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Reviewing the initial complaint:
A valid compliant
It should satisfy the following principles, apparent violation of a policy provision, a contract provision, a rule or statute or if there is a valid concern that is raised in regard to a practice or service that is not in conduct with the customary medical practice
Notification to the upper management is the best thing to do if you have a complaint not unless they are part of the implicated party. The following steps should be undertaken to determine the people involved in the complaint.
The place of occurrence
This is where the illegal act ought to be committed
The time of occurrence
The specific time that the act was done is very important when it comes to raising a complaint
Obtaining additional information as necessary and developing a plan for the investigation:
Items important to the investigation
Record keeping
Documentation is a key tool for legal defense. A good documentation will translate to either a win or a loss in a complaint.
What to record
Every incident, complaint and misconduct should be recorded. Records should include:
Factual summaries of incidents noting the time, date, location, and the person involved
Relevant documents
Memos and letters
Any other relevant paperwork documenting your complaint, investigation interviews, witness statements among others.
Conducting interviews with staff, residents and/or management:
Interviews should be held only if they are appropriate
The types of questions to ask in the staffs:
What do you know about this investigation?
What really happen?
Where did it happen?
Who was present?
Who else may know relevant information?
Who did the fraud and abuse?
Who did or said what?
Are there notes, documents, phone messages or other evidence?
Can you list all the individuals who have the knowledge about this issue?