Presented by: Melanie Balestra, NP, JD Law Offices of Melanie - - PowerPoint PPT Presentation
Presented by: Melanie Balestra, NP, JD Law Offices of Melanie Balestra balestralaw@cox.net OBJECTIVES Participant will be able to find 11 elements of SPs Participant will be able to name two types of BRN Accusations Participant
Presented by: Melanie Balestra, NP, JD Law Offices of Melanie Balestra balestralaw@cox.net
Participant will be able to find 11 elements of SPs Participant will be able to name two types of BRN Accusations Participant will be able to name two entities a NP can be an owner Participant will be able to name two types of social Particpant will be able
DRUGS
Unprofessional conduct
(a) Committing fraud or deceit in obtaining, attempting to obtain
(b) Social media—Facebook, texting (c) Committing a felony, whether or not involving moral turpitude,
conviction by a court of competent jurisdiction or a plea of no contest is conclusive evidence of the commission. (d) Aiding or abetting in a criminal abortion or attempting, agreeing or offering to procure or assist in a criminal abortion
(e) Any conduct or practice that is or might be harmful
(f) Being mentally incompetent or physically unsafe to a degree that is or might be harmful or dangerous to the health of a patient or the public. (g) Having a license, certificate, permit or registration to practice a health care profession denied, suspended, conditioned, limited or revoked in another jurisdiction and not reinstated by that jurisdiction. (h) Willfully or repeatedly violating a provision of the Nurse Practice Act
(i) Committing an act that deceives, defrauds or harms the public. (j) Failing to comply with a stipulated agreement, consent agreement or board order. (k) Violating a rule that is adopted by the BON (l) Failing to report to the board any evidence that a professional or practical nurse or a nursing assistant is or may be: (i) Incompetent to practice. (ii) Guilty of unprofessional conduct
(iii) Mentally or physically unable to safely practice nursing or to perform nursing related duties. A nurse who is providing therapeutic counseling for a nurse who is in a drug rehabilitation program is required to report that nurse only if the nurse providing therapeutic counseling has personal knowledge that patient safety is being jeopardized. (l) Failing to self-report a conviction for a felony or undesignated
Gross negligence
Carelessness in reckless disregard for the safety or lives of others, which is so great it appears to be a conscious violation of other people’s right to safety. It is just shy of being intentionally evil. Punitive damages
STANDARDIZED PROCEDURES (1) Be in writing, dated and signed by the organized health care system personnel authorized to approve it. (2) Specify which standardized procedure functions registered nurses may perform and under what circumstances. (3) State any specific requirements which are to be followed by registered nurses in performing particular standardized procedure functions. (4) Specify any experience, training, and/or education requirements for performance of standardized procedure functions. (5) Establish a method for initial and continuing evaluation of the competence of those registered nurses authorized to perform standardized procedure functions.
Standardized Procedures (6) Provide for a method of maintaining a written record of those persons authorized to perform standardized procedure functions. (7) Specify the scope of supervision required for performance of standardized procedure functions, for example, immediate supervision by a physician. (8) Set forth any specialized circumstances under which the registered nurse is to immediately communicate with a patient's physician concerning the patient's condition. (9) State the limitations on settings, if any, in which standardized procedure functions may be performed. (10) Specify patient record keeping requirements. (11) Provide for a method of periodic review of the standardized procedures
Alcohol use
Cloning Not documented, not done Amendments considered late charting
Falsification/Misrepresentation
How many hours per provider? How many collaborating physicians? Hourly wage, not salary. Always a written contract. What to do if abused?
California Labor Board
Physician 51% shareholder and Medical Director
Job description Availability Input on hiring professionals Familiar with SPs
Nurse Practitioner 49% shareholder
Patient records available to physician Regular meeting time to discuss business (quarterly) Consults as necessary
Only provides management services
Leasing Support personnel Utilities Management contract
Does not employee any health care providers Can be LLC or corporation
Provide services for one or many physicians Cannot pay physician directly
Corporate to corporate contracts Physician provides free collaborating services Lease space in physician’s office Online services Physician participates and understands SPs
No corporate protection Cannot pay physician for collaborating services Must have physician involved chart review and
Beyond the BRN
Medicare/Medicaid Fraud
HIPAA Violations
Antikick back statutes
No reimbursement for referral
Elements of Compliance Program
Written policies & procedures Compliance professionals Effective training Effective Communication Internal monitoring Enforcement of standards Prompt response
Last but one of the most important tips
Document, document, document
Electronic Medical Records
Cloning Eprescribing Where did my documentation go?
March 23, 2015 Sacramento Supports IOM Suggests legal monitoring of reviewers Will it pass?
Sen. Ed Hernandez (D-West Covina) and Assembly member Susan Eggman (D-Stockton) have introduced legislation that will grant full practice authority to nurse practitioners in California, joining 20 other states and the District of Columbia as jurisdictions that permit NPs to practice to the full extent of their education, experience and expertise
Covers NP for disciplinary actions as well as mal Allows NP to have own lawyer to negotiate terms Occurrence policy covers you after you leave a job CANP endorses Nurses Service Organization
First insurance company to offer NPs insurance Have advisory board comprised of NPs, faculty and RN leaders Listen to NPs
Attorney interview
Discussion of fees and costs
Mitigating evidence/witnesses for defense
Expert witnesses
Dialogue with prosecuting attorney/investigator Preparing for the hearing Preparing the for the outcome