Unifying Forces: Streamlining Compliance Across Multiple Facilities

Managing compliance across dozens of healthcare facilities spanning multiple states isn’t just about scaling policies—it’s about orchestrating a complex symphony of relationships, technology, and strategic thinking that can make or break organizational integrity.

This episode of The Ethicsverse explores the significant regulatory shifts occurring under the Trump administration in 2025, examining three critical areas that compliance professionals must navigate: white collar enforcement policy changes, diversity, equity, and inclusion (DEI) executive orders, and artificial intelligence regulatory frameworks. The discussion reveals how these policy changes create both opportunities and challenges for compliance programs, requiring practitioners to balance legal compliance with business objectives while maintaining effective risk management strategies. Through expert insights from regulatory veterans, this content provides actionable guidance for compliance officers, legal counsel, and HR professionals working to adapt their programs to an evolving enforcement landscape.

Featuring:

• Dawn Geisert, Chief Integrity & Compliance Officer, Trinity Health
• Michelle Frazier, Chief Compliance & Privacy Officer, Advocate Health
• Nick Gallo, Chief Servant & Co-CEO, Ethico

Strategic Organizational Design for Multi-Site Success

• Multi-site compliance programs require intentional organizational restructuring that balances centralized oversight with dedicated regional presence to maintain local relationships and cultural awareness.
• Effective compliance leadership structures must include on-site integrity officers who serve as bridges between system-wide standards and day-to-day operational realities at individual facilities.
• Breaking down organizational silos requires deliberate cross-functional team meetings and regular collaboration sessions that build trust and enable knowledge sharing across geographic boundaries.

Balancing Standardization with Local Customization

• Healthcare compliance leaders must establish unified vision and foundational policies while allowing flexibility for regional differences in culture, leadership styles, and local regulatory requirements.
• Risk assessment frameworks and materiality thresholds must be standardized across the enterprise to ensure consistent decision-making and resource allocation while accommodating state-specific legal variations.
• Technology platforms and documentation systems require complete alignment across all facilities to enable meaningful data aggregation and enterprise-wide trend analysis.

Change Management and Stakeholder Buy-In

• Successful compliance program integration demands comprehensive change management strategies that acknowledge different organizational histories and existing stakeholder relationships.
• Building authentic buy-in requires understanding individual team members’ strengths and perspectives while clearly communicating how their roles contribute to the broader compliance vision.
• Leadership must foster openness to new ideas and continuous improvement while managing the natural tension between long-tenured employees and newcomers with fresh perspectives.

Ambassador Programs and Extended Reach

• Compliance ambassador programs can effectively extend program reach across large healthcare systems, with over 300 ambassadors serving as eyes and ears on the ground in diverse facility environments.
• Regular training, annual retreats, and ongoing engagement initiatives are essential for maintaining ambassador program effectiveness and preventing volunteer fatigue over time.
• Ambassador programs require dedicated compliance team members to manage relationships, provide education, and ensure alignment with evolving program objectives and organizational changes.

Technology Integration and Data Strategy

• Modern compliance programs must leverage artificial intelligence and machine learning to identify highest-risk areas for investigation rather than relying solely on random sampling methodologies.
• Data analytics platforms enable compliance teams to shift from simply tracking activity metrics to monitoring outcome-focused indicators that drive meaningful risk mitigation.
• Technology solutions should streamline processes for both compliance teams and stakeholders, such as reducing physician time spent on conflict-of-interest reporting through automated systems.

Cross-Training and Burnout Prevention

• Compliance leaders must implement cross-training initiatives that enable team members to provide coverage during absences and prevent over-specialization that leads to professional burnout.
• Wellness and self-care programs require leadership commitment beyond platitudes, including realistic expectations for response times and support for flexible work arrangements.
• Organizational design should avoid excessive specialization that traps compliance professionals in narrow roles focused solely on investigating problems without opportunities for proactive education and relationship-building.

Resource Optimization and Partnership Development

• Large-scale compliance programs benefit from strategic partnerships with other organizational functions, such as transferring appropriate monitoring responsibilities to finance teams while maintaining oversight coordination.
• Compliance departments should focus on core competencies while leveraging business partners and clinical teams to share responsibility for risk monitoring and mitigation activities.
• Regular prioritization and reprioritization processes help compliance leaders allocate limited resources toward highest-impact activities while managing stakeholder expectations about implementation timelines.

Regulatory Coordination Across Multiple Jurisdictions

• Multi-state healthcare systems face complex compliance challenges due to varying state laws, different attorney general interpretations, and diverse regional enforcement approaches.
• Compliance programs must decide whether to customize approaches for different jurisdictions or implement the most stringent standards universally across all facilities and operations.
• Proactive engagement in strategic planning and operational changes prevents compliance issues from being discovered after system-wide implementation when fixes become exponentially more difficult and costly.

Performance Monitoring and Risk Intelligence

• Effective compliance programs require sophisticated metrics beyond simple activity tracking, focusing on meaningful indicators such as hotline reporting rates and investigation outcome ratios.
• Dashboard systems should monitor enterprise-wide trends while enabling drill-down analysis of facility-specific patterns that may indicate emerging risks or program effectiveness variations.
• Compliance teams must continuously evolve their monitoring approaches to ensure metrics actually drive improved compliance behavior rather than simply documenting past activities.

Building Organizational Value Proposition

• Compliance professionals must actively campaign for their program’s value proposition, positioning themselves as strategic business partners rather than regulatory enforcement functions.
• Having “a seat at the table” during strategic planning enables compliance teams to provide proactive guidance and prevent costly remediation efforts after problems emerge.
• Compliance programs achieve greater organizational support when they demonstrate measurable value through risk mitigation, efficiency improvements, and strategic guidance that enables business objective achievement.

Closing Summary