An analysis on the effectiveness of Tenet Health Care Corporation's Compliance Program

Majority of healthcare firms have established their compliance programs, but is such a program effective? How do organizations know whether they covered all the elements effectively?. These and others are the questions we asked one compliance officer at Tenet Healthcare Corporation in Texas. The personnel gave us insights on how the program fairs at his institution. This interview was carried out over the mail over a period of two days where the interviewee was free to respond to my questions.

In general, the compliance program at Tenet Healthcare Corporation was found to be effective, but needs various improvements to make it stronger. The author has outlined the strengths of this program, its weaknesses and recommendations on how it can be made better for its success as well as the success of the entire organization.

Introduction

Tenet Healthcare Corporation is a large tertiary hospital for acute care purposes established in 1967. Among the major services offered by the facility includes: provision of specialties and sub specialties in surgery, medicine, pediatrics, oncology, obstetrics, gynecology and laboratory medicine. The facility, whose services are considered as being state of the art, has greatly contributed to the development and provision of enhanced health services in the whole of Texas. The health care facility employs both nursing and medical professionals from many countries including but not limited to U.S, German, India, South Africa, England, China, Malaysia, philipines among other nations.

Interview Report

I managed to strike an interview with Mr. Stephen Ziko, the chief compliance officer at Tenet Healthcare Corporation via mail. The purpose for this interview was to find out the type of compliance program the institution harbor, its strengths, risks and weaknesses. Mr. Ziko is a licensed attorney with over 10 years experience in regulatory compliance. At Tenet Healthcare Corporation, he is in charge of implementing the compliance programs, conducting risk assessment reviews and organizational engagements. Mr. Ziko employs his stance within the sector and his expertise in corporate governance including various compliance guidelines, and the federal sentencing guidelines in advising Tenet Healthcare Corporation’s senior management and board of directors concerning the sensitive issues of the company’s corporate compliance program. Mr. Ziko is also a member of the health care compliance and is active locally, regionally, and nationally in many areas of corporate compliance.

Mr. Ziko’s specific duties at this firm entail provision of training, education and awareness programs on employees. He is also mandated to responding and addresses various compliance issues such as proper documentation, billing, business practices, coding and investigations of impropriety and uncouthly behavior among employees. He goes on to reveal that the management at this firm selected him because of his commitment to integrity, high ethical standards, and his experience in applicable laws and regulations.

The Tenet Hospital’s Compliance Function

According to Mr. Ziko, Tenet Healthcare Corporation has been committed to establish and maintain an efficient compliance program in accord to the regulation of the U.S Department of Human Services and Health. The compliance program at this entity is aimed at detecting and preventing violations of the federal and state policies and regulations. This company has a culture of maintaining a high level of ethical and professional standards with regard to its operations and management. The company is focused on maintaining a favorable image within its stakeholders. In doing so, it adheres to the values of integrity, honesty, and high ethical standards. All the personnel in this entity including the management, nurses, doctors and other experts are obliged to conduct themselves according to the required ethical standards.

At this company, employees who fail to adhere to stipulated ethical standards are disciplined accordingly. There are also awareness programs among employees on the applicable state and federal laws, which are incorporated on the organization’s documentation, billing, coding, competitive practices, as well as the daily operations. All employees are involved in all types of company documentation, billing, coding and competitive practices. This is aimed at giving them an obligation of familiarizing themselves on the applicable regulations and laws, which they are supposed to adhere to at all times. Tenet Health Care Corporation has come up with a number of compliance procedures and policies, which shows its commitment to federal and state policies and regulations. The company’s compliance program is aimed at preventing abuse and fraud by providing employees with conduct guidelines as well as working in risk areas.

From the Tenet’s Compliance officer, we were able to note that the corporation compliance program harbors seven key components, which include

1. An oversight committee provided by the facilities director and the chief compliance officer. The chief compliance officer reports directly the Compliance, Quality and Ethics committee of Oman’s board of directors
2. The Hospital has written policies and standards
3. Training
4. Monitoring and Auditing
5. Open communication lines through their ethics action line
6. Responses to detected deficiencies and
7. Disciplinary procedures and actions

Strengths of this Compliance Program

From this interview, it is apparent that Tenet Healthcare Corporation compliance program plays a critical role in the operation of this institution. The management at this institution has worked diligently in adhering to the high standard of integrity and ethics. Every employee at this institution plays a crucial role to achieve this objective. Tenet Healthcare Corporation’s compliance program constitutes of unique elements, which are created for the particular business operations. Tenet Healthcare Corporation’ hospital’s compliance program is based on the seven elements of an effective compliance program as stipulated by the Office of Inspector General’s Compliance program guidance for Hospitals. For instance, the hospital has special audit programs for skilled nursing facilities, acute care hospitals, psychiatric operations and rehabilitation facilities. Additionally, Tenet has in place all the elements of the OIG model compliance plan for clinical institutions since it incorporates the required acquisition forms, standard beneficiary, audit processes, physician education and charge protocols.

The hospital’s code of conduct is distributed among all the employees working in this institution, physicians, nurses, subordinate staff, vendors and contractors. The hospital’s code of conduct is also displayed at the company’s website and communication system. The compliance officer in this interview reveals that, Tenet Healthcare Corporation complies with the requirements of the federal and state health care program. The corporation also provides the regular and necessary updates to the compliance programs and standard of conduct. Further, the set of procedures, and policies for Tenet Healthcare Corporation can be described as being comprehensive since it deals with various compliance issues such as coding, physician relationship, reimbursement topics, specific billing and other compliances that are related to human resource regulations.

The chief executive officer and compliance officer at Tenet Hospital are mandated to offer regular reports to the quality, ethics and compliance committee for the board of directors. All Tenet hospitals have employed a full time compliance officer. Additionally, the entity has also other corporate departments and regional compliance directors who provides additional resources and support to the main department.

Challenges on Tenet Healthcare Corporation’ Compliant Programs

There are many strengths and success of Tenet Healthcare Corporation’s compliance program. However, some weaknesses are associated with it. In most occasions, a company’s standard of conduct is the core part of its integrity program. However, for Tenet Healthcare Corporation, the compliance program is put at risk since its central communication seems not to be well constructed. Specifically, the company’s code of conduct does not fully address its needs and characteristics. For example, the company’s code of standards has not addressed the operations of the institution, nor has it addressed its culture. Further, the compliance program is too detailed. This aspect might undermine the effectiveness of the compliance program as well as its integrity.

A number of faults can be derived from Tenet Healthcare Corporation’ compliance program. These includes

1. They have not addressed the institution’s operations and particularly its core ones
2. Its code of standards is not clearly connected to the institutions core business culture and objectives
3. They are also not effectively connected to the organization’s business integrity concepts
4. The general tone of the compliance program appears to be too vague and legalistic
5. It has well contain the wrong degree of details concerning its expectations
6. It has not addressed the expectations of health care functions and activities
7. It has not offered employees with the effective means of addressing challenges at their institution

Compliance risks

It should be noted that a complete compliance program requires other functions as well. For instance, there should be means by which the company staff and other workers report violations in the code of conducts, investigation mechanisms, and discipline procedures. These aspects are not clearly outlined in compliance plan of Tenet Compliance Plan. An organization with outside consultants or contractors does have general confidentiality principles. However, in the case of Tenet Hospital, the compliance program and code of conduct do not fully address the prohibition of trading of the company’s confidential information by the outside consultants and contractors to outsiders.

Conclusion and Recommendation

By articulating its compliance program, the management of Tenet Hospital Corporation has taken a significant step in ensuring that the organization’s reputation stands for integrity. However, the management of this entity ought not to stop at this level. In ensuring that it achieves the best returns for its efforts in attention, time, effort and other resources, the management must wake up to ensure that its programs and code of standards are well written and implemented.

The code of standards and compliance program at this entity must not be left to fall prey to the various noted challenges, which will hinder its success. In other words, they should find means of leveraging the weaknesses in order to prevent them from hindering the progress and effectiveness of this compliance program. With the assumptions placed by the senior management of conduct standard being a risk control instrument, it is paramount for the management to evade typical weakness that may hinder the effort of this and other companies as well as leaves employees confused on the real intentions of the management.

What the management at Tenet Hospital should understand is that a compliance program is not solely a matter of “circulating a plan” or instituting policies. Because of this, the management at this entity should set mechanisms of making everyone in the firm comply, and conduct a review of all financial incentives to the contrary. Further, the firm’s compliance program ought to address the specific problems that are affecting the hospital.

Finally, the significance of conducting an official risk evaluation cannot be overemphasized. In addition, the company should regularly review and update its compliance plan as a measure of creating a thoughtful compliance program.