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Having a serious convo w/ boss tomorrow, and it probably isn't going to go well

edited March 2015 in Chit Chat

TL;DR: I have been doing my job wrong for the past 2 years and may or may not get fired.

I work for a community mental health agency, and every 2 years we have a site visit by the state to check our charts and make sure we're doing things correctly. Luckily (or so I thought) the last time we went through this, I had JUST got a therapy job so I didn't have to check any charts. I didn't have any of my own yet.

Our next site visit is next month, and they check charts from every program. In my particular program, I'm the only therapist, and there's only one case manager, so it's our job to split the charts for our program and we have to supply the state with 10 *perfect* charts.

I've checked all but 12 charts, and not one of them is perfect. Why? Because I didn't realize I wasn't following up as frequently as I should, and I also didn't realize I wasn't providing as many services as I was supposed to be. I learned this information in January, so my charts from January to now are great, but everything from May 2013-December 2014 SUCKS. I know the last 12 charts are going to be exactly the same, and this is a huge problem.

My boss emailed me and the other woman today saying if we don't provide the state with our 10 perfect charts, they will cut our program during site visit. You guys, we don't have 10 perfect charts, and it's completely my fault. Our program is going to get cut because of ME.

So I'm planning to talk to my boss first thing in the morning to tell her, that way she knows the situation now as opposed to when the state starts ripping through our charts, but I really have no idea how it's going to go. She's super nice and laid back, but this is a huge problem, and there is absolutely no way to fix the damage that's been done.

I have the following outcomes in mind:

-They cut our program. The other girl and I get moved to another program.

-They cut our program. The other girl and I get fired due to lack of funding to keep our jobs.

-They cut our program and I get fired for being responsible for it.

I'm terrified honestly. And I'm not the only therapist with this problem (lots of others have the same problem of not following up/providing the right services), but I'm the only therapist in my program so it's a huge deal. There's no one else to pick up the slack with good charts like in the other programs.

Any thoughts on how to be professional with my boss tomorow? Or prayers that I'm not unemployed soon?

Anniversary



Re: Having a serious convo w/ boss tomorrow, and it probably isn't going to go well

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    Oh my gosh! How stressful and scary!

    Were you not trained properly on the procedures? Why weren't the charts done correctly? It kind of sounds like there was a failing in management, and it's unfortunate that now you have to take the brunt of it! :(

    No real ideas, just good thoughts!



    As far as training, I really wasn't. I took over after someone else had left so I was just shown things as they came up, and for some reason this stuff never came up. It's basically a billing problem because I'm not billing for certain things as often as I should be (because I thought the requirement was something different entirely), and I wasn't following up with people like I should have been after missing billing opportunities because I didn't realize I had missed anything, until now when it's too late. It's more unethical for me to lie about it and try to say I did something when it didn't happen.

    Unfortunately, the state isn't going to care that I wasn't trained. They're just going to see that we've seriously been dropping the ball for the past 2 years. And even without the training, I've been here for 2 years, I can't believe I'm just now realizing what I was doing wrong.  

    Anniversary



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    ditto @jennycolada. It really seems like there is just a severe lack of training, especially if you are not the only one who doesn't do it correctly. 
    The good thing is you identified your mistake and have fixed it going forward...I know in my line of work that helps a lot.
    Wedding Countdown Ticker

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    I think the best thing to do is to be humble, but not emotional, and own up to everything at the first opportunity. Hopefully being up front and honest will win you some brownie points. I hope the best for you! Who knows, maybe this is such a wide spread problem that they will throw "perfect" out the window and take note of how you've worked to correct these issues over the past few months.
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    Agree with blergbot.  Humility will get you a long way.  Do what you have to do to not be emotional.  Take responsibility.  Yes, your training may have been lacking, but you had two years to figure it out and could have pursued documentation (read up on the statutes or regulations) to educate yourself.  And sounds like you eventually did - just too late to help you out.  Make sure you don't use inflammatory language.  So use phrases like "My understanding of the regulation was..." instead of "I just did it the way so-and-so taught me."  If they follow up to ask how that became your understanding, be tactful and try not to throw people under the bus.  They very well could fire you, but if you come in showing an
    understanding of the problem, taking the responsibility without shifting
    the blame, and showing the steps you took to correct the problem once
    discovered, you'll at least increase your odds they'll find another
    position for you or be willing to rehire you when funding allows.

    Best of luck.  It sucks, but I think this is definitely a situation that needs to be addressed sooner than later because letting your employer be blindsided by this will not work in your favor.
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    Also make sure to emphasize you realize you can't fix the past documents but you have since corrected it and from January moving forward everything will be done properly.

    I fully emphasize -- I work in an industry that has site visits and audits and I know how stressful it can be when it comes to the paperwork. *hugs*
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    Often with audits it helps to be able to show that u discovered the problem, corrected it, and put procedures in place to ensure it doesn't happen again. So in this case you did a self audit in January and discovered the problem. You corrected it by learning the correct procedures and implementing them as evidenced by your most recent charts. I would write up a procedure showing how the charts should be done/follow up frequency/etc and have it sent out to the other therapists with read receipts on the email so the office can prove it was sent out. The reality Is you can't undo what was done wrongin the past but you can be proactive in making sure it is done correctly going forward.

    Obviously I don't know how this type of audit works but usually auditors are willing to work with you to correct mistakes.
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    As your boss, I would want to know why, if you figured this out in January and fixed it then, I am only finding out about this issue now. Three months later.

    I'd be prepared to answer that q. Good luck!!
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    Good luck. I know it's really stressful. 

    Take what I say with a grain of salt but it sounds to me like it could well be an empty threat. Like, they cut the program- then what? No community mental health program in that area? That's a terrible idea. It's kind of like how schools always have budget cuts and test scores hanging over their heads, but really, the school stays open and the school stays staffed. Or technically I shouldn't be an employee at my job anymore because I'm supposed to work at least 10 hours per month and stay up on training to stay on as a fill-in, but at this point I haven't been in for a couple months, am WAY behind on trainings, but they would gladly let me fill a sift if I took it. 

    So maybe I'm being overly optimsitic; I don't know a ton about how being a therapist works, but that's my take. Best of luck to you and just be very matter of fact and honest, recognize it's a problem, but emphasize it's an honest mistake that you have since fixed, and maybe come up with a way to suck up a bit- I should have been fired from a job for a stupid mistake I made but I immediately called and said I'd come in and work for a few hours for free so that my mistake wouldn't screw over the next shift. 
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    So I had a speech all planned out and was going to address all of the points you guys brought up, and take ownership and talk about how I had since fixed the problem after learning about it, and I got to work 20 minutes before my boss normally does to prepare myself and....

     

    she's off the rest of the week. On vacation.

    So I have to wait until Monday afternoon to talk to her about this. That SUCKS.

    However, I was talking with another very seasoned (been here several years) therapist about this, and she said that the mistakes I've made are not huge mistakes. She said she'd be much more concerned about me talking to people without a release (which gives us permission to talk to people) or my treatment plans being out of date. Those two problems could get easily us sued or cause my agency to have to refund insurance reimbursements. Luckily, my charts are perfect in regards to those aspects. And I know that this therapist isn't my boss, but talking to her made me feel a little better. Especially now that I have to wait 5 days to talk to my boss about it.

    I'll update you guys on Monday after we have the talk. Thank you for your kind words and suggestions so far.

    Anniversary



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    I have no advice, but I wish you the best of luck. One way or another, it will be ok! 
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    Try to relax a bit until Monday then. Wine!

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    edited March 2015

     

    I have no advice, but I wish you the best of luck. One way or another, it will be ok! 


    That's true. When I was talking to FI about it, he says, "Well babe look on the bright side. You hate this job." lol he's right, but I didn't want to get fired from it! I'd rather leave because I found something better.

    ALSO, after checking through more charts this morning, there are a lot of problems with all our charts and many of the problems have nothing to do with me. No, it doesn't make my situation any better, but at least now if the program gets cut it won't be totally 100% my fault. Again, it's not better but it's certainly not any worse for me.

    Example: I'm checking a chart now that overall looks pretty damn good, except that back in March of last year I saw that one of the case managers, who is no longer here, talked with someone about this client and we did not have a release to talk to that person. Annnnd that's illegal, but thank God it's not my mistake!

    ETA: quote novella

    Anniversary



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    Is there anyway you can talk to your boss before Monday? I think your boss deserves a heads up before your site visit.
    BabyFruit Ticker
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    KatWAG said:

    Is there anyway you can talk to your boss before Monday? I think your boss deserves a heads up before your site visit.


    Other than calling her while she's on vacation, I wouldn't be able to talk to her. And I hate to call her from work while she's on vacation. Luckily, site visit isn't until the end of April-first of March, so she'll still have several weeks heads up about it.
    Anniversary



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    Yikes. I'm sorry! 
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    I agree with all of the PP's advice. I'll also offer another suggestion or two:

    1. Though you haven't done the follow up as is required, do you have any examples where the work was done but not documented in accordance with the rules? I don't know much about your world but I wonder if you may have done the work on occasion but not have the documentation. While regulators need you to follow the rules, perhaps you can show examples of the work being done, albeit improperly. It may be better than nothing....

    2. Show your boss an improvement plan. Walk through what you're doing to insure that this type of problem never happens again. And, if you're really worried, perhaps suggest a few presentations/classes/etc. that you can run for the other therapists on proper documentation procedures. Tell your boss that you want to get yourself trained on ALL of the regulations (god forbid any of you missed some others) and that you will train the rest of the team based on what you learned.

    Good luck!
    Daisypath Anniversary tickers
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    I agree with all of the PP's advice. I'll also offer another suggestion or two:

    1. Though you haven't done the follow up as is required, do you have any examples where the work was done but not documented in accordance with the rules? I don't know much about your world but I wonder if you may have done the work on occasion but not have the documentation. While regulators need you to follow the rules, perhaps you can show examples of the work being done, albeit improperly. It may be better than nothing....

    2. Show your boss an improvement plan. Walk through what you're doing to insure that this type of problem never happens again. And, if you're really worried, perhaps suggest a few presentations/classes/etc. that you can run for the other therapists on proper documentation procedures. Tell your boss that you want to get yourself trained on ALL of the regulations (god forbid any of you missed some others) and that you will train the rest of the team based on what you learned.

    Good luck!



    For #1, I can do this, it'll just be wrong still. For example, I could add a generic note documenting that I did something, say back in December, but it will still show that I didn't document this until March, so that's still a problem, though not as big of one.

    And for #2, that's a good idea, I'm definitely going to show her how I plan to continue working on this and make sure it doesn't happen in the future to the best of my abilities.

    Anniversary



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    Oof. PPs have good advice about how to approach this.


    If I were you, though, I might take this as a sign that your dissatisfaction with your job and your desire to switch industries was actually spot-on, and treat this as an opportunity to really ramp up your job search. Even if you don't get fired, even if things turn out as perfectly as they possibly can, you'll still be in a job you don't like, right? Prepare yourself for the worst (being fired) by getting your resume out, but even if the worst doesn't come to pass, you will have used this bad situation to spur you to get started finding the next thing.
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    This baby knows exactly how I feel
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    However, I was talking with another very seasoned (been here several years) therapist ...She said she'd be much more concerned about me talking to people without a release (which gives us permission to talk to people) or my treatment plans being out of date. Those two problems could get easily us sued or cause my agency to have to refund insurance reimbursements.



    Hrm.

    To me this kind of sounds like she was saying "you're not that fucked. But you're fucked anyway, so don't relax!"

    Eek.

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    Fuck, how frustrating. Fingers crossed for you. Try to do something fun for yourself this weekend. Spa, movie, a nice dinner anything.

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