Kusserow on Compliance: Compliance culture a key measure of program effectiveness

The compliance culture is the set of shared attitudes, values, goals, and practices that characterizes an institution or organization when it comes to compliance with laws, regulations, rules, standards, code of conduct, and policies.   Oversight agencies believe the compliance program should be a change agent in promoting a culture of compliance that creates an environment less likely to have regulatory or enforcement problems.  This means establishing a culture in which everyone in the work environment embraces and adheres to rules, regulations, laws, code of conduct, and policies.  The Department of Justice (DOJ) and the HHS Office of Inspector General (OIG) frequently encounter organizations with compliance programs that exist on paper, but that culturally failed to be effective in operation. Compliance officers should find means to evidence that the culture of the organization matches the compliance goals.

Positive compliance culture promotes good business

Carrie Kusserow, with over 15 years’ experience as a compliance officer and consultant, makes the case that a good compliance culture is also good for business and does not just serve as a “cost center.” She notes there are many positive benefits to be derived from the effort. She offered the following points in her argument.

  • Organizations are less likely to have liabilities, arising from wrongful behavior.
  • Evidence suggests compliance-committed organizations are more efficient.
  • Lower employee turnover occurs when the organization culture is to abide by rules and standards.
  • There exists greater employee commitment to compliance with laws, rule, code of conduct and policies.
  • Employees feel less pressure to compromise company standards to achieve company goals.
  • Employees are empowered to report wrongful behavior and misconduct internally, not externally.

Compliance culture surveys evidence compliance program effectiveness

Steve Forman, CPA has been using compliance culture surveys for the last 20 years, both as a compliance officer and as a compliance consultant. He believes that one of the best and most inexpensive methods for evaluating, evidencing, and benchmarking compliance program effectiveness is through a compliance culture survey that measures employee perceptions of ethical culture and/or the compliance program. He likes using this type of survey, alternately with a compliance knowledge survey that tests employee knowledge of the program. He points to the fact that the OIG recommends this in its Compliance Program Guidance, wherein it noted that “as part of the review process, the compliance officer or reviewers should consider techniques such as . . . using questionnaires (employee surveys) . . . developed to solicit impressions of a broad cross-section of . . . employees and staff.” Results from a professionally administered survey provide a very powerful and credible report to the compliance oversight committee, as well as to any outside authority questioning the program. They can also identify relative strengths in the compliance programs, as well as those areas requiring special attention that are invaluable for compliance officers.

Compliance survey benefits

Conducting a compliance survey provides numerous benefits to an organization.  For example, it can:

  • provide outcome measurements for the compliance program;
  • serve as critical evidence in determining the degree of effectiveness of the compliance program;
  • identify program strengths and potential weakness warranting attention;
  • evidence the extent of individual and leader commitment to compliance;
  • assess the current state of the compliance climate or culture of an organization;
  • communicate a positive message that employee opinions and perceptions are valued;
  • underscore organization commitment to employees;
  • increase management attention on what is being measured;
  • provide metrics as to progress in developing an effective compliance program;
  • benchmark compliance program effectiveness improvement;
  • signal the organization as to employee attitudes and perceptions;
  • tell employees that what they believe and understand is important; and
  • provide guidance as to where improvements are needed.

Benchmarking compliance program progress

Jillian Bower, with many years of experience in administering compliance surveys, as well as serving as interim compliance officer, notes the OIG compliance guidance says that “the existence of benchmarks that demonstrate implementation and achievements are essential to any effective compliance program.”  Surveys can be used to meet that standard. If the survey being used is anchored in a large database of users, the organization can benchmark them against that universe, viewed as very important by most organizations. Furthermore, an initial survey can establish a baseline from which future surveys can be used to benchmark progress of the compliance program. The surveys can benchmark and measure change in the compliance environment over a period of time. However, Bower warns it is inadvisable to use the same survey annually, as significant changes among the work force takes time to show results.

Alena Treen, of the Compliance Resource Center (CRC), has many years’ experience in administering compliance surveys. She explained that culture surveys focus on the beliefs and values which guide the thinking and behavior of employees within an organization. They are usually presented in a Likert Scale format that offer a series of gradation in which respondents are asked whether they “Strongly Disagree,” “Disagree,” are “Neutral,” “Agree,” or “Strongly Agree,” with the statement presented in each item. This is in contrast with a compliance knowledge survey designed to learn how much employees know about the program with questions answerable as yes or no. She notes it is highly advisable to use a valid and independently web-based administered survey that has been tested over many organizations and ensures participant confidentiality. Using a professional survey service specializing in health care compliance is surprisingly inexpensive and less costly than developing and delivering a survey in house that doesn’t carry the same level of credibility. The CRC has been using the Compliance Benchmark Survey© since 1993 and has been employed by hundreds of health care organizations and over a half million surveyed population. Treen normally deals with reports that are about 50 pages in length that provide advice on each topical area and question as to how improvements may be made.   Clients find that comparing their results with the universe to be the most beneficial information.

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2017 Strategic Management Services, LLC. Published with permission.