Compliance & Ethics

Code of Conduct

Evergreen Health & Rehab’s mission is “To exemplify excellence in quality care to our Residents by providing an environment that enhances personal growth, individuality, dignity and respect to all staff and residents” by conducting its business and operations in accordance with applicable laws and regulations and the highest standards of integrity.

All Evergreen employees, affiliates, and healthcare providers are expected to perform their jobs or services in accordance with the applicable laws, regulations, as well as Evergreen’s policies and directives; and recognize and report actual or suspected conduct or actions in conflict with the applicable laws, regulations, the Code, and/or Company policies.

Always act with fairness, honesty, integrity and openness; respect the opinions of others and treat all with equality and dignity without regard to gender, race, color, creed, ancestry, place of origin, political beliefs, religion, marital status, disability, age, or sexual orientation. Promote the mission and objectives of Evergreen Health & Rehab in all dealings with the public on behalf of Evergreen Health & Rehab. Provide a positive and valued experience for those receiving service at Evergreen Health & Rehab.

Act with honesty and integrity and in accordance with any professional standards and / or governing laws and legislation that have application to the responsibilities you perform for or on behalf of Evergreen Health & Rehab. Comply with any training or orientation provided to you by the Evergreen Health & Rehab in connection with those responsibilities. Adhere to the policies and procedures of Evergreen Health & Rehab and support the decisions and directions of the administration. Take responsibility for your actions and decisions. Follow reporting lines to facilitate the effective resolution of problems. Ensure that you do not exceed the authority of your position.

Deficit Reduction Act Policy

PURPOSE

The purpose of this policy is to comply with certain requirements set forth in Sections 6031 and 6032 of the Deficit.
Reduction Act of 2005 (DRA) with regard to federal and state false claims laws at the Evergreen Health & Rehab.

POLICY

All employees of Evergreen , including staff, management, and any Contractors or Agents should be educated regarding the federal and state false claims statutes and the role of such laws in preventing and detecting fraud, waste and abuse in federal health care programs. For the purposes of this Policy, “Contractor or Agent” means any contractor, subcontractor, agent, or other person which or who, on behalf of either hospital, furnishes, or otherwise authorizes the furnishing of Medicaid health care items or services, performs billing or coding functions, or is involved in monitoring of health care provided by Evergreen.

PROCEDURE

DRA Information Requirements

The DRA includes provisions that require all healthcare providers receiving at least $5 million in annual Medicaid payments to establish written policies for all employees, contractors and agents that provide detailed information about :

The following information addresses the DRA requirements:

False Claims Laws General Information

One of the primary purposes of any false claims laws is to combat fraud and abuse in government programs. False claims laws do this by making it possible for the government to bring civil actions to recover damages and penalties when false claims are submitted. These laws often permit qui tam suits (whistleblowers suits) as well, which are lawsuits brought by lay people, typically employees or former employees that suspect false claims have been submitted.

There is a federal False Claims Act and a various states have adopted the False Claims Laws. Under the federal False Claims Act, any person or entity that knowingly submits a false or fraudulent claim for payment or retains an overpayment of United States Government funds is liable for significant penalties and fines. The fines include a penalty of up to three times the Government’s damages, civil penalties ranging from $5,500 to $11,000 per false claim, and the costs of the civil action against the entity that submitted the false claims. Generally, the federal False Claims Act applies to any federally funded program. The False Claims Act applies, for example, to claims submitted by healthcare providers to Medicare or Medicaid.

Qui Tam Provision

One of the unique aspects of the federal False Claims Act is the qui tam provision, commonly referred to as the whistleblower provision. This provision allows a private person with knowledge of a false claim to bring a civil action on behalf of the United States Government (“Government”). The purpose of bringing the qui tam suit is to recover the funds paid as a result of the false claims. If the suit is ultimately successful, the whistleblower that initially brought the suit may be awarded a percentage of the funds recovered. Sometimes the Government decides to join the qui tam suit. In such cases, the Government assumes responsibility for all of the expenses associated with the suit and the percentage received by the whistleblower will be lower than if the Government had not joined the suit.

Regardless of whether the Government participates in the lawsuit, the court may reduce the whistleblower’s share of the proceeds if the court finds that the whistleblower planned and initiated the false claims violation. Further, if the whistleblower is convicted of criminal conduct related to his role in the preparation or submission of the false claims, the whistleblower will be dismissed from the civil action without receiving any portion of the proceeds.

Whistleblower Protections

The federal False Claims Act also contains a provision that protects a whistleblower from retaliation by his or her employer. This applies to any employee who is discharged, demoted, suspended, threatened, harassed, or discriminated against in his or her employment as a result of the employee’s lawful acts in furtherance of a false claims action. The whistleblower may bring an action in the appropriate federal district court and is entitled to reinstatement with the same seniority status, two times the amount of back pay, interest on the back pay, and compensation for any special damages as a result of the discrimination, such as litigation costs and reasonable attorney fees.

Fraudulent claim. In addition, there may be a separate criminal prosecution for violations of this statute.

Reporting Concerns Regarding Fraud, Abuse and False Claims

Evergreen recognizes that questions, concerns or disputes sometimes arise. Evergreen believes that it is in the best interest of both its employees and the organization to resolve those questions, concerns or disputes in a forum that provides the fastest and fairest method for resolving them. Evergreen’s employees, Contractors and Agents are encouraged to contact the Facility’s Compliance Officer or the Compliance Reporting System via the website

Information Distribution

All employees of Evergreen, including staff, management, and Contractors or Agents are provided with this Policy within 90 days of commencing employment or contractor status.. In addition, the Policy will be posted on Evergreen’s internet site.

PROCEDURE

DRA Information Requirements

The following information addresses the DRA requirements:

False Claims Laws General Information

One of the primary purposes of any false claims laws is to combat fraud and abuse in government programs. False claims laws do this by making it possible for the government to bring civil actions to recover damages and penalties when false claims are submitted. These laws often permit qui tam suits (whistleblowers suits) as well, which are lawsuits brought by lay people, typically employees or former employees that suspect false claims have been submitted.
There is a federal False Claims Act and a various states have adopted the False Claims Laws. Under the federal False Claims Act, any person or entity that knowingly submits a false or fraudulent claim for payment or retains an overpayment of United States Government funds is liable for significant penalties and fines. The fines include a penalty of up to three times the Government’s damages, civil penalties ranging from $5,500 to $11,000 per false claim, and the costs of the civil action against the entity that submitted the false claims. Generally, the federal False Claims Act applies to any federally funded program. The False Claims Act applies, for example, to claims submitted by healthcare providers to Medicare or Medicaid.

Qui Tam Provision

One of the unique aspects of the federal False Claims Act is the qui tam provision, commonly referred to as the whistleblower provision. This provision allows a private person with knowledge of a false claim to bring a civil action on behalf of the United States Government (“Government”). The purpose of bringing the qui tam suit is to recover the funds paid as a result of the false claims. If the suit is ultimately successful, the whistleblower that initially brought the suit may be awarded a percentage of the funds recovered. Sometimes the Government decides to join the qui tam suit. In such cases, the Government assumes responsibility for all of the expenses associated with the suit and the percentage received by the whistleblower will be lower than if the Government had not joined the suit.
Regardless of whether the Government participates in the lawsuit, the court may reduce the whistleblower’s share of the proceeds if the court finds that the whistleblower planned and initiated the false claims violation. Further, if the whistleblower is convicted of criminal conduct related to his role in the preparation or submission of the false claims, the whistleblower will be dismissed from the civil action without receiving any portion of the proceeds.

Whistleblower Protections

The federal False Claims Act also contains a provision that protects a whistleblower from retaliation by his or her employer. This applies to any employee who is discharged, demoted, suspended, threatened, harassed, or discriminated against in his or her employment as a result of the employee’s lawful acts in furtherance of a false claims action. The whistleblower may bring an action in the appropriate federal district court and is entitled to reinstatement with the same seniority status, two times the amount of back pay, interest on the back pay, and compensation for any special damages as a result of the discrimination, such as litigation costs and reasonable attorney fees.
Fraudulent claim. In addition, there may be a separate criminal prosecution for violations of this statute.

Reporting Concerns Regarding Fraud, Abuse and False Claims

Evergreen recognizes that questions, concerns or disputes sometimes arise. Evergreen believes that it is in the best interest of both its employees and the organization to resolve those questions, concerns or disputes in a forum that provides the fastest and fairest method for resolving them. Evergreen’s employees, Contractors and Agents are encouraged to contact the Facility’s Compliance Officer or the Compliance Reporting System via the website

Information Distribution

Compliance Reporting Form

Please let us know if you have a concern. Your message will only be discussed with those necessary to investigate and address your concern. If you choose to remain anonymous, please be aware that we will not be able to respond or follow up with you.