Surprise Health Inspections Require Immediate Legal Advice

Keeping documents and records in order will help regulated health professionals should they face a surprise inspection or audit, says Elyse Sunshine.

Sunshine says practitioners should seek legal advice immediately in the event of an audit, inspection, or investigation by their regulatory body or if they've been served with a search warrant by police.

Prior to speaking with counsel, they should not volunteer any information, she cautions.

There are numerous kinds of regulatory audits and inspections an individual or organization can encounter, including investigations based on a complaint to, or information provided to, the overseeing regulatory body, Sunshine tells AdvocateDaily.com.

"Of those, investigations where advance notice has not been given by the regulatory before they attend at the professional’s office can be the most challenging," she says.

"Obviously, that's not a situation you can prepare for. In those cases, the primary reason the regulator elects to attend unannounced is because there's a concern that the member may have engaged in misconduct, but if notice is given, the member may interfere with the investigation including by tampering with potential evidence."

During an unannounced inspection, practitioners should try to ensure that investigators confine themselves to the area of concern or complaint, Sunshine says. Also, the investigated party should ask to see the initiating documents to determine why inspectors are there, and under what legal authority, she says.

"There are circumstances where you have to let them in, but you are entitled to get legal advice, even when someone shows up with a search warrant," Sunshine says. "You can ask them to wait a moment while you call a lawyer."