REMEMBER receiving gold stars way back when? I'm a little embarrassed to say that my memories involve more red, silver and blue than gold. Well, for those of you who share my memories, here's our chance to change that.  

I'm sure all of us, as professionals in our skilled nursing home industry, would agree that gold stars are routinely earned throughout our facilities:  nursing, social work, admissions, business, human resources, risk management, etc.  If we took the time to actually award gold stars for every "very well done" effort throughout our days in our efforts to improve the quality of life for our residents, no doubt we'd all have an ever-growing library of notebooks filled with gold stars.

When the Office of the Inspector General walks in the front door and asks for proof that we have an effective compliance program, we need to assertively but humbly present our libraries of notebooks filled with gold stars. Why? Because a gold star represents far more than success in any particular situation, moment or process.  A gold star represents, ultimately, a good faith effort to do the right thing. When we organize all of the gold stars together, we can see a mosaic of our organization's corporate culture. A mosaic of gold stars clearly presents a corporate culture of good faith efforts to comply with laws and regulations.  We want to present a culture of compliance in order to convey that a mistake is a mistake and to negate any possible inference of criminal intent.

Where are our gold stars that are either lost or gathering dust?  Lost to everyone other than those who participated in the momentary process or event that earned the gold star; gathering dust because recognition was bestowed upon the participants but with no further recognition.

- Incidents and Accident reports;

- Quarterly QAPI Committee Reports;

- Reimbursement Consultant reports;

- Audit reports from all departments

When the OIG comes in the front door, we want to present our Compliance Program Workplans as evidence of a corporate culture of compliance. To do so, we must gather the most telling and significant gold stars from all departments and processes within our facilities. Perhaps even more importantly, we need to also gather all of the red, blue and silver stars too - to show our objectivity, transparency and honesty.  After all, we are human.  But that's not enough - we must clearly show stubborn, persistent and unrelenting efforts to elevate red, blue and silver stars into gold stars and especially show the results of those efforts, never stopping until we have achieved this alchemy and continually maintaining the gold star.  

Now we have our blueprint of a real and effective corporate culture of compliance. 

With the extensive discussion regarding the impact of Obamacare insurance requirements on the balance between full and part time employees, there have been questions regarding whether for New Jersey purposes, the definition of full versus part time has changed at all.

New Jersey's definition of the hours needed to make someone eligible for health coverage has NOT yet changed. It is still 25 hours per week on a regular basis. The federal definition is 30 hours per week on average or a 130 hour month. It appears that the more liberal New Jersey requirement may be changed to match the federal definition in 2016, but that won't be certain for some time. Therefore, New Jersey employers must continue to apply the state standard for defining full and part time employees.

It is important to note though that now, independent contractors (1099) individuals are not eligible for Small Group coverage in New Jersey, even if those individuals are above 25 hours. They must now be W-2 employees in order to be eligible.

If you have any questions regarding full versus part time employment options or determining whether an individual should be a W-2 or 1099, please contact Brandon Goldberg, Esq. at 609-454-5351 or bgoldberg@barmak.com.

Our law firm provides integrated regulatory, transactional, employment and litigation/advocacy services to healthcare organizations.

Representative Clients: 

Entities:  Skilled nursing facilities; Home health agencies; Hospice agencies; Hospitals.

Providers: Physicians; Therapists; Orthotists and Prosthetists

Suppliers:  Durable medical equipment; Long-term care pharmacies; Retail pharmacies.

Businesses: Billing; Management service organizations; Independent provider associations

Regulatory Issues: Corporate Compliance Programs (Fraud, waste & abuse; Privacy & Data Security; Employment); Healthcare facility; Licensed Professionals; Medicare & Medicaid (certification, survey and reimbursement); Auditing (legal; clinical; administrative; and reimbursement).

Transaction Issues: General Counsel Services; Contracts.
          
Employment Issues: Wage and hour; Equal employment opportunity; Discrimination; Whistle-blowing; Employment agreements; Severance packages; Employee release agreements, Non-compete agreements; Non-solicitation agreements; Confidentiality agreements, Employee leave issues, Electronic monitoring and employee privacy, Employee separation (suspensions, terminations and reductions in force); Documentation.

Litigation/Advocacy: Contracts; Employment; Fiduciary issues; Commercial leases; Payment (Managed Care Organizations; Medicare; Medicaid); Guardianship; Professional and facility licensing; Healthcare regulatory; Fraud and privacy issues.
  
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This newsletter has been prepared by Barmak and Associates, 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

www.barmak.com