Gathering Compliance Investigation Evidence

Richard P. Kusserow | August 2019

Sorting Through the Details to Find What’s Relevant and Reliable in a Compliance Investigation

The two major tasks in the investigative process are gathering evidence from interviews and gathering documents. Interviews are the most sensitive part of the process and need to be understood, planned, and conducted properly with the right questioning process. This type of evidence may provide first-hand knowledge from the people involved or secondary knowledge or hearsay learned from others.

After the interviews, the bulk of the investigative effort will be gathering documents and other physical evidence and reviewing the evidence collected to verify, confirm, or refute statements made by a complainant, witness, or subject.

Documentary evidence consists of information, documents, and objects that are used to establish the facts and establish context for the investigation. These include such things as written rules, regulations, laws, policies, or employee manuals. Documents or physical objects may provide solid factual evidence.

A surveillance camera with a date/timer could establish that a person was present at a location. A serial number on a piece of property could establish ownership. Other documents and objects gathered during an investigation may have little value or relevance.

The challenge for the investigator is determining which documents and evidence provide value to the investigation in answering questions about the matters under investigation. In short, does this information shed light on the case and add factual understanding to the case? For the purposes of an internal investigation, evidence should be considered relevant if it tends to make a fact more probable.

About the Author

Richard P. Kusserow established Strategic Management Services, LLC, after retiring from being the DHHS Inspector General, and has assisted over 2,000 health care organizations and entities in developing, implementing and assessing compliance programs.