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 13, Issue 7                           ADVERTISEMENT                                               JULY 2012

In This Issue
Filling Beds in a Nursing Home
Sara DeMonte - Barmak Law Firm Legal Information Technology Specialist in the Spotlight

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Filling Beds in a Nursing Home

Filling beds is much more complex than just marketing to potential referral sources. Marketing to referral sources, for example, hospitals and physicians, is certainly a starting point. However, when that hospital calls and says "Will you take this patient", that is where the success or failure lies. If the nursing home is not prepared from both a resource and skill perspective, to be able to handle that patient, after a couple more tries the hospital will not refer that type of patient or any patients to the nursing home.


This requires looking at the entire admission process from a clinical competency perspective. The competency of the staff in being able to handle IVs, antibiotics through IVs, fractures, really skilled nursing, is something that requires a self assessment of the nursing home in terms of its honest capabilities. The last thing that anyone wants is for the nursing home to take a patient whom the nursing home is truly unable to care for. But if a nursing home does not staff up and skill up and resource up to handle complex skilled nursing patients, the nursing home is going to have difficulties filling its beds, and it is going to end up with case mix indexes that are low scores which translate into low reimbursement.


Rehab needs of residents, which might result in ultra high case mix index scores, are excellent. But many facilities at most can only hope for 25% of their population to qualify for this. Fifty percent of residents at an ultra high rehab case mix index can easily result in being an outlier and being investigated for potential fraud. If the case mix index for skilled nursing is very low, then the facility is going to end up with walkie talkies, i.e. people who are ambulatory and really do not need skilled nursing, the case mix index will be low, and they will have difficulties filling the beds and motivating hospitals to refer patients to them.


The admission process is very complex. It starts with a self assessment as to what the nursing home's skills and resources are and what capabilities the nursing home has. Based upon that, the nursing home is in a position to be able to promote itself to hospitals. This ties right into the accountable care organization strategies that are needed.


Sara DeMonte - Barmak Law Firm Legal Information Technology Specialist in the Spotlight



Sara started her career at the Law Offices Of David S. Barmak, LLC in 2007 working part time while attending college. She is a 2012 Summa Cum Laude graduate of Rutgers where she received a Bachelor of Arts degree in Political Science.


Sara was a member of the Rutgers Chapter of Alpha Sigma Lambda, the University College National Academic Honor Society and Pi Sigma Alpha, the National Political Science Honor Society.


During her years at the law firm Sara has served as an administrative assistant and litigation / accounting software specialist.  The experience she gained while in these various positions has led to her current position as the firm's Legal Information Technology Specialist.


In addition to her law firm experience, Sara worked as an intern clerk at the Superior Court of New Jersey (Monmouth County) Special Civil Part Division. 


While working part time and attending college Sara was a youth group leader at the Perrienville Jewish Center for which she received a Youth Leadership Award.


Sara is a resident of Millstone Township. 



Law Offices Of David S. Barmak, LLC

Our firm is dedicated to helping health care providers, such as skilled nursing facilities and other health care providers, and the suppliers to those firms, manage risk through comprehensive compliance programs that focus on early intervention through  on-site training, communication, policy & procedure review, monitoring and consultation. The program includes on site training in the areas of, but not limited to, fraud & abuse, HIPAA privacy and data security, employment, emergency preparedness, workplace violence, clinical documentation, sexual harassment and social networking.


The firm's compliance team includes experienced compliance attorneys, nurses, physical therapy and pharmacy consultants who are available to assist clients with pre and post Department of Health (DOH) survey procedures, respond to DOH questions, prepare for re-inspections, minimize risks for deficiencies, offer support to Directors of Nursing regarding correct care plans, incident reports and therapy notes, review Medicare billing and audit PPS/Medicare/Medicaid insurance documentation.


The recipient may, if the newsletter is inaccurate or misleading, report the same to the Committee on Attorney Advertising.


This newsletter has been prepared by the Law Offices Of David S. Barmak, LLC for informational purposes only and is not intended to provide legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.


For more information, please contact David S. Barmak, Esq.:

Telephone (609) 454-5351

Fax (609) 454-5361

Copyright, 2012.  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.