Called the Compliance Hotline...did I overreact?

  1. A few months ago I started my first informatics job at a small community hospital. Over the past few weeks I realized that several of the LPNs were labeled as RNs in our EMR, so I asked my Regional CI from corporate HQ to help me fix the error when she visited my facility. She shared my alarm that this had been allowed to go on for over a year, as it is a clear violation of every state's BON rules and regs.

    The truth is, I have found numerous causes for alarm on this job, and I have repeatedly been silenced when I voiced concern. So this time I didn't bother going to my CNO, who just responds by yelling at/blaming me, I called the corporate compliance hotline and crossed my fingers that it would bring some oversight to our lax operations.
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    About nontoxic

    Joined: Aug '18; Posts: 4; Likes: 7


  3. by   Pixie.RN
    This doesn't sound like a great environment; I hope you get some response to your report! Having staff members incorrectly labeled in the documentation sounds like a huge issue from several directions! Fraud, etc.
  4. by   caliotter3
    Since you have been repeatedly silenced when voicing concern, it is logical to think that someone could guess that it was you who lodged the compliance complaint. Since you find this place to be that locked into less than desirable practices, it would behoove you to make plans to exit for a better workplace and in the interest of self preservation. The probability of you effecting positive change at this facility is next to nil and more than likely not worth the consequences to you.
    Last edit by caliotter3 on Aug 14 : Reason: Grammar/Typo
  5. by   Toadette
    I agree with caliotter3. That doesn't sound like an environment where employee feedback is welcome. If you don't see a positive response from your corporate compliance report, it might be wise to look for employment elsewhere.

    Good luck!
  6. by   nontoxic
    Of course you're all right about how bad this workplace is.
    But I've had a stalker for 5 years who has terrorized me from state to state and caused gaps in my employment history, so I felt lucky to get any job where I could use my MSN at all.

    I'll be persona non grata from now on with the C-suite, but they can't outright fire me for reporting, and hopefully I can hang in there until a transfer opens up.

    Thanks for confirming that I didn't totally overreact under the circumstances; it's 20 months of false documentation and I can't let it look like I covered it up.

    What's sad is that all the nurses knew the problem existed, but they don't have the power to speak up. smh
  7. by   NRSKarenRN
    I was reviewing a home health chart for Medicare audit and noted our OT staff notes did not have their credentials listed, so submitted IT correction ticket. Our IT database manager called me, ran staff credentialing list and found several staff without credentials listed + corrected issue same day. Sorry you did not have that experience. They will be thankful when accreditation time comes or insurance chart audit requested and discrepancy comes to light.
    Last edit by NRSKarenRN on Aug 14 : Reason: spelling
  8. by   djh123
    I think you did the right thing. And I'm sorry to hear about the stalker... I hope you've evaded them at this point.
  9. by   Pixie.RN
    Quote from nontoxic
    But I've had a stalker for 5 years who has terrorized me from state to state and caused gaps in my employment history, so I felt lucky to get any job where I could use my MSN at all.
    I am so sorry. That is AWFUL. *hugs*
  10. by   Have Nurse
    You absolutely did NOT over react. And good for you! So what if they figure out it was you. If there are any repercussions, have an attorney waiting in the wings.....they love to go after the big buck corporations, especially when they're in the wrong.

    What on Earth do they have Corporate Compliance for, if not to make them behave?
  11. by   KelRN215
    The facility is probably committing fraud and billing for RN services when it's really LPN services.

    I worked for a home health agency that tried something like this. A few select LPNs were listed as RNs in the new computer system they contracted with because only those with RN credentials had the access to complete OASIS assessments (because, you know, Medicare guidelines say that LPNs cannot complete OASIS assessments). I left this employer when this was happening but I suspect that they were billing the visits this nurse completed as RN visits.