A corporate compliance program is a system designed to detect and prevent violations of the law by the company’s employees, agents and officers and directors. An effective compliance program works at establishing and maintaining a corporate culture committed to the highest level of ethical and legal behavior.
The hallmark of an effective compliance program requires that the organization exercise due diligence in seeking and preventing illegal and unethical conduct by employees and its agents. This due diligence requires, at the minimum, an organizational commitment to establish a corporate Code of Conduct that represents the corporate philosophy of ethical and legal management. The organization must appoint and charge a specific individual within its high-level personnel to have the overall authority and responsibility to oversee compliance standards and expectations. Compliance additionally requires the organization to thoroughly screen applicants and current employees for any propensity to engage in illegal activity, as well as communicate effectively to employees and agents, the organizational standards and procedures. An important component of an effective compliance program is constant and systematic risk assessment, system monitoring and auditing to detect illegal or unethical conduct as well as having in place and publicizing a reporting system whereby employees and other interested persons can report noncompliant conduct by others within the organization without fear of reprisal.A compliance program only is effective when standards are consistently enforced through appropriate disciplinary measures as well as taking reasonable steps, when a problem is discovered, to implement corrective action and any necessary program modifications.
Avalon Health Care, Inc., through its Board of Directors, years ago determined that establishing a voluntary and robust compliance program was the right thing to do. It made good business sense by protecting the company from waste, fraud and abuse. The Avalon Board appointed a full time nurse/attorney with broad base experience in compliance matters as Vice President of Compliance. Moreover, the Board acknowledged that companies that have a sound foundation of ethical conduct and act in a responsible manner outperform those lacking such a brand perception. To that end, the establishment and continued commitment to Avalon’s Corporate Compliance Program, from the top down, is a strong indicator that the Avalon brand stands for the provider of choice.
For further information about Avalon’s Corporate Compliance Program, contact the VP of Corporate Compliance at: 801-325-0165 or mnester@avalonhci.com
Avalon’s anonymous whistleblower hotline communication system can be accessed through www.silentwhistle.com or 877-874-8416
Mary. A Nester
Vice President of Corporate Compliance
801-325-0165
mnester@avalonhci.com
Ms. Nester was appointed Vice President and Corporate Compliance Officer for Avalon Health Care, Inc. in 2007. Prior to accepting this position, she had been a nurse for thirty years and an attorney for almost twenty years.
During her nursing career, Ms. Nester had been Director of Cancer Clinical Research at a 500 bed medical center, as well as an active member overseeing and coordinating research studies through that center's Institutional Review Board and with a five hospital consortium focused on national cancer research programs. She was part of the development and planning committee instrumental in establishing the first free standing hospice center in the Pacific Northwest. She continued her nursing career as a Director of Nursing first for a chemical treatment and rehabilitation organization, and then later as the Director of Nursing for a large private for-profit home health agency. During this time she served on the professional board for the Oregon Chapter of the American Cancer Society and the Professional Advisory Board of the Oregon Multiple Sclerosis Society. Her most recent foray into nursing included the Nursing and Risk Management Director for a 180 bed skilled nursing facility and a Hospital Administrator at a regional non-profit hospital.
As an attorney, she started her career litigating in the court system by representing injured people against medical providers and hospitals. In her first case out of law school, she helped her client obtain a six figure settlement against a local physician. Shortly thereafter she was instrumental in obtaining a million dollar plus judgment against one of the largest Health Maintenance Organizations on the West Coast. Her legal career slowly evolved to representing parties before regulatory agencies and in court, including appellate proceedings in the Veterans Appeals, 9th Circuit and Federal Circuit Court of Appeals.
As a partner in a healthcare law firm she developed her specialty as an expert in all regulatory aspects associated with long term care entities, physician practice associations and professional license defense. She has been a recognized national speaker and retained expert on such topics as ERISA litigation, Anti-Kickback Act, Stark regulations, HIPAA Privacy and Security Regulations, provider reimbursement appeals, bringing and defending Whistleblower actions, nursing home litigation and state and federal Administrative Procedure Act claims.
During her legal career, Ms. Nester was one of the first attorneys to receive an appointment by the Oregon Attorney General as a Special Assistant Attorney General for Consumer Protection. She served as a member to the Oregon State Bar Administrative Law Committee and actively worked with state legislators to amend and tighten regulatory oversight of several professional licensing boards. She has acted as a
court designated special consultant on behalf of white-collar health care criminal defendants and has participated as a consultant on behalf of federal investigators in health care whistleblower fraud claims.
For the past ten years, Ms. Nester has developed compliance programs and has acted as a consultant for health care organizations in Alaska, Washington, Oregon, Ohio and California according to the standards set out in the Office of Inspector General Compliance Guidelines. In addition, she regularly lectured and published throughout the country on all aspects of regulatory compliance.
As Avalon's full time Corporate Compliance Officer, she is responsible for the development and execution of the Corporate Compliance Plan, including training, monitoring, auditing and enforcement components throughout the entire organization. She reports directly to the Board of Directors and Chief Executive Officer identifying potential areas of compliance vulnerability and risk as well providing input and analysis of pending legislation and government issues impacting operations as they pertain to compliance. In her role as Corporate Compliance Officer, Ms. Nester provides ongoing and independent review to ensure that compliance issues and concerns within the organization are being appropriately evaluated, investigated and resolved. This includes her ongoing monitoring and interaction with Avalon's independent whistleblower reporting system.
