I was pleased to share the stage with Janet Brown and Tim Nanof, both ASHA staff members to discuss Productivity Pressures in the SNF Setting: A Top Down and Bottom Up Approach. After Janet and Tim spoke about what ASHA is doing to address SLPs’ concerns, I spoke about what SLPs can do right now. Here are some notes from my portion of the session about talking to your supervisor about ethical and legal concerns. .
You should speak to your supervisor first about ethics and legal concerns. Of course, if your supervisor is participating in the activity of concern (e.g. billing for patients, they aren’t seeing), you might want to skip this step.
Otherwise, speak to your supervisor first. And acknowledge the pressure they are probably under too. While you may be frustrated, don’t enter the conversation with an “us versus them” attitude.
Pick a specific concern to address one at a time. Go for the low hanging fruit (something easily addressed) or something that impacts patient safety.
If you do not achieve desired results, move on to the next rung in the corporate ladder. Remember the definition of insanity – doing something over and over again and expecting different results.
Next in line is the regional director, but from speaking to many of you it may be uncomfortable to speak to the regional director, especially if you fear it being seen as going above your supervisor’s head.
The next person in your company to contact is the compliance hotline or department. They are very familiar with current regulations and want the company to run ethically. Complaints to the compliance department are protected from retaliation; after all it’s your job to report things that put the company at risk (like safety concerns, labor law violations, and fraud).
While you are preparing to speak to your supervisor (or another member of your company) about your concerns, I recommend that you start a journal. Document the when and where of your concerns, your response, and the result of your response. This information will be extremely helpful as your talk to the compliance department or report externally.
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