Advice from an Unexpected Source
By: David S. Barmak, JD, CEO
Most people have heard the old proverbial saying, “out of the mouths of babes,” used when a child offers some unexpectedly profound wisdom. Well, sometimes the best wisdom and insight comes from the very people we serve.
Med-Net Concepts, LLC Introduces New Blog:
A Valuable Resource For All Healthcare Professionals
Med- Net Concepts, LLC has a new blog! It includes a compilation of healthcare articles and case studies based on relevant and “hot” topics written by members of our
interdisciplinary team. Our team is comprised of various healthcare specialists
including nursing home administrators, directors of nursing, registered nurses, dieticians, former Department of Health surveyors, healthcare associations executives and healthcare attorneys. We intend for this blog to be a valuable resource of
information for all healthcare providers, including long term care employees.
The Reality of the Nursing Home Admission Process
By: David S. Barmak, JD, CEO and
Betty Frandsen, MHA, RN, NHA, CDONA, FACDONA, C-NE, IP-BC
In the nursing home admission process, consideration of an arbitration agreement is not high priority for the individual being admitted or for the family dealing with the emotional trauma of placing a loved one into a nursing facility. What they all want to know is, “Will my mom or dad get better, and if that is not possible, will his or her needs be met? And will the staff be respectful of this person who means so much to me?” Most people have been exposed through the media reports to claims of abuse in nursing homes. That is a more weighty concern than a statement in the admission agreement about arbitration, which the person may not even understand. Admission
paperwork, including whether to sign a document that contains an arbitration clause or
not, is a mere distraction on the way to getting the patient/resident settled comfortably into a room. Family members are dealing with fear of the unknown, guilt over not being able to care for the individual, financial concerns, and the stress of maintaining
their personal and work commitments while carving out time for this new chapter in
life that does not seem to come with answers.
Negligence in Long Term Care: Avoiding Potential Liability
By: Betty Frandsen, MHA, RN, NHA, CDONA, FACDONA, C-NE, IP-BC and
Kimberly A. Keeman, B.S.
Certified nursing assistants (CNAs) play a vital role in the delivery of healthcare to patients and residents. Specifically in long term care facilities, CNAs work very closely
with their residents. Their daily duties are diverse and include, but are not limited to:
feeding, bathing and dressing residents, incontinent care and toileting residents,
taking vital signs, positioning and transferring residents, using mechanical lifts, performing range of motion, assisting with ambulation, and observing changes in a
resident’s condition. Working in healthcare as a CNA comes with the potential
exposure to liability.
Laboratory to Pay $8.5 Million in False Claims Settlement: Wisconsin companies Pharmasan Labs, Inc. and NeuroScience, Inc. have agreed to an $8.5 million settlement following allegations under the False Claims Act. Pharmasan allegedly submitted false claims to Medicare for laboratory services including those referred by non-physicians for almost five years. Pharmasan and NeuroScience are also to enter into a Corporate Integrity Agreement which will require them in part to implement a compliance program. For more information, visit http://www.justice.gov/usao-wdwi/pr/osceola-laboratory-agrees-pay-85-million-resolve-false-billing-case
Ohio Long-Term Care Facility to Pay $1 Million Following Death of Resident: Beachwood Pointe Care Center, an Ohio nursing home, is to pay a total of $1 million in punitive and compensatory damages following the death of a resident. The lawsuit filed against the facility alleged that staff was negligent and reckless in treating the resident and failed to notify her family and physician of her poor condition. For more information, visit http://www.mcknights.com/news/nursing-home-to-pay-1-million-for-residents-death/article/453359/
South Carolina Hospital To Pay $237 Million to Resolve False Claims Act Violations: Tuomey Healthcare System, a SC hospital, is to pay $237 million for violations of the False Claims Act and Stark Law. In May 2013, a jury found that Tuomey violated the Stark Law by illegally billing Medicare for services referred by physicians with whom the hospital had an improper financial relationship. According to the U.S. Department of Justice news release, “Tuomey, fearing that it could lose lucrative outpatient procedure referrals to a new freestanding surgery center, entered into contracts with 19 specialist physicians that required the physicians to refer their outpatient procedures to Tuomey and, in exchange, paid them compensation that far exceeded fair market value.” According to the news release, the government also argues that Tuomey ignored and suppressed warnings from one of its attorneys that the physician contracts were “risky” and raised “red flags.” Under the settlement, Tuomey is to enter into a five year Corporate Integrity Agreement which will require any physician arrangements to be reviewed by an independent organization. For more information, visit http://www.justice.gov/opa/pr/united-states-resolves-237-million-false-claims-act-judgment-against-south-carolina-hospital
FRAUD/ABUSE
Long-Term Care Pharmacy Agrees to Settlement: PharMerica Corp., a long-term care pharmacy, has agreed to a $9.25 million settlement following allegations that it received kickbacks from a pharmaceutical manufacturer in exchange for the promotion of one of their drugs. The settlement is a result of a 2007 whistleblower lawsuit. The $9.25 million will be split between the federal government and Medicare. For more information, visit http://www.mcknights.com/news/pharmerica-agrees-to-925-million-settlement/article/443733/?DCMP=EMC-MCK_Weekly&spMailingID=12624302&spUserID=MTM2NDA4NTY3MTQ4S0&spJobID=640565786&spReportId=NjQwNTY1Nzg2S0
$118.7 Million False Claims Settlement Reached: A Florida-based healthcare company that operates nursing homes and hospitals in Florida, North Carolina, Tennessee, and Texas agreed to pay $118.7 million to settle False Claims allegations. The whistleblower lawsuit alleged that the company paid kickbacks, in the form of bonuses and increased salaries, to doctors in exchange for referrals. The settlement will be split among the federal government, the states of Florida, North Carolina, Tennessee, Texas, and the whistleblowers involved. For more information, visit http://www.mcknights.com/news/adventist-to-pay-118-million-to-settle-false-claims-suit/article/440139/
