In the news – 02/23/2017

Provider pays $5.5 million in HIPAA settlement

A Florida healthcare provider has paid the government $5.5 million to settle potential Health Insurance Portability and Accountability Act violations after information on more than 115,000 patients was “impermissibly accessed” several years earlier, officials announced Thursday.

Memorial Healthcare Systems, which operates a nursing home, six hospitals and other healthcare facilities in South Florida, reported to the Department of Health and Human Services that patients’ protected information, including names, dates of birth and social security numbers, had been accessed by employees and “impermissibly disclosed to affiliated physician office staff.”  Full Article

In the News – 04/12/16

Another View: State not prepared to handle mentally ill and aging population (by James Gomez, The Sacramento Bee) “The Sacramento Bee article, “Shifting population in California nursing homes creates ‘dangerous mix’ ” (Page 1A, April 3), identifies growing challenges for our state’s nursing homes, but it fails to focus on the root cause of what got us here. State and local policy on mental and behavioral health care, and its lack of dedicated services in this area, are key to this issue. California, by conservative estimates, is several thousand beds short of adequately serving those with mental illness or behavioral issues. The shortage of 24-hour care – and the beds required for that treatment – places a strain throughout the health care system, and specifically in long-term care and skilled nursing facilities.”  Entire Article

In the News – 04/11/16

The California End-of-Life Option Act: The opponents of the Act included the Coalition of Physicians & Other Healthcare Providers and organizations dedicated to the rights of people with disabilities. Faith-based organizations advocate that while protections for healthcare providers are present, it is the patient who remains without adequate protections. The Coalition wrote that the Act does not require a psychiatrist to evaluate a patient before he or she decides to end their life; does not require anyone to be present when the patient takes his/or her lethal prescription; and allows the patient, or designated agent, to pick up their lethal prescription at the local pharmacy. In addition, the opponents assert that the Act will have a devastating impact on the treatment of terminally ill and disabled patients because it will quickly become another treatment option, always being the cheapest. The Medical Oncologist Association of Southern California, Inc. believes that no matter how many parameters are placed around the practice, legalizing a form of suicide will have spill over effects in society at large.

Source for News notes: The California End-of-Life Option Act: To Participate or Not to Participate by Larry T. Pleiss, Shareholder at Wroten & Associates.

The California End-of-Life Option Act

Among the rapidly evolving areas of health law are the legal, medical, and ethical issues relating to death and dying. California is now the fifth state to authorize medical aid-in-dying. This raises the thorny and inevitable question as to whether your institution, facility or agency will participate or not participate in the activities authorized under the End of Life Option Act [the “Act”] signed by Governor Jerry Brown, on October 5, 2015. (Cal. Health & Safety Code, § 443, et seq.) The Act permits a competent, qualified individual who is an adult with a terminal disease to receive a prescription for an aid-in-dying drug if certain conditions are met. These conditions include two oral requests, a minimum of 15 days apart, and a written request signed by two witnesses. These requests must be provided to his or her attending physician who then refers the patient to a consulting physician to confirm diagnosis and capacity to make medical decisions. The attending physicians refers the patient to mental health specialists, if indicated.


Source for News notes: The California End-of-Life Option Act: To Participate or Not to Participate by Larry T. Pleiss, Shareholder at Wroten & Associates.

In the News – 03/01/2016

Direct care staff (defined as staff members of residential care facilities for the elderly who assist residents with personal activities of daily living as well as CNAs, RNs, and LPNs) must now receive 40 hours of training before working independently with residents, and an additional 12 hours annually for in-servicing. The training must include topics related to physical limitations and the needs of the elderly, techniques for personal care, Residents’ rights, policies and procedures regarding medications, psychological needs of the elderly, building safety, the use and misuse of antipsychotics, special needs for residents with dementia and Alzheimer’s as well as cultural competency and sensitivity. This is a huge increase in training requirements as prior to January 1, 2016, direct care staff are only required to receive 10 hours of training within the first four weeks of employment, meaning on-the-job training. Further, required training hour topics have not previously included the use and misuse of antipsychotics, special needs for residents with dementia and Alzheimer’s as well as cultural competency and sensitivity.

Source of Update notes: Training Requirements by: Lora A. Ajello, Senior Attorney at Wroten & Associates


In the News – 02/22/16

All RCFE caregivers must receive dementia care training, regardless if the RCFE promotes or advertises a memory care unit or any special programs related to the residents with dementia. This training is in addition to the increased requirements laid out in section 1569.625. As of January 1, section 1569.626 now requires 12 hours of dementia care training, six of which must be completed prior to the staff member being able to work independently with residents and the remaining six hours must be completed within the first four weeks of employment. The Code is very clear: beginning on January 1, 2016, all 12 hours must be devoted to the care of persons with dementia. In-servicing relating to dementia care likewise must be performed annual for at least eight hours. In-service training must “be developed in consultation with individuals or organizations with specific expertise in dementia care or by an outside source with expertise in dementia care.”

Source of Update notes: Training Requirements by: Lora A. Ajello, Senior Attorney at Wroten & Associates

In the News – 02/09/2016

AB 1570 and SB 911 have now amended Health and Safety Code section 1569.23 and section 1569.625 to require the certification program for a prospective Administrator to consist of 100 hours of course work and a state-administered exam of no less than 100 questions. The current law requires an Administrator of an RCFE to successfully complete a department approved certification program prior to employment that requires, among other things, a minimum of 40 hours of classroom instruction on a uniform core of knowledge. Starting on January 1, 2016, the minimum hours of classroom instruction for Administrators jumps to 80 hours, including 60 hours of in-person instruction, and would add additional topics to the uniform core of knowledge, including the adverse effects of psychotropic drugs for use in controlling the behavior of persons with dementia.

Source of Update notes: Training Requirements by: Lora Ajello, Senior Attorney at Wroten & Associates


CVS to Spend $10.4 in cash on drug distributor Omnicare

[Los Angeles Times, May 21, 2015] CVS Health will spend more than $10 billion to buy pharmacy services provider Omnicare and tap a growing target for prescription drug distribution: care for the elderly. The deal announced Thursday will give one of the nation’s biggest pharmacy benefits managers national reach in dispensing prescription drugs to assisted living and skilled nursing homes, long-term care facilities, hospitals and other health care providers. Omnicare’s long-term care business operates in 47 states and the District of Columbia.

Drive by Shakedowns – Americans with Disabilities Act (ADA)

Limit your exposure to “drive by shakedowns” by addressing common ADA parking lot issues:

  • Determine whether your loading zones/ van access aisles are compliant.
  • Determine whether your parking lot signage is compliant.
  • Determine whether your parking lot contains the required minimum number of accessible parking spaces.
  • Determine whether the routes to and from the parking lost as “accessible”.
  • Determine whether curb ramps or entrance ramps are compliant.

Source for News Notes: Drive by Shakedowns – Americans with Disabilities Act (ADA) by: Stephen R. Hunter, Senior Attorney at Wroten & Associates.

Government Sues Skilled Nursing Chain HCR Manorcare for Allegedly Providing Medically Unnecessary Therapy

“The government has intervened in three False Claims Act lawsuits and filed a consolidated complaint against HCR ManorCare alleging that ManorCare knowingly and routinely submitted false claims to Medicare and Tricare for rehabilitation therapy services that were not medically reasonable and necessary, the Department of Justice announced today.  ManorCare is one of the nation’s largest healthcare providers, operating approximately 281 skilled nursing facilities (SNFs) in 30 states.” Entire Article