1.17 – Internal Compliance Program
Regulatory standards outlined by the Ohio Department of Developmental Disabilities require all providers of service to develop and implement an Internal Compliance Program. The components of Open Door Internal Compliance Program are as follows:
Written Policies and Procedures
Open Door has developed a review schedule for each policy to be reviewed at least annually by Executive Committees and the Board of Directors and revised, as necessary. All Open Door staff receive updates through payroll notification email when policies are revised. All staff receive initial and annual training on Open Door policies and procedures.
Open Door has established management teams that are responsible for program oversight. Open Door provides 24/7 on-call systems to allow employees to receive guidance and to report any incident.
Training and Education
Open Door complies with all training and education requirements outlined by regulation. In addition, Open Door has checklist and mock surveys which assist with monitoring and tracking completion of training and education for all employees. All employees receive annual training on Internal Compliance.
Open Lines of Communication
Open Door maintains an open door policy for management. Open Door has established multiple avenues that are available for all stakeholders to report any concern or to ask questions.
Audits and Quality Improvement Monitoring
Each department/service area has established audits and required checklists to complete that identify compliance issues and areas that need addressed. Each have a follow-up task grid that is monitored by department representatives to ensure correction/completion. In addition, Open Door has Quality Improvement Program outlined in Policy 3.10.
Open Door has established Standards of Conduct that are outlined in policy 2.15. Consistent discipline is applied according to the Standards and Disciplinary policy and procedure for all departments within Open Door.
Billing Procedures/Overpayment Obligations
Open Door has developed billing systems that meet regulatory requirements. Open Door has developed specific policy for Health care fraud, waste, abuse in policy 1.16. If and when Open Door becomes knowledgeable regarding a billing error resulting in overpayment, the Accounting Department works diligently to correct the billing entry by backing out the billing. The documents outlining the overpayment cause and correction are maintained in the shared folder reflecting the reference number of the correction being completed.
Conducting Background Checks
Open Door conducts background checks for all employees as outlines in regulation.
Open Door has developed specific policies on ethics (2.00) that prohibit kickbacks and other prohibited actions. All employees are trained on this policy at least annually.
Service Delivery Documentation Requirements
Open Door has developed documentation systems that meet service delivery requirements for each service area, including, but limited to, location of service, address of service, start and end time of service, provider number, billing code, the individuals served, verification of provision of service, mileage readings, destination for travel, name of staff completing service, etc. Each department has systems to review and analyze data to identify any concerns/issues for follow-up.
Last Revised: 8/16/21