A call came into the hotline at a hospital from an employee who reported that a co-worker had received a piece of jewelry—an antique ring—from a patient. The caller was worried the gift could cause the employee to favor the generous patient over other patients.

Her concern was not misplaced. It explains why many hospitals have a no-gift policy when it comes to patients and vendors, with de minimus exceptions, says Christine Hogan-Newgren, chief compliance officer at Stormont Vail Health in Topeka, Kansas, who managed the situation at a different organization. “We talked with the co-worker who got the ring and told her she needed to give it back,” Hogan-Newgren says.