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Debriefing Sources of Allegations and Complaints

Tips From Experts

The major sources of information leading to internal investigations are from complainants, most often through the hotline, but also directly to compliance officers or members of management.  The proper handling and resolution of matters raised by such parties often hinges on how well the caller is debriefed. Carrie Kusserow, who has managed one of the largest hotline vendor operations, notes: “If the hotline is outsourced to a vendor, then an organization is dependent on how well the vendor debriefs callers. A properly qualified and managed vendor should be able to ensure that this is done professionally. If the vendor’s report of allegations falls short of the organization’s expectations, then consideration should be given to finding another vendor.”

Emil Moschella, JD, has had decades of experience in debriefing complainants and witnesses during his time as an FBI agent and as a compliance officer. He states: “A key factor in a proper debriefing is to identify and understand the motivation of the complainant. This goes a long way in assessing the value of the information being provided, as well as the complainant’s expectation from reporting his or her issues. It is important to determine why the complainant is making the complaint and the level of personal concern for the issues, to be in a position to evaluate the allegations and determine the appropriate response. It is important to remember that not all motivation is altruistic and may be a result of personal animus towards someone.” Moschella makes the following suggestions in determining complainant motivation:

  1. Has there been any prior history between complainant and subject?
  2. Is the complainant friendly with or hostile to the subject?
  3. Is complainant personally affected by the complained-of conduct?
  4. Are the complainant’s friends affected by the alleged conduct?
  5. Why is the complainant raising concerns at this time?

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Suzanne Castaldo, JD, who has years of experience as a practicing attorney, compliance officer, and consultant, believes, “In order to really understand the value of what is being provided, it is necessary to ask specific clarifying questions to guide the person back through the information by following the standard: WHO, WHAT, WHERE, WHEN, and WHY. These questions should be designed to expand on the factual details and to test and corroborate the information.”

Kashish Chopra, JD, a health care compliance consultant, advises, “Be sure the chronologies of events are established. It is important to look for avenues that will provide a means to either substantiate the allegations or dismiss them, inasmuch as the allegations may relate to a specific event, something personal or organization wide, an ongoing process problem, etc.”

All of the experts make the point that it is not possible to draft a set of questions that would apply in every circumstance.  However, collectively, they provided the following questions as a useful part of any debriefing of a complainant:

  1. What happened that led to making the complaint?
  2. Why are you now coming forth with it?
  3. What occurred, where, when, and how?
  4. Did that person engage in similar conduct with anyone else?
  5. Has anyone else complained to you about similar conduct?
  6. When did it occur (date and time)?
  7. Where did it take place?
  8. How did you respond when it occurred?
  9. Who did you discuss it with and when?
  10. What did you say? What did they say?
  11. How has this incident affected you?
  12. Has your job been affected in any way?
  13. Who else was present when the act occurred?
  14. Where were they in relation to you?
  15. Who else has any knowledge of the act?
  16. Has anyone else discussed it with you?
  17. If so, who, and what did that person say?
  18. Did anyone see you immediately after the act?
  19. Who else was involved, knows about, or witnessed it?
  20. Who else have you told (employees, supervisor, attorney, media, etc.)?
  21. Why do you think it happened?
  22. What documentary evidence would help in the investigation?
  23. What do you believe should be done to resolve this matter?
  24. Has it happened before (an isolated event or part of a pattern)?

Moschella warns: “Sometimes a single complaint may encompass several different allegations. However, regardless of how many different allegations may be included in a single complaint, treat each of them independently. Any information that warrants investigation should be acted upon immediately. Any delays could prove to result in serious problems and possible liability. The individual who made the complaint is able to make another call to an attorney, government agency, media, etc. The same holds true for those who raise the issue by other means. Time is not a friend once information is received that may warrant immediate action.  Castaldo also notes, “The U.S. Supreme Court issued a unanimous decision in the Escobar case, adopting a form of the “implied certification” theory of knowingly fraudulent representations under the civil False Claims Act (FCA). The provider was alerted to a possible improper claim by a ‘whistleblower’ and failed to disclose and repay the overpayment in a timely manner. This underscores the critical importance of ensuring that information from complainants is complete and acted upon quickly.”

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