From the Contributor’s Corner: Are You Prepared to Properly Conduct Internal Investigations?

April 22, 2013 by Richard Kusserow

Relatively few compliance officers, HR professionals, safety officers, HIPAA privacy/safety officers, and others charged with determining potential wrongdoing or liability have had any formal training in how to conduct internal investigations. Improperly trained investigators may aggravate matters and create new liability problems, whereas properly trained internal investigators can reduce the exposure to lawsuits, litigation, and government adverse actions.

Failure to act upon allegations and complaints may lead employees to feel their complaints are not taken seriously internally, and cause them to choose to go externally for redress of grievances and concerns. To prevent individuals reporting to a government agency, attorney, or the media, it is critical to have a credible response and investigative response to information received, regardless of the source. Failure here may mean initiation of legal civil action, or a report to a local media outlet about a potential problem.

Matters requiring investigation extend far beyond issues limited to the concern of the compliance office.  The following are examples of the types of cases that may result in an internal investigation that cuts across compliance, human resources, privacy officers, risk management, and others:

• Violations of laws/regulations
• Violations of the Code/Policies
• Unlawful Harassment
• Discrimination
• Fraud or Theft
• HIPAA Privacy/Security Violations
• Conflicts of Interest
• Drug or Alcohol Abuse
• Patient Abuse
• Safety Violations

There are different ways to answer this need. 

• Expert investigators can be retained to assist whenever a matter arises warranting a serious investigation , but this could be costly, if used very often......
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