Tag: Primary Source Verification
Read how we identified and resolved a 30% gap across the required licenses and credentials neccessary for providing care, as outlined by our client's internal policy.
A comprehensive guide to healthcare license monitoring and verification.
A healthcare license is a privilege and not a right. By that we mean one must earn a professional healthcare license. The individual must graduate from an accredited school/program and then pass a competency exam. Such exams are administered by and regulated by a State Licensing Board or a certifying board, recognized by the state. Upon successful completion, a license is granted to such individual. Thereafter, there are obligations and requirements in order to stay in good standing with the issuing Licensing Board. The State Licensing Board is considered a primary source ("Primary Source") and will be the single place to verify and monitor for renewal, standing and in some cases, disciplinary actions taken against the individual and/or his/her license. In order to conduct effective compliance monitoring of licenses, a monthly monitoring of the license is critical. Why Monthly?
Ever wonder if today is the day the Joint Commission shows up to begin its audit of your Human Resource compliance practices? How will you confidently demonstrate compliance with Joint Commission HR standards 01.02.01 with regard to staff qualifications and 01.02.05 with regard to verification of qualifications? For most people, this causes waves of panic and uncertainty. Will they find that you are compliant with your own internal requirement policies? Do your HR files contain all of the primary source documentation that your policy requires? Do you have a record of monthly OIG exclusion checks? Are you missing any key licenses, certificates, proof of MMR...? The list goes on and on. Failure of compliance in any one of these areas can result in the forced compliance of a CIA. But no need to panic. Educating your organization on how to implement best practices will result in an “audit-ready” compliance plan as well as avoiding any potential CIAs.
Healthcare has changed in so many ways in the last 25 years. I often think about how, if my grandfather(s) were alive today and practicing medicine, rather than in their lifetimes, how foreign the delivery of medicine would be to them. With the advances in technology, vaccines and even the cures that have been discovered for once deadly diseases, I am not sure if they could process all of the advancements. However, the one thing I know they 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. On the business side of medicine, I think they would particularly be struck by how in today's healthcare industry HR and Compliance are not so divided anymore. HR and Compliance 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.
“An ounce of prevention is worth a pound of cure.” At least that is what Benjamin Franklin said a century ago. He is right, and that was insightful - even before his face would appear on U.S. currency. Little did he know how many “Benjamins” it would cost a healthcare company in fines for non-compliance with licenses.
Nursing Boards have been proactive in making it easier for nurses to have a license in one state that is accepted in another state. The Nurse Licensure Compact allows for Nurses to have one multistate license, with the ability to practice both in their home state and other compact states. To date, there are 25 states that have enacted legislation accepting the Compact effect in their state.
"The moment you meet a stranger, both of your brains are making thousands of computations at lightening speed to make major decision about one another," according to an article in Forbes. This only take seven seconds. It only takes seven seconds to make a first impression.
Cindy Daigle, Director of Compliance at U.S. Renal Care, shares her thoughts on hiring best practices. Compliance Team hiring practices plays into the long term success of the organization as well as driving the company’s compliance.
Check out our license monitoring blog series: 1. Primary source verification - when, where & why2. Three common nuances in the healthcare license verification process3. Time Delays in Healthcare License Reporting to State Licensing Boards 4. Healthcare license fraud is a reality - here's how to avoid it Nurses help people. Nurses care. Nurses are to be trusted. So, would it surprise you that some people who practice as a nurse, are not actually nurses? As sad as it is, it happens. There are numerous cases each year where a person either claims to be a nurse and was never licensed, or who practices even though their license was revoked or suspended. Check out the OIG site to read about recent enforcement actions which include cases on fraudulent licenses. So how do you know if you have an employee who is not actually licensed? Here are 4 steps to combat healthcare license fraud and to ensure your staff is properly licensed and qualified through healthcare license verification:
This blog elaborates on the time delays in the reporting of disciplinary actions to state licensing boards and how those delays impact monthly monitoring of licenses for healthcare organizations. The differences in reporting between the states: Just like the reporting delay between the state Medicaid exclusion lists and the OIG, there can be delays in reporting disciplinary actions to the individual licensing boards. This happens for many reasons. The main reason for this delay is due to the inconsistency in how and when the states release and publish the minutes of the disciplinary actions by the board.