Tenet Healthcare.

The Healthcare Financing Administration notes the annual health care expenditure in the United State has exceeded $ 3.1 trillion. 10% of these expenditures ($ 100 billion) are government and health insurance companies losses due to fraudulent healthcare transactions. Timely detections and prevention of these fraudulent transactions and abuses can help recover the huge amount of resources to medical institutions and patients thus improving the quality of care and decreasing the cost of healthcare for taxpayers. Inability to detect fraud can become an extremely costly, painful and damaging problem to the organization and thus the need for an effective fraud detection system (Mcmahon & Chopra, 2013). In 2012, Tenet health Corporation was ordered to pay the United States F$ 42.75 million to settle accusations of violating the False Claims Act by overbilling the federal Medicare Program (Department of Justice, 2012). This action research will discuss how healthcare billings happen in the United States and will give details of the fraudulent billing occurring in Tenet Healthcare Corporation. I will show the impact of this fraudulent billing to the stock prices and financial statements of Tenet, showing that they directly impact the shareholders finances having their stocks at Tenet

Tenet Health Corporation (Tenet) is an investor-owned health care services corporation. Tenet Health corporation operates 77 acute care hospitals, 173 outpatient centres, 5 health plans and 6 accountable care organizations. In addition, the corporation operates Conifer Health Solutions that provides health business process solutions in fifteen centres that serve clients in 43 states.

The study will help Tenet develop a fraud detection system that will sufficiently address it billing process to avoid future billing errors that will ruin the reputation of the company and destroy its financial base. In addition, the study will offer insight to other health care institutions on factors that precipitate fraudulent cases in institutions and the financial implications of the fraudulent case.

The study will be based on the Cressey Fraud Triangle. Three components of the triangle include pressure, opportunity and rationalization. Pressure relates to the financial difficulties such as a large amount of credit card debt, overwhelming financial burdens, and financial difficulties. Opportunity to fraud exists when an employee discovers a weakness in the organization’s ant-fraud controls. Rationalization is the psychological process whereby individuals who have committed fraud convince themselves either that the act is not wrong or that even though it may be wrong, it will be corrected because they will eventually return the money. In addition, employees may justify the fraud by taking the attitude that they deserve the stolen money (Goldman, 2009)

A comprehensive detection and prevention system should have the right combination of financial analysis, business/relationship analysis, medical insight and analysis, detection of changing behaviours and a feedback loop (Abbasi, Albrecht, Vance, & Hansen, 2012). Therefore, the study will primarily focus on evaluating the effectiveness of this component in Tenet. In addition, the study will focus on analyzing the effect of the fraudulent on the stock prices and financial performance of the Tenet. The study will focus on the financial statement fraud and the stock prices of the company during the time the fraud occurred. Financial statement fraud is mainly dedicated to the fact that financial statement audit ensures that the financial reports of the company are free from material misstatement and fraud. A firms’ propensity to commit a fraud depends on the expected benefits and cost of engaging in the fraudulent. The expected cost of the fraudulent has two components that include the probability of the fraud detection and the penalty upon detection.

The financial statements of Tenet will be evaluated to identify the misstatement and the impact of those misstatements, the investment trend of the company and the stock prices of the Company stock. The data will be obtained from the annual reports including Form 10 K and other strategic documents. The reports will be analyzed through various econometric models to evaluate how the fraud case affected their trend. A five year period analysis will be conducted. In addition to the financial econometric analysis of the financial reports, a detailed key informant interview will be conducted with stockholders of the company who will be selected randomly. The interviews will be conducted through open-ended questions to allow the respondents to disclose as much information as possible. The interviews will substantial the findings of the analysis. The findings of the study will be corresponded to Tenet Corporation in the form of a report. In addition, the result will be published and disseminated to online databases to benefit other scholars and organizations.

The research will be conducted with the authority and supervision of the University Committee. In addition, consent will sort with the Tenet Corporation. The current CEO and the chief finance officer will be contacted advance to approve the research. Some of the key ethical issues to be addressed in the research is the confidentially of any confidential information accessed during the research and limiting the finding of the study to academic use. The key limitations of the study are its reliance on the documented reports. The study will not allow the research to evaluate the raw financial data of the company but will rely on data from SEC listing and other stock sites such as NYSE.

Changing roles of correctional officers

Introduction
Before the 1960s, roles of correctional officers were custody-oriented. Personnel selection standards were low and in, many cases they never existed. Candidates for correctional officer jobs were only required to have minimal education level and in some prisons, education wasn’t considered in hiring. The main incentive for correctional officer job remained security provided by the civil service employment in an employment that many found appealing as well as lucrative as compared to farming or manufacturing jobs. Individuals were also forced work as prison officers by unfortunate circumstance like job scarcity unavailability of job scarcity, layoffs, injuries, or as a result of their failure in their primary occupation choice. As a consequence, the typical correctional officer was a rural, male with little or no education. They were also politically conservative characterized by brutality and they in many case proved slow in accepting change. Many came to correctional jobs at relatively mature ages after success in the civilian life while other had retired from military. Training in all cases was done the job and always involved nothing on top of a recruit being handed cell block keys and t instructed to quickly learn the demands of the job (Josi & Sechrest, 1998). The custody- focused correctional officer role definition remained unambiguous. Their roles were to keep security as well as control by enforcing institutional regulations. The accomplish ability to this goal based on unchallenged authority to accuse and punish prisoners from violating violations rules without regarding the due process as well as inmate rights. The control approaches to prisoners relied on physical coercion as well as discipline.

Correctional Officers were therefore referred to as always guards since guarding prisoners was their sole expected role. As a consequence, there exist a widespread public view that correctional officer have low intelligence, alienated, cynical, brutal, burned out, alienated stressed, and their role is to repress minority people. However, commencing 1960s a wide range of prisoner rehabilitation programs became introduced in prison institutions that historically were viewed custody and control as only organizational goal. The new rehabilitation emphasis also introduced an expectation that correctional officers were to go beyond their vividly defined security tasks and assume the much more ambiguous responsibility of human service-oriented workers who would help highly trained treatment professionals in prisoners’ rehabilitation. Rehabilitation introduction in [prisons developed an ambiguous social organization through the introduction of sets of contradictory objectives. The custody goal requires the maintenance of enough social distance between correctional officers and prisoners and avoiding informal relationships, affective ties as well as discretionary enforcement of rules. However, treatment goal demand relaxed discipline, informal relationships minimizing social distance, affective ties as well as the exercising of discretionary rule enforcement depending on particular inmate characteristics as well as circumstances. Punitive regulatory policies became subordinated to an expectation that correctional were to be human-oriented and flexible. Many correctional facilities currently impress the double roles of custody and treatment (McMinn, 2010). As a result, correctional officers are now called change agents when are supposed to utilize their discretion to help in rehabilitation of inmates while at the same time keeping security through enforcement of rules. Simultaneous handling of custody and treatment generates conflict characterized by some uncertainty since correctional officers can be disciplined if they violate the institutional policies that are aimed at rehabilitating inmates.

Introduction of Prisoner Rehabilitation in the US
Introducing rehabilitation coincided by many USA supreme court ruling which provided inmates with more civil rights while at the same time reducing the ability of correctional officer against reliance on punitive controls. The outcome was due process- focused disciplinary hearings, abolishment of using isolation as disciplinary approach and the creation of formal prisoner’s grievance mechanisms. The decision by the court significantly reduced the powers of correctional officers while at the same time providing inmates with strong countervailing rights. These changes in powers created for officers in correctional institutions view of loss of control and a perception that managers and treatment professionals emerged more respect for prisoners than them. As a result, the perception continue to make correctional officers view themselves as unfairly restated thus generating great ingrained frustration and lack of appreciation by superiors (Parker, 2007). Among the significant outcomes of the perception was that the managers as well as the professional were never at par with the correctional officers. On the eve of the 1970s, the US federal law gave the correctional officers the power to unionize. As a result, the joined strong national unions including the American Federation of states, county as well as municipals workers whose management has perfectly challenged many management policies perceived as not being in the best interest of their rank and file. Such unions are critical since they have power to influence management resource allocation making salaries as well as benefits rising drastically. With such efforts, correctional officers continue to serve under the new guidelines while working with inmates. Therefore, the main change in the role of these officers is simply the shift from authority to service in changing inmates from criminality to harmless persons in the society. The reason behind this move was that harsh punitive measures would do more harm to an offender as compared to the perceived benefits.

Inmate Rehabilitation
Inmate rehabilitation is the process of re-integrating a convicted person into the society with the primary objective to counter reoffending or criminal recidivism. Rehabilitation has been a central goal of correctional system. Its goal rests on an assumption that offenders can be treated and returns to law abiding lifestyle. It includes a great array of initiatives such as, substance abuse, mental health as well as educational services. Additionally, specialty initiatives are developed for sex offenders, women and parolees. Despite their original barbaric roles in the medieval dungeon and torture chamber, from the 18th century, correctional officers have combined punishment element with rehabilitation element to assist prisoners (Morris, & Rothman, 1995). As Michel Foucault the French philosopher puts it, ‘punishment shifted from disciplining the body to disciplining the soul”. Rehabilitation of inmates has remained a critical feature of modern criminal justice system directed at reforming both the character of prisoners and preventing recidivism. Many types of research reveal that exposing prisoners to harsh conditions hardens them into harder criminals. Punitive measures make them develop a negative attitude towards the public and more so the victim and upon release, they easily reoffended as a response to the pain realized in prison. Research also reveals that rehabilitation usually makes offenders understand and appreciate their wrongdoing and in the end, they decide to become law abiding. It is evident that chances of recidivism are low among ex-convicts who went through rehabilitative programs as compared to those who go through punitive controls.

Roles of Correctional Officers in Rehabilitation
Rehabilitation as a changing role of a correctional officer presents various roles to them. Some are traditional with punitive dimension while others are humane and rehabilitative in nature. The roles include the inmate security, offender counseling, religious involvement, vocational training, needs assessment, linkage to specialized services and security of detention facilities. These roles are discussed as follows;

Inmate Security and Rehabilitation
Within penal institutions, correctional officers serve as voices of authority, while at the same time ensuring safety and welfare inmates. As courageous law enforcement service providers, they disrupt violence and confrontations among inmates to ensure order and help in rehabilitating prisoners. Over 434, 870 correctional officers in U.S. as of 2011, correctional officers represent one of the critical components of US criminal justice system. Correctional officers prevent exploitation among prisoners while at the same time protecting them from the angry public. Correctional officers instill peace in the penal institutions by suppressing confrontations among prisoners. They also prevent illicit materials which threaten rehabilitation from entering the penal institutions. This practice is very critical in producing an environment that enables healing from criminality to law abiding life. Research reveals that penal institutions characterized by calmness produce an environment that rehabilitates inmate. Similarly, research shows that penal institutions with chaos and fights, always promotes recidivism among inmates. Therefore, correctional officer plays a critical role in protecting the rights and freedoms of inmates which are key in the rehabilitation process.

Offender Counseling and Rehabilitation
In the rehabilitation process, correctional officers play a critical role of acting as a counselor. As counselors, they take prisoner as clients who need their assistance. Counseling helps many inmates to develop abilities of problem solving and decision making which are critical in reforming the prisons. Much research reveals that counseling dome by correctional officers greatly reduced recidivism among inmates. Counseling also makes inmates find meaning in life and the end; they always come out as law abiding citizens (Robinson & Crow, 2009). Counseling offered by correctional officers’ trains’ inmates to address problems of anxiety which is a key factor that motivates crime. Chemical dependency counseling offered by correctional officers enables prisoners with challenges of substance abuse to get therapeutic help. Counseling also provides relief which is critical I offender rehabilitation. Encouragements from correctional officers make the offender take the sentence positively and come out as a reformed person.

Religious Involvement and Rehabilitation
Correctional institutions continue to utilize research in developing a more constructive alternative for prisoners. Correctional officer involves themselves religious instruction to help prisoners. As correctional officers promote religious involvement among prisoners, many of the prisoners find inner hope as well as meaning in life. In the end, they reform into good citizens who pose no threat to the society upon release (Craig, In Dixon & Gannon, 2013). Many studies reveal that inmates who get involved in religion offend rarely. Re-incarceration among offender who was much involved in religion in many cases is low. The reason is that religion shape people’s meditation, and it easily alters the personal perception among offenders. Therefore, as correctional; officer promotes religious involvement among inmates, it gives them a good basis to rehabilitate since many religions instill morals.

Inmate Vocational Training and Rehabilitation
Correctional officers play the critical role in rehabilitating inmates by giving inmates vocational training. Bearing in mind that there are many factors that promote crime, unemployment or poverty always accounts as major factors. Therefore offering vocational training to inmates empowers the inmate upon release (Lin, 2000). Such training is critical in that they provide a ground that an inmate would rely on for his legitimate survival. Installing such skills among prisoners gives them an opportunity to survive when he is released. This program is a critical rehabilitation tool to inmates with poverty or lack of employment crimes. Correctional officers, therefore, act as trainers to prisoners making rehabilitation objectives possible. They provide trustworthy advice in the effort to improve inmates’’ lives. Many correction departments continue to recognize that inmates who perfectly participate in the programs are more likely to conform to the law whenever they complete their term in penal institutions.

Prisoner Needs Assessment and Rehabilitation
Correctional officers also help inmates who are eager to develop their futures positively by assisting them to choose institutional programs that benefit or suits them. The assessment also helps in identifying barriers to successful rehabilitation (Herberts, 1998). Through communication as well as building relationships with inmates, correctional officers manage to get insights into factors that forced the prisoner into crime. Studies show that approximately 80 percent of the prisoner is dependent on drugs; therefore, convincing them to join appropriate cognitive retraining and substance abuse counseling produces uncountable positive effects. Therefore carrying out need assessment of prisoners to identify best interventions is a critical role played by correctional officers in the process of making rehabilitation successful.

Inmate Specialized Services Linkage and Rehabilitation
The other rehabilitative responsibility of correctional officers is that of acting as links with other agencies both in and outside the community. Penal institution always works with different partners in helping offenders. These partners play critical roles in providing specialized services that are not located within boundaries of penal institutions. Specialized services may include medication, business support among others. Upon completion of vocational training and release, some ex-prisoners may need assistance to start life (Great Britain & Beith, 2011). Therefore, correctional officers become the link between the ex-prisoner and the service provider. In many cases, correctional officers are allowed to work outside of the penal facilities to link the newly released inmates with specialized treatment programs, halfway houses as well as community organizations. Correctional officers are working in prisons also assist in the rehabilitation of inmates by communicating the needs as well as risks to the parole officers, parole boards, judges or to the probation officers to help the offender.

Security of Detention Facilities and Rehabilitation
Maintaining the prison remains critical in the rehabilitation of inmates. The reason is that a single breach in the prison security may lead to contraband drugs, weapons as well as communication devices into the correctional facility, which may hamper rehabilitation. Additionally, compromises on the borders may lead to prisoners’ escape which might destruct rehabilitation (The United States, 2008). Correctional officers always identify such threats and give immediate remedies. Correctional officers ensure the facility is safe for the safety of inmates. Safety protects the offender from other influences in the free society that might tempt him into criminality. This safety is paramount in facilitating an environment for rehabilitation.

Limitations Rehabilitation as a Changing Role of Correctional Officers
Apart from prisoners profiting from rehabilitation as a changing role of correctional officers, it seems to make some inmates worse criminals. Rehabilitation presents leniency of the law against crime. Therefore, many prisoners always take advantage of this role to pretend and get released. Research consistently continues to show that time spent in custody does not successfully rehabilitate many inmates, and that majority of criminals return to crime almost immediately. It is argued that many prisoners learn new and sophisticated ways of committing crimes while they are in prison with fellow convicts (Parker, 2007). This situation also offers them the opportunity to make connections and become involved in group crimes. Rehabilitation programs can also make prisoners cheat to be granted parole.research also reveal that rehabilitation seems to make prison life interesting to some criminals since there is no serious punitive element as before. Rehabilitation also diminishes the main role of punishment. They, therefore, offend immediately they are released. Rehabilitation can also pose a threat of increased crime by encouraging potential criminals. They end up offending since they are sure that the penal life is lenient.

Conclusion
The introduction of issues of human rights remains the genesis of the shift in the roles of correctional officers. Promoted by global activism, rehabilitation remains a key role in the penal sector. Despite I t attracting varied perceptions, its idea so handling offenders serving custodial sentences with human remains something to comment. Contrary, its implementation potentially impacts crime control both negatively and positively. From the positive side, rehabilitation can address habitual offending particularly with inmates who learn from their mistakes. On the other hand, it can promote reoffending apart from having ability to motivate potential criminals. The reason for this is that, people will find prison life comfortable and therefore making them not to fear reoffending. Despite entrenching rehabilitation in social as well as criminal justice policy, the notion that penal institutions never intend to rehabilitate but to punish and protect the public maintains considerable public support in many areas. Improved conditions, as well as opportunities for rehabilitation in penal institutions, generate complaints that current life behind bars remains soft and similar to holiday camping. Resentment from the public also remains fired by the deficits in providing similar services for community rehabilitation. Drug rehabilitation, as an example, is greatly perceived to be easily accessible inside penal institutions than in the outside. Nevertheless, there are many criticisms about the rehabilitation level occurring in prisons, mostly because of lack of funding for rehabilitation programmes as well as prison overcrowding, which hinders effective implementation of rehabilitation. The achievement that penal institutions achieve is hindered further by high number of prisoners lacking primary skills while others suffer from social as well as psychological problems. Many prisoners get released without places to live, thus worsening setbacks of homelessness. Prisons also have cases of mental health problems and drug problems making the efforts of rehabilitation hard. Whatever rehabilitation happens inside the penal institutions, many ex- convicts experience some difficulty in reintegrating back to the society because of community attitude. To conclude, rehabilitation as a changing role for correctional officer remains a good initiative that can help some offenders to come out reformed. In their effort to attain its objectives, there is a need for resources and cooperation from other stakeholders as well as offenders themselves. If this role is not critically examined and implemented well, it easily generates repeat offenders.

Five Crucial Skills That Each and Every GMP Internal Auditor Must Have

Conformance with GMP (Good Manufacturing Practices) is still crucial to ensuring the security and quality of pharmaceutical products, even as the business grows and changes. Thus, to ensure compliance with industry standards, GMP is crucial to all pharmaceutical manufacturing processes. Establishing and carrying out an internal audit process is one of the most important measures to meet those standards. To make sure that GMP processes are correctly followed throughout the company, an internal audit team made up of one or more GMP internal auditors is essential.

Which Top Skills Are Needed for GMP Internal Auditors?

In the biotechnology, pharmaceutical, and medical device sectors, Good Manufacturing Practices (GMP) refer to a system of rules and regulations that guarantee the consistency, quality, and safety of products. Tracing issues, confirming compliance, and streamlining procedures all depend on GMP records and documentation. Quality assurance specialists, inspectors, and consultants who need to confirm the veracity, correctness, and completeness of the information must possess the crucial ability to audit GMP documents and records. We’ll look at the abilities required in this post to successfully and efficiently audit GMP records and documentation.

Interpersonal Skills: A successful auditor must possess effective interpersonal skills, such as active listening. 80% of the time should be spent listening and 20% should be spent talking, according to the “80/20 rule”. Since they have to share their opinions, ideas, and proposals with other auditors, executives, senior management, and regulatory bodies, auditors place a high value on communication. Misunderstandings, useless advice, and a loss of trust can result from poor communication. Attend the online GMP auditor training, workshops, or seminars to hone your communication abilities. You can also concentrate on your active listening skills. Almost as important as technology skills, communication skills rank as one of the top two attributes auditors should have.
Know the GMP Requirements: Understanding the pertinent GMP regulations for one’s product, process, and market is essential for conducting an audit of GMP documentation and records. The kind of product, level of complexity, stage of development, and regulatory body may all affect these needs. Understanding relevant GMP standards, guidelines, and regulations from organizations like the ICH, EU, FDA, and WHO is essential. It’s also crucial to interpret and utilize these recommendations in the context and circumstances that are unique to you.
Planning, Multitasking, and Time Management: Since auditing entails organizing the day or days and scheduling procedures to be audited, it is crucial for auditors. Time management is essential to ensuring that activities are prioritized, as smaller businesses frequently create internal audit teams from within their current workforce. Tight timelines for audit completion are necessary, and ineffective time management can result in hurried or incomplete audits, overlooked compliance problems, and postponed corrective action. A thorough audit plan, early deadline setting, and work prioritization using calendars, to-do lists, task management applications, reminders, and audit management software are all effective ways for auditors to enhance their time management abilities. By concentrating on these elements, auditors may guarantee that the audit is finished on schedule and prevent oversights of compliance problems.
Communication Skills: A variety of stakeholders, including the auditee, the auditor, management, regulators, and customers, must be communicated with when conducting an audit of GMP documents and records. Communication with all parties involved must be done in an understandable, professional, and courteous manner. Engaging in active listening, posing pertinent queries, offering helpful criticism, and summarizing your conclusions and suggestions are all necessary. Depending on the audit’s goal, audience, and circumstances, you should be able to modify your communication style and tactics.
Professional Scepticism: To be a trustworthy, moral, and productive auditor, one must possess professional scepticism. Avoiding quick cuts and reassessing every step of the audit process is part of it. This mindset entails remaining impartial, doubting the veracity of information or documents, and approaching evidence with scepticism. Between total trust and total doubt, there is a balance. Using a sound judgment process, taking into account all pertinent facts, being receptive to new ideas, and avoiding biases and judgment traps are all important ways for auditors to develop their professional scepticism. They become an ethical, successful, and trustworthy auditor with this method.