have you ever been asked to sign physician orders, certs and re-certs when you are not licensed to do so?
  • Have you ever taken any pictures or videos of patients without their explicit authorization?

The story behind the story

This is the 4th compliance fable in my original Compliance’s Once-A-Upon-Time Story Series.  My intention is to use fairy tales to share compliance stories and remind everyone of the importance of adherence to laws and company policies.

Although the story is fictitious, the examples are real.  They are based on recent cases that Compliance has seen in the industry.  Some of the issue types have occurred more frequently than others.  The conduct involved in those cases posed significant risks onto patients as well as the public.

Alice in Wonderland is a timeless story loved by people of all ages.  Who can forget that silly little girl who drank all the magic potion labeled “Drink Me” and became BIG, BIG, BIG and then small, small, small all in a few seconds?  There are silly characters, tough choices, and funny conversations.  She was intrigued by the mysterious Cheshire Cat and was chased by the card soldiers of the ruthless Queen of Hearts.  Alice couldn’t decide which door to enter or which path to take.  To a great extent, doesn’t it reflect the choices we face in our own worlds?  In fact, it’s not too far off from the adult world we are in.  Working in the healthcare sector, we have challenges to face and decisions to make on a daily basis.  The only difference may be that we don’t have the magic potion to undo everything we would later regret.

Doing the right thing isn’t always easy.  We may face peer pressure in the workplace.  From time to time, we all need some type of inspiration and assurance, don’t we?  That’s why Compliance is here for our employees.

When co-workers are telling an individual it is okay to share login credentials or to sign documentation on behalf of others without proper authorization/procedures, we ask our employees to believe in themselves and don’t do things blindly.  Under many circumstances, the individual’s intentions are irrelevant when investigators are determining if there was any actual violation of laws and regulations.  Or, when a person thinks it is okay to accept a gift from a vendor because others say that no one will find out, sooner or later it will be discovered.  Do what’s right.  When in doubt, just ask.  Being compliance-minded can save their job, livelihood, career and future.

I hope you have enjoyed reading the story as much as I relished writing it for you.  Achieving compliance is a journey and it’s such a pleasure having you onboard.

Truly, Veronica – Your Compliance Partner