This tool, which was developed by Melissa Andrews, appears in the Health Care Compliance Association’s Healthcare Compliance Forms and Tools.[1]
1. Notify Appropriate Individuals | |
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Privacy officer |
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Director |
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Vice president |
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CEO |
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Compliance committee |
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Board of directors |
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Other: |
2. Timeline | |
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Acknowledge receipt of complaint |
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Identify involved parties |
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Interview complainant |
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Inform accused supervisor |
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Prepare interview |
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Notify Human Resources |
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Inform accused |
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Patient notification |
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Office for Civil Rights (OCR) breach notification |