From the Contributor’s Corner: Decisions to Be Made Before Initiating Investigations

Most Compliance Officers are not professionally trained investigators and the importance of deciding on whether a matter warrants an investigation or not becomes a serious matter. On the other side of the equation, the vast majority of issues presented to compliance officers will involve issues that are relatively easy to resolve and will remain in the domain of administrative action. At any rate, the first step upon receipt of information suggesting a possible need for an investigation is analyzing the matter to determine what needs to be done. It is important to take the time to analyze all known facts upon receipt of a complaint, allegation, or information suggesting a potential wrongdoing has taken place. At this point, the following are alternative decisions that can be made:

  1. Closing the matter without the need of further action;
  2. Taking adverse action against one or more individuals;
  3. Requesting additional investigative steps to clarify issues;
  4. Referring the matter to legal counsel for further legal review and action; and
  5. Disclosing to a duly authorized law enforcement or governmental authority.

If the decision is made that an investigation is necessary, then other decisions are warranted, such as determining:

  • Who will be the deciding official on the results of the investigation;
  • What should be included in the investigative plan;
  • The scope of the investigation;
  • Whether the investigation should be under the direction of legal counsel; and
  • The person best qualified to conduct the investigation.

A Compliance Officer or other representative of an organization conducting an investigation must rely upon professional competence and friendly persuasion to get the job done, not upon the authority and power of a government agency backed by the courts. One of the most common and costly mistakes is for individuals to conduct investigations without proper training and experience. It is advisable to have protocols in place in advance of being confronted with an investigation. This would provide guidance on how to proceed with an internal investigation.

For those unaccustomed to conducting investigations, it will become apparent fairly quickly that conducting internal investigations properly is not easy, nor is it fun. It can be very trying, frustrating, and, at times, intimidating. On the other hand, it can also be very gratifying to resolve a serious problem for the organization or for an individual suffering within the organization. Time is a major enemy and a force to contend with in any internal investigation.

There is a lot involved in even a simple investigation. It includes two key elements:  document examination and interviews. Knowing what documents are needed is important, but being able to conduct interviews requires a lot of training and skill to produce optimum results and reduce the risks of losing valuable information and time. Writing reports of interviews and the final investigations report is also very important, as it is possible that they will be included and challenged in litigation forums. There is a right way to do these and a wrong way.

In every phase of an investigation there are rules that must be followed. These include how things must be done, how to work with other parties internal or external to the organization, how to manage the records of investigations, and so on. It is important for anyone who may be called upon to conduct an investigation to take time to learn some of the fundamentals of the process.

Richard Kusserow served as the DHHS Inspector General for 11 years with prior services in the FBI. He is the author of Conducting Internal Investigations in Health Care Organizations, AIS, 2011, (ISBN 979-1-936230-60-8). He currently is CEO of Strategic Management Services

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Copyright © 2013 Strategic Management Services, LLC.  Published with permission.