The landscape of healthcare compliance is dynamic; hospitals have to constantly evaluate and re-evaluate their compliance protocols. The challenge is that compliance shortfalls tend to be subtle, so this evaluation process requires a very high level of scrutiny.
License compliance, in particular, is challenging because the shortcomings aren’t always obvious, but the consequences can be severe. Hospitals may have providers practicing without proper licensure without realizing it. This is due partly to intermittent license verification schedules. Some hospitals verify only at the time of renewal, and they miss important changes in license status as they happen. This compliance gap - the window of time where providers may be practicing without valid licensure - leaves the organization open to potential loss of accreditation, loss of private funding, exposure to civil suits, and more.
Fortunately, there are preventative measures organizations can take to help mitigate the risk of license compliance gaps.
Create a culture of accountability through self-reporting
Accountability through self-reporting is the first step in closing the license compliance gap. When changes in license status occur, it can be difficult to respond quickly unless you know about the changes as they happen. Placing the responsibility on the provider to self-report disciplinary actions, elapsed licenses, etc. promotes a culture of accountability and helps employers know about these changes faster. When setting this expectation with your providers, it’s important to lay out the details on paper to reduce any ambiguity. And just as important, be sure to get employee acknowledgment of the expectation in writing as well.
Ongoing, continuous verification is necessary
Let’s face the facts: if you left your license compliance program to self-reporting alone, you’d still likely face the dreaded license compliance gap. It’s not enough to verify licenses during the renewal period because changes can (and often do) happen in the in between. The only way to address them is to know about them, and the sooner you know the better. That’s why it’s important to set up strategic verification intervals on an ongoing basis, no less than once per month for all licenses. Verifying licenses regularly minimizes the window that important changes could go unnoticed. Every organization has different needs and available resources to dedicate to the process, but every organization should carefully look for:
- Changes in license status
- Disciplinary sanctions
- License expirations
- Name changes
- Missing documentation
Automated license verification is the best practice approach
Daily primary source verification is the absolute best-practice approach because it ensures that the license compliance gap doesn’t exist. You know about important changes as they happen, not after. This strategy ensures 100% compliance, 100% of the time. Now, if this sounds like a tedious task, that’s because doing it manually is. Imagine verifying hundreds, even thousands of licenses every day. It’s (maybe) do-able, but you have better things to do with your workday. Fortunately, there are solutions on the market today that provide automated license verification. Know more, do less. However, not all solutions are created equal. When vetting your options, look for solutions that provide the following capabilities:
- It monitors the Primary Source daily. The solution should act as a flawless intermediary between you and the Primary Source, and report changes back to you immediately.
- It interprets the raw data for you and supplies you with meaningful, actionable information so you spend less time analyzing and more time resolving issues.
- It provides automated workflows, sends email notifications of important changes or upcoming renewal deadlines, and allows task management within the system.
- It integrates seamlessly with your current HRIS or system of record so the information you have within your HRIS is as up-to-date as the Primary Source.
- It adapts to the changing requirements of the various regulatory agencies such as The Joint Commission, DNV Healthcare, and HFAP.
It's that simple: expect your providers to self-report, verify often, and verify smartly. License compliance is just one piece of a very integrated, complex web of healthcare compliance overall, but having these protocols in place can help you avoid getting dinged during your next regulatory survey.
If you're ready to simplify the impact regulation has on your organization and are interested in automated license verification, visit evercheck.com.