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Corewell Health West
Accounting and Auditing Matters regarding the recording and analysis of business and financial transactions associated with generally accepted accounting practices (GAAP). (Examples include: statement of revenues, statement of expenses, statement of assets, applications of GAAP principles, accounting transactions.)
Billing and Coding Matters regarding billing, coding, medical record documentation practices. This may also include governmental audits regarding these matters.
Conflict of Interest A conflict of interest is defined as a situation in which a person, such as a leaders, board members, physicians, team member, or other professional, has a private or personal interest sufficient to appear to influence the objective exercise of their official duties. (Examples may include: inappropriate vendor relations, bribery, misuse of confidential information, behaviors favoring relatives or friends, inappropriate customer relations)
Disclosure of Confidential Information Unauthorized and unlawful disclosure of corporately owned intellectual property or trade secrets, as well as team member, customer or consumer information, marketing and other corporate databases, marketing plans, business proposals and strategies. For Privacy concerns please use "HIPAA".
Discrimination or Harassment Uninvited and unwelcome verbal or physical conduct directed at a team member because of protected status such as race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected characteristic under federal, state, or local law. (Examples include: bias in hiring, bias in assignments, wrongful termination, bias in promotions, bias in educational decisions, unfair compensation, inappropriate language). May also include creating an intimidating, hostile, or offensive work environment.
Emergency Medical Treatment and Fair Labor Act (EMTALA) Matters relating to the Emergency Medical Treatment & Labor Act (EMTALA). Examples may include: a delay in performing medical screening exams or stabilization procedures of an emergency room patient, inappropriate transfer of emergency patients, or refusal to treat or examine a patient that presents to a hospital or emergency department.
Fraud/Scam Intentional deception or misrepresentation designed to manipulate victims into willingly providing their information. This could include phone calls or faxes trying to gain access to victim or organizational information.
Gifts and Entertainment Matters relating to the giving and accepting of gifts, meals, entertainment, or other items of value. These may include, but are not limited to: cash or cash equivalent, educational events, gifts, travel, or honorarium.
Identity Theft Identity Theft may include the use of another's identifying information for the purpose of receiving health care services under false pretenses, or to cause submission of claims to health insurers without the insured's authorization.
Interoperability Interoperability promotes and encourages the seamless and secure access, exchange, and use of electronic health information. Activities designed to interfere with the access, exchange, or use of electronic health information (EHI) are considered Information Blocking under the regulations.
Misconduct or Inappropriate Behavior Unacceptable or improper behavior that violates a law. Standard, or policy and/or behavior that is unwarranted and is reasonably interpreted to be demeaning or offensive, whether intentional or unintentional.
Patient's Rights This category should be selected if there are concerns with patient rights including but not limited to patient's rights to 1) caring, respectful, quality care, 2) receive information about their treatment and health care team, 3) make decisions about their own care, 4) be comfortable and safe, 5) privacy and confidentiality, 6) resources for expressing concerns.
Physician Payment and Referral Concerns Concerns specifically related to physician payments/benefits and/or payment for referrals. (Examples include: paying a provider to refer patients to a facility, paying physicians more than fair market value for services provided, paying a provider without an executed contract, awarding a benefit to a physician that may violate the Stark regulations, etc.)
Privacy - HIPAA (Begin using January 1, 2025) This Category should be selected if there is an incident, event, or allegation where Protected Health Information (PHI) has been improperly accessed, used, or disclosed. This includes any concern involving PHI, including but not limited to:
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Patient privacy
  • Improper taking and/or sharing photos or other patient information on any medium
  • Social media
  • Interoperability/Information Blocking
  • Impermissible verbal disclosures
  • Misdirected PHI
  • Inappropriate medical record access
  • Lost, missing, or stolen documents or devices containing PHI
  • More than minimum necessary
  • Improper disposal
  • MyChart privacy incident
  • Cyber incident
Retaliation An adverse action taken against an individual who reported a concern in good faith. Retaliation may include, but is not limited to, employment actions (demotion, suspension, termination, pay or hours reduction), negative evaluations, increased surveillance, isolation, intimidation, humiliation, bullying, harassment, discrimination, threats of any kind, hostility, or any other actions that might punish or deter an individual from reporting concerns, violations of law, rules, policies or procedures, safety concerns, or from cooperating with an investigation into any concern.
Safety, Health and the Environment This category should be used if there are safety concerns with the physical environment, known as the environment of care. This includes safety specific to building structures and maintenance, medical equipment, utility systems (heating, cooling, electricity, air ventilation, plumbing, medical gas, etc.), security, hazardous materials and waste management, fire safety, medical equipment, or emergency management.
Social Media Use of websites and applications that enable users to create and share content (as covered by the Corewell Health Social Media Policy), including posting and use of patient's PHI and/or photos. These websites/applications include, but are not limited to, Facebook, Instagram, LinkedIn, TikTok, Twitter, and YouTube.
Substance Use (Abuse) Substance use (abuse) is defined as the misuse of both legal and illegal drugs including alcohol. (Examples may include: prescription medications, cocaine, narcotics, marijuana, stimulants)
Theft The taking of another person's or Corewell Health's property or services without permission or consent with the intent to deprive the rightful owner of it. This also includes falsification of time records that results in additional compensation or time not worked.
Unauthorized/Fraudulent Use of Company Facilities and Equipment The misuse, damage, neglect or use or possession without authorization of the equipment or property of Corewell Health or of other individuals. This includes but is not limited to the use of any facilities, equipment or diagnostic supplies for treating self or others unless the individual is registered as a patient at the time of treatment and any services provided are ordered and/or delivered through appropriate standards of patient care.
Violence or Threat This category should be used to address concerns regarding behaviors including, but not limited to, physical/verbal assault, abuse, threats, or intimidating behaviors that threaten the personal safety of employees, visitors, patients/residents/members and others who are present in our facilities or are working on behalf of Corewell Health at any location. This includes both criminal and non-criminal behavior.
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Other Select "Other" if you feel that the definitions above do not accurately describe the matter.