Facility Compliance – Required Actions and How To Proactively Tackle Them


Facility Compliance – Required Actions and How To Proactively Tackle Them

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Over 90% of facility owners have been positively impacted by a treatment center. We’ve met and work with some amazing founders that are in recovery themselves. Some of them found the care they needed. Some of them wanted to help others because a family member or a friend went through treatment or was impacted by an addiction.

In short, facilities and programs are created out of empathy and a desire to serve. 

But running a facility isn’t as simple as creating a program and treating patients.

In the day-to-day there are a zillion tasks that need to be managed, from operational care – primarily human resources (HR), billing, business filings and payroll – to clinical care, which encompasses everything that has to do with the patients. And the gap between these two areas exists. And it’s growing.

Let´s face it, complying with applicable laws, policies, rules, and regulations can be overwhelming. But it must be done. 

So, what if you could find a cheat code? A way to crack your facilities business compliance so that you can focus on what you really care about?

In this article you will learn about necessary business compliances to keep your facility running smoothly.

5 Things to Be Aware of to Be Legally Compliant

What is the first thing you need to address while getting started with compliance? Hint! It is all about being proactive and establishing a routine. Creating a calendar with deadlines and taking action ahead of time will save you tons of headaches.

In this section you will find a list of mandatory things you need to be aware of in facility compliance.

1. Anti-Discrimination Legislation

Federal law looks after the equality of rights for all people regardless race, color, sex, language, religion, political or other type of opinion, national or social origin, property, or birth. Ensuring everyone in your organization shares this belief and complies with anti-discrimination legislation should be a priority.

Some US laws you should be aware of:

The above is the top federal legislation you need to keep in mind, but don´t forget there also may be state mandated laws that you might need to comply with. Be sure to check on those too!

2. Wage & Hour Legislation

The Fair Labor Standards Act (FLSA) is the federal law that regulates everything that has to do with fair salary and working conditions. Some things that are contemplated in this act are:

Minimum wage: The federal minimum wage is $7.25 per hour but many states also have minimum wage laws, and the higher rate applies.

Overtime: Overtime payment applies for hours worked over 40 per workweek, and the overtime rate should be not less than one and one-half times the regular rate. 

Hours worked: This includes all the time during which an employee is required to be on duty or at the workplace.

Recordkeeping: An official FLSA poster must be displayed at the workplace so that everyone is aware of their rights. Also, employee time and pay records need to be kept.

Child labor: This legislation aims to ensure that when young people work – for instance, in apprenticeship opportunities – the work environment is safe and does not jeopardize their health, well-being, or educational opportunities.

3. Family and Medical Leave

The Family and Medical Leave Act (FMLA) provides employees with up to 12 weeks of unpaid leave per year for family or health care needs – with their job position guaranteed at return.

The two most common types of leaves are:

Family leave: For the birth of a child, adoption, or foster care within the first year of birth or placement. The 12-week leave can also be used to care for the employee’s spouse, child, or parent who has a serious health condition.

Medical leave: For a health condition that prevents the employee to perform his/her essential job functions, and any exigency due to having a spouse, son, daughter, or parent in covered military duty. If a next in kin is gravely injured in duty, the leave goes up to twenty-six annual workweeks.

4. Benefits & ACA 

The Affordable Care Act ensures everyone has access to health care through subsidies and other actions.

For employers, it is important to know that employers with more than 50 full-time employees are obliged to:

  • offer their full-time employees the opportunity to enroll in minimum essential coverage, and the waiting period for enrollment should be less than 60 days, prior to the employees 90th day of employment).
  • Annual reporting to the employee, the state (not required in most states) and the IRS.

5. Safety and Health Standards and Regulations 

The Occupational Safety and Health Administration (OSHA) ensures safe and healthful working conditions for workers. This organization is responsible for setting and enforcing standards. Amongst other requirements, obliges employers to:

  • keep records of all work-related injuries and illnesses,
  • inform employees about chemical hazards through training, labels, alarms, color-coded systems, chemical information sheets and other methods.

There are also state required safety programs that you should bare in mind.

7 Reports You Need to File and How to Do Them

Reports are boring and time consuming. We know it. But they are required for a reason. Compliance laws demand that facilities file important documents to ensure employee’s rights are being respected. And feeling respected is certainly key for employee retention.

That said, you will find below seven reports every facility must complete and submit, with important details about each one.

ACA Reporting 

There are some benefits-related files required by ACA, which must be done annually by Feb 28. There is a difference depending on the type of employer you are:

  • Applicable large employers (ALE) of 50 or more employees: Need to file the form 1095C for employees, and both the 1094C and the 1095C to the IRS.
  • Self-insured employers or employers with less than 50 employees: Should submit the 1095B form to all employees, plus the 1094B and 1095B to the IRS. 
  • Employers who participate in the Multiple Employer Welfare Agreement (MEWA): Must file the M-1 if they provide benefits for two or more employees.

W2 Form

Every year, before January 31st, you need to provide employees with the W2 form that states all wages and compensations, taxes withheld, and retirement benefits provided. Employees can present this federal form to the IRS to request tax return if applicable.


When a former employee files for unemployment benefits, and is awarded benefits, employers will see an increase in their SUTA tax (State Unemployment Tax Act). Proper handling of unemployment responses is critical to managing your SUTA rate and avoiding excess liability. When an employee is terminated for cause, employers should be prepared to respond to the state to provide information regarding:

  • the employee showed misconduct 
  • the employee voluntarily left
  • the employee’s claim form contains false information
  • the worker was an independent contractor
  • unemployment fraud

Of course, the investigating and filing for unemployment can be tiring but, at the end of the day, it will pay off. Working along with an Operational Partner like TruNovus can free your hands up. Furthermore, it can also help prevent future unemployment claims through trainings, handbook creation or updating, and compliance policies.

941 Quarterly Tax Filing

A separate IRS Form 941 must be filed by the end of each quarter. The Employer’s Quarterly Federal Tax Return reports the income and payroll taxes that employers have withheld from their employees’ salary. It also calculates the employer’s Social Security and Medicare taxes.

New Hire Reporting 

Also part of the 941, a new hire report is due within 21 days of each new hire. The employer must submit full name, date of birth, social security number, home address, and hire date of the new employee.

Fun fact: TruNovus can do this for you! Contact us to learn more about our how we automate these reports for you.

Workplace Posters

The U.S. Department of Labor (DOL) requires that some posters with important notices for employees are displayed in the workplace. These are informative notices about federal minimum wage, OSHA, FMLA, and more. Even though there are no citations or penalties for failure to post, they ensure transparency and can have a positive impact on your workers.

OSHA 300 report for injuries and illnesses

Every employer needs to keep an OSHA 300 log. This is a record of all injuries and illnesses that occur on the job, with information on the department and job of the worker, a description of the injury or illness, and the number of lost or restricted days as a result. The Form 300A summary must be posted at the workplace each year from February 1 through April 30.

Benefits Reporting 

Employers are required to report the cost of coverage under an employer-sponsored group health plan in the W2 form. 

Additionally, companies that collect any health-related data on employees must notify the employees and provide the EEOC with related Wellness Program reporting.

Employment Law and Health Coverage

I-9 filing & E-Verify

Form 1-9 is a verification form used by companies to verify an employee’s identity and to verify that they are eligible to work in the United States. It is important to run this verification as failure to comply with it can result in significant fines and even jail time, if not properly managed. 

Also, be sure you take this step after the employee has received a job offer, or it could be considered as discrimination if you don’t proceed with the hiring.

Verification is very simple. Confirm eligibility by reviewing key documents within the employees first 3 days of employment. Another tool to consider is e-Verify, a free web-based system that compares information on the I-9 to government records, such as DHS and Social Security Administration records.

COBRA Continuation of Health Coverage

The Consolidated Omnibus Budget Reconciliation Act or COBRA, requires that health plans sponsored by employers with 20 or more employees offer the employees and their families the opportunity for a continuation coverage in certain instances where they would otherwise lose the benefit. These circumstances are:

  • Involuntary Job Loss
  • Reduction in the Hours Worked 
  • Transition Between Jobs
  • Death
  • Divorce
  • Other Life Events

The act outlines how the procedure for the continuation coverage should be carried out, and what notifications employers need to give their employees.

Summary of Benefits and Coverage

All group health plan sponsors are required to provide a Summary of Benefits and Coverage (SBC) to all eligible employees and plan participants. 

The SBC is an easy-to-read summary that allows comparisons of costs and coverage between health plans, among them health plan’s costs, benefits, and covered health care services.

Leveraging An Operational Partner for Assistance

It’s exhausting reading through all the must-dos, deadlines, and the endless legal obligations you are subject to as a business owner. And the worst part is this is not your real job. You likely started your facility to run a program, heal others, and give back. Memorizing a list like I’ve presented likely was not a goal of yours.

The good news is we can help with everything I’ve mentioned.

Working together with an operational partner will help you easily manage and fulfill all compliance “to-do’s”– and avoid massive headaches.

Some of the time-consuming compliance-related operational tasks TruNovus can help you with:

  • ADA (Americans with Disabilities Act)
  • FLSA (Fair Labor Standards Act)
  • State & federal payroll tax filings
  • Regulatory
  • Workers compensation (claims management)
  • EEOC/Discrimination (Equal Employment Opportunity Commission)
  • ACA (Affordable Care Act)
  • Federal and state wage & hour requirements

Do you want to hear the best part?  We operate under an IRS classification call “co-employment”. This means we become a co-employer who shares and manages employee of record responsibilities and liabilities. We share your burden – and your risks.

Staying compliant with your operations can be exhausting, but it must be done. It’s advantageous (and necessary) to a transparent, non-discriminatory, fair, and safe work environment.

This is specifically true for behavioral health facilities and addiction treatment centers, where being an example to patients is part of the healing process.

At TruNovus we know operations is a form of patient care. When operations demand time and attention, it can take away from clinical patient care.


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