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When Kathy Moskowitz, RN, BSN, MBA, PCHA, moved away from direct patient care, she did not see it as leaving nursing.
“I didn’t really leave nursing—I changed how I practiced it,” she said.
Today, Moskowitz works as a clinical compliance specialist with AQORD, a national association for health and human services organizations, where she consults with senior living organizations nationwide, reviews documentation and procedures, conducts compliance audits, develops training, investigates concerns, and helps organizations address potential risks.
Her career offers a look at a less visible nursing role as healthcare organizations navigate increasingly complex regulatory, documentation, quality, privacy, and patient-safety requirements.
For nurses considering careers beyond the bedside, Moskowitz says many of the skills they already use in clinical practice, including assessment, critical thinking, documentation, communication, and patient advocacy, translate directly to compliance work.
“Compliance requires many of those same skills, but you’re applying them to systems rather than individual patients,” she said.
What Healthcare Compliance Actually Looks Like
Compliance can conjure images of audits, regulations, and someone checking whether staff followed the rules. Moskowitz said the reality is considerably broader.
“Compliance is much more than checking boxes or making sure policies are filed away. Compliance is about making sure that the organization’s practices align with regulatory requirements, professional standards, internal policies, and, most importantly, patient-safety expectations.”
Her work can include reviewing patient charts and policies, evaluating clinical processes, preparing for audits, interpreting regulations, analyzing data, investigating concerns, and talking with frontline staff about what is actually happening in practice.
That last piece is particularly important.
“A significant part of compliance is also listening,” Moskowitz said. “You have to understand what is happening at the bedside and why staff are doing things a certain way before you can determine whether a problem exists and how to address it.”
The objective is not simply to find a problem, she said, but to determine why it happened and how to prevent it from happening again.
Common Problems Compliance Reviews Uncover
Documentation problems are common, according to Moskowitz, but they are far from the only issues she encounters.
Compliance concerns can involve medication-related processes, staff education, communication, inconsistent adherence to policies and procedures, or workflows that have changed over time without corresponding updates to policies or practices.
Sometimes, the problem isn’t the individual nurse.
“Sometimes the issue isn’t that people don’t know what they’re supposed to do,” Moskowitz said. “The problem may be that the process itself isn’t practical or that expectations aren’t being communicated consistently.”
Moskowitz recalled identifying a recurring process problem that could create a patient-safety risk. Instead of treating each occurrence separately, the team examined the pattern, reviewed the process, and spoke with staff to determine where it was breaking down.
The team made changes, clarified expectations, and provided additional staff education. Over time, the issue decreased.
“That experience reinforced something I’ve learned throughout my career: compliance is most valuable when it leads to meaningful improvements in patient care,” she said.
Compliance Is Not Supposed to Be About Catching Nurses
One misconception Moskowitz would like to change is the idea that compliance professionals are there to police clinical staff.
“I think the biggest misconception is that compliance is about policing nurses or looking for people who have done something wrong,” she said. “That’s not how I view it. Compliance should be a resource for the clinical team. My job is not to walk in looking for someone to blame. It’s to identify risk, understand the underlying issue, educate when necessary, and help create systems that make it easier for people to do the right thing.”
The job can also require reconciling what regulations require with how healthcare is actually delivered.
“The most challenging part is sometimes balancing regulatory requirements with the realities of clinical practice,” Moskowitz said. “Regulations and standards are essential, but healthcare is complex, and every situation isn’t black and white. You have to understand the regulation, understand the clinical environment, listen to the people doing the work, and then determine how to implement the requirement in a way that is both effective and sustainable.”
That is one area where clinical experience can become particularly valuable.
Why Nurses Can Be Well Suited to Compliance
Moskowitz spent years in direct patient care before becoming increasingly interested in why problems continued to occur and how to address them at the organizational level.
Before joining AQORD, she held leadership and compliance-focused roles across home care, hospice, senior living, and education, including compliance specialist, nursing educator, and executive leader.
Over time, she recognized how much of her nursing training transferred to compliance.
Critical thinking tops her list.
“Nurses are trained to assess a situation, identify what isn’t right, determine priorities, and take action,” Moskowitz said.
Communication is also essential. A compliance professional may need to discuss the same issue with staff, managers, executives, and regulatory representatives, communicating appropriately with each audience.
Clinical judgment, attention to detail, organization, documentation, patient advocacy, teaching, and the ability to remain calm in difficult situations are also valuable, she said.
The difference is where those skills are applied.
“Direct patient care taught me how important individual interactions are, but compliance gave me an opportunity to influence systems that affect many patients and many nurses,” Moskowitz said.
Interested in Compliance? Start Where You Are
Nurses do not necessarily have to wait until they leave bedside practice to begin building experience relevant to compliance.
Moskowitz recommends developing strong documentation, communication, leadership, critical-thinking, and data-analysis skills. Nurses can also learn to read and interpret policies and regulations and become more comfortable asking why a process exists and whether it is achieving its intended outcome.
Quality-improvement projects, audits, committees, policy development, and patient-safety initiatives can introduce nurses to compliance work.
Certifications can help nurses demonstrate specialized knowledge, Moskowitz said, but she cautions against viewing a credential as the only route into the field.
“Clinical experience, critical thinking, communication, understanding of healthcare operations, and the ability to apply regulations to real-world situations are equally important.”
For nurses wondering whether they might be suited to the work, Moskowitz describes someone curious, analytical, objective, professional, attentive to detail, and willing to ask questions.
“You don’t have to know everything. In fact, one of the most important qualities is being willing to say, “I don’t know—let me find out.””
A Nursing Career That Doesn’t Require the Bedside
Nurses, Moskowitz said, are particularly well positioned for compliance work because they understand what actually happens in patient-care environments.
For Moskowitz, that clinical perspective has remained central to her work even after moving away from bedside care.
“After 30 years in nursing, I still think like a nurse. I continually think of patient safety. When I can identify a risk, help correct a process, educate a team, or influence a system that ultimately protects patients, that’s incredibly rewarding.”
It also points to a broader lesson for nurses who may be ready for a change but are reluctant to leave the profession they trained for.
“I wish someone had told me earlier in my career that there are many ways to be a nurse,” Moskowitz said. “For a long time, nursing is often portrayed as bedside care only. But nursing can lead into education, leadership, quality, risk management, informatics, research, compliance, administration, and many other areas. Leaving the bedside doesn’t mean leaving nursing. You can take everything you’ve learned as a nurse and apply it in a completely different way.”
“I may not be standing at the bedside anymore, but I am still advocating for patients—just at a different level.”
