Kings Harbor Multicare Center

 

                                    Compliance Program - Code of Conduct

 

 

 

A.       Introduction

           

Effective __________________, Bronx Harbor Health Care Complex, Inc. d/b/a Kings Harbor Multicare Center ("Kings Harbor") adopted a compliance program, which is more fully described and contained in the Kings Harbor compliance program manual (“Compliance Manual”), which is available for review in the office of the Administrator.

 

Kings Harbor adopted the Compliance Program in order to embody its commitment to conducting its business in compliance with all applicable laws, rules, regulations and other directives of the federal, state and local governments and agencies.  An expression of this commitment is the code of conduct (“Code of Conduct”) described herein which is applicable to all individuals, including, as applicable, Kings Harbor's members, managers, shareholders, officers, directors, employees, contractors, vendors, agents and other providers working for or providing services for Kings Harbor (“Associates”).

 

The Code of Conduct is intended to provide general guidelines to assist Associates to understand and appreciate the manner in which Kings Harbor wishes to conduct business. Although the Code of Conduct can neither cover every situation in the daily conduct of our many varied activities nor substitute for common sense, individual judgment or personal integrity, it is the your duty to adhere, without exception, to the principles set forth herein.

 

The Code of Conduct shall be distributed and available to all Associates.  Associates shall be responsible for ensuring that their behavior and activities are consistent with the standards embodied in this Code of Conduct.

 

B.        Compliance with Laws and Regulations

 

It is the duty of Kings Harbor and its Associates to uphold all applicable federal, state and local laws, rules, regulations and standards (“laws and regulations”).  Each individual must be aware of the legal requirements and restrictions applicable to his or her respective position and duties.

 

While the duty remains the responsibility of each individual, Kings Harbor shall implement programs necessary to foster further awareness of applicable laws and regulations and to monitor and promote compliance with such laws and regulations.  Any questions about the legality or propriety of any actions undertaken by or on behalf of Kings Harbor should be referred immediately to an individual's supervisor, the Administrator, or the Compliance Officer.

 

C.       Fraud and Abuse

 

Kings Harbor expects its Associates to refrain from any conduct that may violate applicable federal and state laws and regulations, with special emphasis on those related to fraud, waste and abuse. 

 

These laws generally prohibit: (1) the transfer of anything of value in order to induce the referral of patients or any government program business (i.e., Medicare, Medicaid and other federal or state health care programs); and (2) the making of false representations or the submission of false, fraudulent or misleading claims to any government entity or third party payor, including claims for services not rendered, claims which characterize the service differently than the service actually rendered, or claims which do not otherwise comply with applicable program or contractual requirements.

 

More specific guidance with respect to laws and regulations applicable to fraud and abuse can be found in Kings Harbor’s Compliance Manual.

 

D.       Professional and Ethical Standards

 

All Associates have a duty to promote Kings Harbor’s goals to provide medical services of the highest quality that respond to the needs of our residents.  The services provided must be reasonable and necessary to the care of each resident.  Resident care shall be provided by appropriately qualified individuals and properly documented as required by law and regulation, payor requirements and professional standards.

 

Kings Harbor and its Associates shall conduct all activities in accordance with the highest ethical standards of their respective professions at all times and in a manner which shall uphold Kings Harbor’s reputation and standing in the community to which we serve.

 

E.       Confidentiality

 

Kings Harbor and its Associates are in possession of, or have access to, a wide variety of confidential and sensitive information.

 

It is the duty of Kings Harbor and its Associates to protect the privacy rights of the residents.  Kings Harbor and its Associates shall maintain the confidentiality of resident medical records and personal information, as well as proprietary information, by actively protecting and safeguarding such information in a manner designed to prevent the unauthorized use or disclosure of such information.

 

Any questions or concerns relating to the use or disclosure of information should be referred to an individual’s supervisor, the Administrator, the Compliance Officer, or the Privacy Officer.

 

F.       Business Practices

 

Kings Harbor’s business practices must be conducted with honesty and integrity and in a manner that upholds Kings Harbor’s reputation with residents, payors, vendors, competitors and the community.  Kings Harbor expects its Associates to be loyal to Kings Harbor’s interests.  Associates should not use their positions to profit personally or to assist others in profiting in any way at the expense of Kings Harbor.  Associates must refrain from activities that create conflicts of interest with Kings Harbor or give the appearance of impropriety.

 

Associates involved in business transactions on behalf of Kings Harbor shall not offer or pay, or solicit or receive any gifts, favors or other improper inducements in exchange for influence or assistance in a transaction or the referral of business.  Associates are required to disclose any conflicts of interest or concerns about the propriety of specific arrangements, conduct or activities to the Compliance Officer.

 

G.       Employment Practices

 

Kings Harbor is committed to providing equal employment opportunities for all persons, without regard to race, color, creed, religion, sexual orientation, national origin, age, sex, marital status, handicap, or disability.  Kings Harbor is committed to providing resident care and a workplace environment that emphasizes the dignity and respect of every individual.  In that regard, harassment and/or other types of prohibited discrimination in any form or context will not be tolerated.

 

Violence in the workplace will not be tolerated and such behavior will result in immediate disciplinary action, which may include termination.

 

Kings Harbor is committed to providing a healthy and safe workplace.  Kings Harbor and its Associates will comply with federal, state and local laws and regulations that promote the protection of health and safety.  Workplace injuries or any situation presenting a danger of injury should be reported immediately.

 

H.       Reimbursement

 

Kings Harbor and its Associates are responsible for complying with the laws and regulations governing the submission of billing claims and related statements.  A detailed description of the Federal False Claims Act, the Federal Program Fraud Civil Remedies Act, New York State civil and criminal laws pertaining to false claims and the whistleblower protections in contained the DRA Information Handout appended hereto.

 

All claims for reimbursement for services must be supported by adequate documentation, which justifies that the service is reasonable and necessary, provided by properly qualified persons and coded correctly.  Such documentation must conform to legal, professional and ethical standards.

 

Claims for reimbursement must be truthful and accurate and conform to all applicable laws and regulations.  Kings Harbor and its Associates are prohibited from knowingly presenting or causing to be presented claims for payment that are false, fictitious, fraudulent or otherwise not in compliance with applicable laws and regulations.

 

I.        Administration and Application of this Code of Conduct

 

Kings Harbor expects that the Code of Conduct will be a part of the daily activities of all who provide services on behalf of the facility.  The Code of Conduct is in addition to, and does not limit, specific policies and procedures of Kings Harbor.  Associates must perform their duties in accordance with all such policies and procedures as well as laws and regulations.

 

Associates are responsible for promoting the standards set forth in this Code of Conduct and for reporting potential violations in accordance the reporting procedures outlined in the Compliance Manual.  All reports of unethical or illegal conduct will be investigated by persons designated by, and pursuant to procedures established by, Kings Harbor.  All reports will be held in the strictest confidence possible, consistent with the need to investigate any allegation of wrongdoing.

 

It is a violation of the Code of Conduct to take any action to intimidate, or in retaliation against, anyone who participates in good faith in the compliance program, including reporting possible illegal or unethical conduct.

 

Failure to abide by the Code of Conduct and compliance standards of Kings Harbor, including failing to report suspected problems, participating in non-compliant behavior, or encouraging, directing, facilitating or permitting either actively or passively non-compliant behavior, will result in disciplinary action.  Disciplinary action will be determined on a case-by-case basis and may, in Kings Harbor’s discretion, range from a warning to termination.  If Kings Harbor determines that a violation has included criminal violations of law or regulation, Kings Harbor will cooperate with law enforcement authorities in connection with the investigation and prosecution of the offender.

 

 

How to Report a Violation of the Code

 

 

Associates should report any violation of the Code of Conduct to your immediate supervisor, the Administrator, and/or Kings Harbor’s Compliance Officer.  If you prefer not to report such matter to a supervisor or the Administrator because you believe they may be involved in the actual or perceived violation, if you otherwise have a legitimate reason to be concerned about intimidation or retaliation, if your previous reports have not been acted upon, or for any other reason, you should call Kings Harbor’s Compliance Hotline at 718-405-3691.  While Hotline calls may be made anonymously, supplying your name and contact information may assist in the investigation.  It is an explicit violation of Kings Harbor’s policy to intimidate or retaliate against an individual who reports in good faith an actual or potential violation of applicable laws, rules, regulations, or the Code of Conduct.

           

Nothing in this Code of Conduct is intended to nor shall be construed as providing any additional employment or contract right to Associates or other persons.

 

Kings Harbor will attempt to communicate changes to the Code of Conduct prior to the implementation of such changes.  However, Kings Harbor reserves the right to modify, amend or alter the Code of Conduct and its policies and procedures without prior notice to any person.