Guidelines for Human Resource Compliance

I often wonder what my grandfather would say if he were living today and practicing medicine. He was one of the old-fashioned doctors that actually made house calls. During his career, he was Chief of Medicine at Vanderbilt Hospital before MRI machines and targeted gene therapy for cancer.  

Healthcare has changed in so many ways in the last 40+ years. One thing I know he would be astonished by would be how much healthcare delivery has been changed by increased regulation, fines and penalties, fraud and abuse, and even how medicine has evolved into a business. I think he would, however, cherish the importance the human element of medicine plays, even as technology is quickly advancing. In this article, we’ll take a look at the parallels between Human Resources and Compliance and how they intersect to build a valuable work environment. 

In today’s healthcare industry, HR and Compliance are not siloed in ways they historically were understood. These two departments work in conjunction with one another; the separation is not so black or white, tomato/tomahto, potato/potahto. Instead, they go hand in hand with one another.

Specifically, compliance is a way of defining “proper” work behavior as well as outlining specific laws and policies. There are many thoughts and steps that have to go into it. In order for compliance to be successful, it has to start from the top and trickle its way down to all levels, educating and enlightening coworkers and employees on how to be compliant.

What is Human Resource Compliance?

To answer this question, we went right to the source and spoke with a healthcare industry veteran- Perry Stahlman (mentored by one of HCA’s stars, Ron Marston), SVP HR and Administration for Meridian Surgical Partners. Perry cut his teeth in the early days of HCA both internationally and domestically, and at Spheris a decade later. He felt that he learned the most about HR and Compliance during and through the HCA and Columbia/HCA days.

At Meridian Surgical Partners, Perry also serves as Chairman of the Corporate Compliance Committee where he is responsible for training and providing compliance resources for everyone from the Board of Directors to center level employees. The committee represents a cross-section of disciplines including HR, Finance (CFO), Operations (COO and an RVP with BSN and Nursing backgrounds) and a physician representative not affiliated with the company.

Perry said it succinctly: “Human Resource Compliance is a process, one that should not be taken so lightly.” The process varies from company to company. At Meridian Surgical Partners, compliance starts at the top. From Senior Management and the Board of Directors to all staff and physicians, compliance is top of mind and embedded in a company Code of Conduct and Compliance Plan.

If compliance is part of the daily vernacular and employees see management as leaders of that culture, then the company will practice what it preaches and will demonstrate in its internal and external actions a compliant culture.

Daily Practice of Human Resource Compliance

Each spring, Perry is given the opportunity to lead part of a weekend-long intensive gathering of business offices, managers, clinical managers, and facility administrators who travel to Nashville to learn and share best practice for HR Compliance.  Perry said the key to this success is centered on how to effectively communicate, listen, and respond at all levels of the organization and in all interactions with staff and patients.  

Their compliance plan emphasizes, among other key factors:

• Prompt response to alleged offenses
• Timely investigation
• Corrective action initiation
• Voluntary disclosure consideration
• Voluntary reporting mechanism
• Policy development for disclosure consideration
• Potential issues reported  no matter how seemingly minor                      

With the education of healthcare compliance comes what Perry describes as “the fear of stimulating demand.” Compliance training requires a balanced approach. If your only tool is a hammer, every problem starts to look like a nail. The point is that not everything that fails to align with our expectations is a compliance issue.  

After all, we deal with people, and people are non-fungible, infinitely diverse, and intractably messy, so it’s important to be able to discern, for example, when an employee relations issue rises to the level of an actual compliance issue. Mishandling compliance training can create an environment of distrust and a breeding ground for self-styled “whistleblowers” as opposed to a team invested in a collaborative effort to do the right things.

One must know where to go and what to do about non-compliance and ensure that management acts upon it and continues to communicate effectively. Schooling this process can accidentally educate a whistleblower. Perry says to do this effectively, it all hinges back on one simple principle: open and effective lines of communication. If the staff have an open channel to report or discuss an HR concern and/or potential compliance issue, AND management will listen and timely investigate each concern, both parties can co-exist and even flourish with one common goal: quality care from qualified staff.

Summary

Compliance is dependent on humans and processes. Good governance is reflective of a Human Resource Compliance driven organization like the one that Perry Stahlman describes. It is heartwarming to know that people like Perry and organizations that embrace a Human Resource Compliance driven organization are in healthcare today. I wish my grandfather could see it and I know he would be proud of how healthcare has evolved.

Written by Michael Rosen, ESQ