Practice Management Alert

Although hiring interviews can make or break your practice, exit interviews can be equally critical. Don't give any would-be whistle-blowers more incentive to slander your office and practice handle their exit with care.

Let employees go with skillfully handled exit interviews. Otherwise, an unhappy employee can spell trouble for your practice by disclosing potential compliance problems to federal agencies. Regardless of whether they're true, these rumors could hurt your record, not to mention reputation.

Whether the employee is leaving voluntarily or involuntarily, you should discuss his or her experiences with your practice. Follow these eight tips to get through the exit interview and its aftershocks with as little turbulence as possible.

1. Determine why the employee is leaving if it's a voluntary departure. Determine your employee's knowledge of your compliance plan with a general question such as "How do you think our compliance plan is working?" This question at least shows you're interested and involved with what's going on, experts say.

2. Give your employee one last chance to report any activity that is in violation of any government regulation and law and record and document your conversation, says attorney Donna Thiel with Morgan Lewis & Bockius in Washington, D.C. Of course, this demand works most effectively if you include in your employee training the charge that employees have an affirmative duty to report any activity that could be in violation of regulations and laws. Also, consistently remind employees of their obligation to report.

3. Add a questionnaire to the interview. Some providers use the questionnaire at the same time as the interview, while others find it more effective to mail it to former employees afterward. Include a mix of questions that address both retention and compliance. You should also append a letter that asks the former employee to help you improve, says consultant Cynthia Hohmann with Health Care Management Consultants in Jacksonville, Fla.

4. Immediately address any of the employee's criticisms or complaints. You can begin to solve a compliance problem before a government investigation even begins.

5. Communicate with the employee about what you plan to do if there are criticisms or complaints. Here's your chance to correct misconceptions, defuse intense emotions and show that you're hearing what the employee is telling you. Disenfranchised employees who feel that the practice will not listen and doesn't take them seriously are most often the source of False Claims Act suits, says attorney Howard Young with Arent Fox Kintner Plotkin & Khan in Washington, D.C.

6. Don't demand silence on the part of your terminated employee. Be careful not to coerce the employee to agree not to disclose a compliance problem, experts say. Never offer additional severance pay to an employee if he will promise not to disclose information about your practice, because this will likely backfire, they add. The government might see your payment as evidence that you're trying to hide something, Young says.

7. Prevent uneasy terminations. Don't target scapegoats for problems. Some whistleblowers are employees, or former employees, whom you blamed for problems they did not create or for actions authorized or sanctioned by higher-ups at one time, Thiel states. You should identify the full scope of a problem and take corrective action, or you may be vulnerable to a disgruntled employee who feels unfairly treated, she adds.

8. Document, document, document. Send copies of any notes, questionnaires or signed statements pertaining to the exit interview to your compliance officer. Your documentation allows for follow-up investigation and communication. And if the employee denies in a signed document knowing of any illegal activities, that will reflect on her credibility if she later claims otherwise.