Reader story: “I called the compliance hotline.”

By October 1, 2014 Ethics One Comment

This is a guest post; however, it will not be attributed by name for protection. The writer is a therapist that contacted me several weeks before they called the hotline. We talked through it. They made the call. I’m so proud to share their story. I’ll share your story too.

I am a whistle-blower. Feels odd to say it now that I am past it but just a few weeks ago the idea of being labeled as such was a source of extreme stress!

For months I knew I needed to report my DOR for fraud and unethical behavior, but I was honestly terrified. The DOR was very manipulative and well-liked by staff. I was the new clinician the DOR tried to fire for refusing to pick-up inappropriate patients. I wanted to report the DOR, but I was afraid of retaliation. I was a part of a small therapy team, and I thought the DOR would easily deduce I was the reporter. I also didn’t know what the process behind the compliance hotline looked like, so I kept quiet for months.

Eventually the DOR started to pick on another therapist, who has many years of experience. The DOR would yell at the therapist in front of patients when they said a particular patient wasn’t appropriate for therapy.

The DOR stopped calling our full-time floating therapist in favor of a PRN therapist the DOR knew…and who’s password and user name he had. Documents started getting signed even though none of us had seen the PRN therapist around. As an assistant, the DOR rarely saw patients but continued to bill high minutes. A PRN therapist came in to help with the caseload and patients were confused, because they didn’t know they were receiving therapy!

The DOR required a two week notice for discharges, but would often “lose” or “forget” the notice we gave forcing us to see patients another two weeks.

Early on the DOR tried to convince me to pick-up patients by saying this is all a business. It was stressful to say the least, and there is even more to the story, but it took him yelling at a therapist on our team to make up my mind.

I called the hotline after work one day. The chief compliance officer listened to my concerns and was openly appalled at the DOR’s behavior. The compliance officer assured me they would keep me anonymous by only referring to “the caller” or “the reporter” throughout the investigation. The DOR was suspended, so they could not influence the investigations.

The chief compliance officer did have me send a picture of documents the DOR kept that were against company policy. They also asked me to name specific patients, so they could complete audits of their records. Another officer headed up the investigation for anonymity, so I was interviewed along with my co-workers with same questions and informed that there had been a hotline caller about the DOR.

The DOR resigned a few days into the investigation. While there have been a few whispers among the staff of the SNF of an unnamed “snitch”, all of the therapy staff who worked for the DOR have all noted how relieved we feel and how we don’t dread going to work anymore. Most importantly the patients are finally receiving the therapy they need!

It was a stressful, scary decision, but I would not change my mind for anything. Life is calmer, therapy is better, and I am proud of my company for how they handled my concerns. If you are in a situation similar to mine, please don’t hesitate to call your company’s compliance hotline; my one regret is that I waited too long and endured way more stress than I needed to!

Rachel Wynn
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Rachel Wynn

Speech-Language Pathologist at Gray Matter Therapy
Rachel is a speech-language pathologist and creator of Gray Matter Therapy. She started making noise as a patient-centered care advocate in 2013. She believes great care happens when patients are informed and engaged.
Rachel Wynn
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  • carole datwho

    Congrats to you and welcome to the club. I too reported a dor for billing while not treating. The behaviors went on for years, with a revolving door of therapists who just left instead of speaking up. My regret is the same as yours, I waited to long. I also regret not reporting to state licensing board, because he moved on to another facility and continues the same practice.