Health Care Matters

A Complimentary Newsletter From:

Law Offices Of David S. Barmak, LLC

Managing Risk for Long Term Care and Health Care Providers

Volume 10, Issue 7                               ADVERTISEMENT                        OCTOBER 2009

In This Issue
Patient Safety Act
Free Teleconference - CEU Program
New Restrictions on Consignment Closets and Stock and Bill Arrangements in Health Care Providers' Facilities Take Effect on March 1, 2010
In the Spotlight
David S. Barmak, Esq. 
David Photo
Licensed to practice law in the States of New Jersey, New York, Connecticut and Pennsylvania 
Patient Safety Act
In 2004, the New Jersey Patient Safety Act (P.L. 2004, c9) was signed into law. The statute was designed to improve patient safety in hospitals and other health care facilities by establishing a mandatory medical error reporting system. Instead of seeking to place blame, the goal of the law was to instead promote comprehensive reporting of adverse patient events, systematic analysis of their causes, and creation of solutions that would improve health care quality and save lives.
Not surprisingly, the initial root cause analyses during the initial phase of implementation (hospitals) showed that the majority of reported events were classified as either falls or were hospital acquired pressure ulcers.
The New Jersey Department of Health and Senior Services has adopted administrative rules to implement the "Patient Safety Act". The rules require every licensed health care facility to report every serious preventable adverse event that occurs within the licensed facility to the Department of Health and Senior Services.
Medicare and/or Medicaid Nursing Homes must establish patient safety committees. Based upon discussions with the State, it is projected that further implementation for skilled nursing facilities will be required towards the beginning of 2011. 
It is recommended, however, that facilities do more than just set up patient safety committees in name only; that facilities begin to draft and plan on how to implement a policy and procedure for the Patient Safety Act. This will enable the facility to immediately start working towards achieving the intent of the Patient Safety Act for the benefit of its residents as well as to be prepared for the eventual implementation requirement by the Department of Health and Senior Services.
The State of New Jersey Department of Health and Senior Services created a web site designed to help health care facilities develop strong patient safety programs and fulfill the law's mandatory reporting requirements. The site can be found at In addition, the Law Offices Of David S. Barmak, LLC can also assist in the development and implementation of a policy and procedure for the Patient Safety Act.
For more information, please contact us:
Telephone (609) 688-0055
Fax (609) 688-1199

Free Teleconference - CEU Program

David S. Barmak, Esq. will present "HIPAA Compliance:  What Every Health Care Provider Should Know" and will provide 1.0 CEU for New Jersey LNHA and CALA.  Call Saul A. Fern, Marketing Director at (609) 688-0055 to schedule date in January, 2010.
New Restrictions on Consignment Closets and Stock and Bill Arrangements in Health Care Providers' Facilities Take Effect on March 1, 2010
The Centers for Medicare and Medicaid Services (CMS) issued, on September 1, 2009, Transmittal 300 that defines compliance standards for consignment closets and Stock and Bill arrangements between enrolled suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) and physicians, non-physician practitioners and other health care professionals (Professional) to take effect as of March 1, 2010.
CMS is requiring that as of March 1, 2010, the following conditions must be met in order for the National Supplier Clearinghouse to allow Professionals to distribute DMEPOS at their locations:
  • "The title to the DMEPOS shall be transferred to the [Professional] at the time the DMEPOS is furnished to the beneficiary;
  • The [Professional] shall bill for the DMEPOS supplies and services using their own enrolled DMEPOS billing number;
  • All services provided to a Medicare beneficiary concerning fitting or use of the DMEPOS shall be performed by individuals being paid by the [Professional], not by any other DMEPOS supplier; and
  • The beneficiary shall be advised that if they have a problem or question with the DMEPOS they should contact the [Professional], not the DMEPOS supplier who placed the DMEPOS at the [Professional's location]."
  • Only one DMEPOS supplier may be enrolled and/or located at a practice location (this prohibition does not exist for one or more physicians enrolled as DMEPOS suppliers at the same physical location) and
  • Each practice location must have a separate entrance and separate physical address.
  • Professionals have the responsibility for determining compliance with these new provisions.


Does this apply to all third party payor patients? No. At this time these restrictions appear to only apply to Medicare patients. 
If you decide to continue with consignment closets or Stock and Bill arrangements after March 1, 2010, please consult with your attorney regarding the current federal and state requirements as of that date as well as ensure that your documentation is complete to show adherence to all requirements.
In the Spotlight
Susan Sy Suan is the Food Service Director at New Vista Nursing & Rehabilitation Center in Newark, NJ.
Question:  Good morning. What do you find is the most important ingredient for an employee in the kitchen to do his job properly?
Answer:  I like that perspective - "ingredient". Well, I have found over the years that the most important ingredient is for my staff to have knowledge of what their jobs really require. I constantly stress my department's goal - provide quality food so that our residents will be both healthy and happy.
Question:  Do you stress that goal in the same way for all of your employees?
Answer:  Yes; however, I recognize that every employee has slightly different abilities to both think and perform. I am consistent in stressing the department's goal but I take into account each employee's abilities when managing them towards that goal.
Question:  What do you mean by that?
Answer:  Well, for example, I take more time to educate some employees than others depending on their needs. I don't get frustrated with that but instead just accept that is the way I need to manage.
Question:  Is respect an important ingredient in your management mix?
Answer:  Yes, very important. I start with myself. I believe I respect and treat my employees for who they are and for the efforts they make without regard to race, religion or national origin. I also expect, in return, that my employees will respect themselves, each other and the residents similarly.
Question:  Well, how does that respect translate into day to day managing?
Answer:  I do not curse. I do not yell. I have found I have more influence on my employees if I maintain a positive attitude towards them at all times. I have found that if I don't treat my employees with respect then they won't listen to me. If they don't listen to me, I can't manage their efforts towards achieving our department's goals. I try to speak softly to my staff because I want them to listen.
Question:  What do you do with an employee who does not listen and does not show respect for himself, a co-worker, a resident or you?
Answer:  I do whatever it takes to get through to the employee. If an employee is difficult to deal with then I have no choice but to stand up to that employee. If an employee in my department expresses himself intensely - volume, force, etc. - I not only match that level of intensity but go up one notch or 10% higher. I make sure that employees do not think they can overwhelm me with their intensity of communication. Bottom line - the facility put me in charge to care for the residents and to provide safe and productive jobs for my employees. I am in charge and my employees know that I am in charge. I recognize that all of my employees want to be respected and I give them that respect - as long as they return that respect in terms of how they treat the residents, their co-workers and me as the representative of the facility.
Thank you, Susan, for your participation and viewpoint.
Law Offices Of David S. Barmak, LLC
David Barmak established his health care law firm in 1984 to deliver legal services, both in transactions and litigation, to organizations and professional practitioners in the health care field.  We call this approach "Enterprise-Wide Risk Management" because it includes three important facets:
  1. Counsel and advisement on all aspects of legal risk, from setting up the entity to corporate governance and compliance;
  2. Protection of your practice or business through litigation prosecution or defense in the Courts; as well as regulatory compliance and licensure issues before government agencies; and
  3. Operations improvement through the implementation of enterprise-wise onsite audits, programs and training seminars in the areas of, but not limited to, Fraud and Abuse, HIPAA Privacy and Data Security, Employment, A/R Management, Emergency Preparedness, and Workplace Violence.

David S. Barmak, Esq. received his JD from Cornell University and BA from Duke University.  He is licensed to practice and serves clients in the States of New Jersey, New York, Connecticut and Pennsylvania.  Before making your choice of attorney, you should give this matter careful thought.  The selection of an attorney is an important decision.  The recipient may, if the newsletter is inaccurate or misleading, report the same to the Committee on Attorney Advertising. 

For more information, please contact us:
Telephone (609) 688-0055
Fax (609) 688-1199
Copyright, 2009.  Law Offices Of David S. Barmak, LLC.  All rights reserved.
No portion of these materials may be reproduced by any means without the advance written permission of the author.