Action Item |
Compliance Elements |
Risk Domains |
Lead Assigned |
Staff Assigned |
Current Status |
Due Date |
Completion Date |
Comments | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 |
Department Infrastructure | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
2 |
Communications | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
3 |
Policies & Procedures | |||||||||||
a | ||||||||||||
b | ||||||||||||
4 |
Enterprise Risk Management | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
5 |
Investigations, Issues & Initiatives | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
6 |
Training | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
7 |
Conflict of Interest | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
8 |
ADA/1557 Compliance/Discrimination Complaints | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
9 |
Audits | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
10 |
Contracts | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
11 |
Joint Ventures | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
12 |
Physician Compliance Management | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
13 |
Privacy | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
14 |
Overpayment Process | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
15 |
Legal | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
16 |
Insurance | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
17 |
Compliance & Risk Week | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
18 |
Program Evaluation | |||||||||||
a |
0% | |||||||||||
b |
0% | |||||||||||
Total |
0% | |||||||||||
Compliance Elements | ||||||||||||
1 |
Policies & Procedures | |||||||||||
2 |
Chief Compliance Officer & Compliance Committee | |||||||||||
3 |
Training | |||||||||||
4 |
Communication | |||||||||||
5 |
Discipline | |||||||||||
6 |
Monitoring & Auditing | |||||||||||
7 |
Prompt Response | |||||||||||
8 |
Evaluation | |||||||||||
Risk Domains | ||||||||||||
1 |
Operational | |||||||||||
2 |
Clinical/Patient Safety | |||||||||||
3 |
Strategic | |||||||||||
4 |
Financial | |||||||||||
5 |
Human Capital | |||||||||||
6 |
Legal/Regulatory | |||||||||||
7 |
Technology | |||||||||||
8 |
Hazard |
General Compliance Program
Compliance Work Plan
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Table of Contents
- Auditing
-
Board and Committee Documents
- Sample Compliance Committee Charter
- Sample Compliance Committee Meeting Agenda
- Sample Compliance Committee Meeting Minutes
- Sample Compliance Committee Work Plan
- Sample Corporate Compliance Report
- Sample Governance, Compliance, and Ethics Committee Charter
- Sample Quality Committee Charter
- Sample Board Report 1: Audit Status Update
- Sample Board Report 2: Quarterly Report
- Sample Board Report 3: Compliance Work Plan
- Sample Board Report 4: Annual Compliance Risk Assessment
-
Clinical Research
- Sample Deferral Checklist
- Sample Exempt Research Guidance Summary
- Sample Flexible Guidance Summary
- Sample Institutional Research Policy
- Sample IRB Review Worksheet/Checklist
- Sample Limited IRB Review Guidance Summary
- Sample Minimal Risk Research Guidance Summary
- Sample Project Transition Form
- Sample Request to Conduct Research Form
- Sample Research Compliance Assessment Form
- Sample Single IRB Review Guidance Summary
- CMS Conditions of Participation
- Communication and Education
- Conflicts of Interest
- Employee Evaluation
-
General Compliance Program
- Code of Ethics for Healthcare Compliance Professionals
- Compliance Calendar
- Compliance Work Plan
- Job Description, Compliance Officer
- Job Description, Vice President of Corporate Compliance
- Sample Code of Conduct Attestation Form
- Sample Corporate Compliance Helpline Policy
- Sample Compliance Program Policy
- Model Anti-Retaliation Policy
- Sample Non-Retaliation Policy
- Sample Policy Against Retaliation
- Sample Policy Template
- Sample Policy Implementation Master Tracker
- Sample Written Standards Matrix
-
Internal Investigations
- Sample Internal Investigation Checklist
- Sample Interview Notes Template
- Sample Interview Tips
- Checklist for Interviewing a Reporter, Complainant, or Witness
- Checklist for Interviewing a Person Accused of Wrongdoing
- Sources of Potential Information in an Investigation
- Sample Investigation Checklist
- Sample Checklist for Assessing Investigation Capabilities
- Sample Internal Investigations Policy
- Sample Upjohn Warning
- Sample Evidence Collection Worksheet
- Sample Investigator Script
- Sample Key Allegations Worksheet
- Sample Key Facts Worksheet
- Sample Investigation Report Form 1
- Sample Investigation Report Form 2
- Sample Privacy Incident Questionnaire
- Excluded Individual Investigation Worksheet
-
Key Laws in Healthcare Compliance
- Sample Stark Law Compliance Checklist for Commercial Reasonableness Review
- Sample Stark Law Compliance Checklist for Employee Arrangement Exception
- Sample Stark Law Compliance Checklist for Fair Market Value Arrangement Exception
- Sample Stark Law Compliance Checklist for Personal Services Arrangement Exception
- Measuring Program Effectiveness
- Monitoring
- Patient Privacy and Security
- Post-Acute Care
- Provider-Based Rules and Regulations
-
Risk Assessment
- Compliance Program Structural Risk Assessment
- Sample Compliance Risk Assessment Questionnaire
- Sample Heat Map
- Sample Risk Assessment Policy and Process
- Sample Risk Assessment Summary
- Sample Risk Assessment Template
- Sample Risk Committee Charter
- Sample Risk Rating Survey
- Privacy, Risk, and Discipline Assessment
- Vendor Management