Post MVA: GO FUND ME for Kirby “Sasha” Fenton

Post M.V.A.

By Dr. Charles F. Fenton III JD

My son, Kirby “Sasha” Fenton sustained a devastating medical injury in a motor vehicle accident on January 16, 2018 in Marietta, GA.

As of this writing, he had surgery last night and has additional surgery planned for this morning (due to blood loss during the first surgery). Additional surgeries are expected. He will be in Wellstar Kennestone Hospital for at least a week and then will be transferred to a rehabilitation facility for an extended period of time.

He is NOT expected to make a full recovery. He will have permanent, significant disability.

Sasha needs funds for (1) medical expenses, (2) legal expenses connected to the accident, (3) rehabilitation expenses, and (4) most especially expenses relating to his transitioning to his life as a disabled person – this is really where he needs the bulk of funds.

Marietta Daily Journal Article: http://www.mdjonline.com/news/police-marietta-teen-thrown-from-motorcycle-after-passing-cars/article_c6a53874-fb02-11e7-a34c-8325493600cf.html

Sasha will appreciate your generosity.

Thank You

https://www.gofundme.com/kirby-sasha-fenton-rehab-fund

EDITOR’S DISCLOSURE: Dr. Fenton is a friend, colleague and frequent contributor to this ME-P, as well as our textbooks and related white-papers.

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On Items NOT Purchased in the Sale of a Medical Practice

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Excluded – Not Included – Items

By Dr. Charles F. Fenton III JD

fentonMuch is written about the sale of a medical practice: price, taxes, terms, loans, negotiations and FMV etc; especially on this ME-P by Editor Dr. Dave Marcinko and his team. Excellent thoughts, all! But, little is written about items not purchased.

So, here is a different perspective.

Excluded Items

Items not purchased or “excluded items” often list the personal items of the parties – or of the employees of the parties. Such items would often include:

  1. All cash on hand or on deposit;
  2. All accounts receivable generated prior to the closing date;
  3. All prepaid expenses, utility deposits, tax rebates, insurance claims, credits due from suppliers and other allowances after Closing Date;
  4. The personal effects, including but not limited to; photographs, diplomas, uniforms, books, mementos, memorabilia, personally owned art objects and any other personal property owned by them;
  5. Life insurance, disability insurance, and disability buy-out insurance on seller;
  6. Motor vehicles used in connection with the practice;
  7. Any and all tangible and intangible assets used in conjunction with another practice of seller; and
  8. All other assets owned by seller other than those specifically described as items purchased.

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Assessment

The exact items transferred will often depend upon the prior negotiations of the parties.

For example, the parties may have agreed that the accounts receivable will be transferred with the practice. In such an instance, the accounts receivable will be listed as an item to be purchased.

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Conclusion

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Understanding Medical Practice Stock Sale vs. Assets Sale

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Insights for Physician-Focused Financial Advisors

By Dr. Charles F. Fenton III, FACFAS, JD

www.BusinessofMedicalPractice.com

In most cases, healthcare knowledgeable financial advisors [FAs] recommend that the physician buyer of a medical practice solely purchase the assets of the practice and not the stock of the practice itself http://www.CertifiedMedicalPlanner.org

A Risk Reduction Strategy

Why? By purchasing selected assets, the buyer is ensured that he will not become responsible for the known or unknown liabilities of the corporation; thus a risk reduction strategy. In prior days, avoiding purchasing the stock of the corporation was a wise recommendation www.MedicalBusinessAdvisors.com

Enter the Managed Care Era

However, with the advent of managed care, the purchase of the stock of the corporation can provide the new practitioner with certain competitive advantages.

For example, it may take a new practitioner three to nine months to get onto enough managed care panels to make the practice profitable. Purchase of the stock of the corporation ensures the new practitioner of acquiring the Federal tax identification number of the corporate entity.

Assessment

Since most managed care corporations identify providers by the Federal tax identification number, purchase of the stock of the corporation should allow the new practitioner to be enrolled on managed care panels in a shorter period of time. Instead of applying anew to the managed care entity, the new practitioner merely needs to be listed as a new member of a provider already on the managed care panel.

Conclusion

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OSHA and Sharp Medical Instruments

Understanding OSHA Requirements

By Patricia A. Trites; MPA, CHBC, CHCC, CMP™ (Hon)
Dr. Charles F. Fenton, III; JD, FACFAS
Hope Rachel Hetico; RN, MHA, CMP™

The OSHA Standard requires that contaminated needles and other contaminated sharp instruments (sharps) must not be bent, recapped, or removed.

Definition

Contaminated sharps are defined as any contaminated object that can penetrate the skin including, but not limited to: needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires.

Contaminated needles and other contaminated sharps must not be recapped or removed from the syringes unless the employer can demonstrate that no alternative is feasible or that such action is required by a specific medical procedure. Also, shearing or breaking of contaminated needles is prohibited. This would include those instances, such as during surgery, where recapping was necessary due to the need to give multiple injections from the same syringe. If needles are recapped, it must be through the use of a one-handed technique.

Two-Handed Recapping

Two-handed needle recapping is strictly prohibited by the Standard. Recapping of needles can be a very dangerous procedure. It is during recapping that most skin punctures occur.

Immediately, or as soon as possible after use, contaminated reusable sharps must be discarded and placed in appropriate containers until properly reprocessed. The containers must be:

  • puncture resistant;
  • labeled or color-coded; and
  • leak proof on the sides and bottom.

Assessment

Finally, containers must be at the site as close as feasible to the use of the sharps. This will limit the risk of injury during the time the sharp would otherwise have been transported from the site of use to the site of disposal. During use, the sharps container must be maintained upright, not be allowed to be overfilled, and replaced routinely. When moving containers of contaminated sharps from the area of use, the containers must be closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling. The container must be placed in a secondary container if leakage is possible. Reusable containers must not be opened, emptied, or cleaned manually or in any other manner that would expose employees to the risk of percutaneous injury. Physicians can purchase turn-key sharps containers that, when full, can be shipped back to the distributor for proper disposal.

Sharps

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. How has OSHA affected your practice? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Hand Washing for Healthcare Facilities

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Understanding OSHA Standards

[By Dr. David E. Marcinko; FACFAS, MBA, CPHQ, CMP™]

[By Patricia A. Trites; MPA, CHBC, CHCC, CMP™ (Hon)]

The OSHA Standards for healthcare require that hand washing facilities be readily available to employees.

Definition

Hand washing facilities are defined as a facility providing an adequate supply of:

  • running potable water;
  • antiseptic soap; and
  • single-use disposable towels or hot air drying machines.

Location

The hand washing facilities must be located where the employee will have easy access. This will ensure that the employee will be likely to use the hand washing facility and will minimize the time that the contamination will remain in contact with the employee. In those instances where the provision of hand washing facilities is not feasible, either an appropriate antiseptic hand cleaner (e.g., alcohol-based rinse, antiseptic foam, or antiseptic-impregnated paper wipes) in conjunction with clean cloth or paper towels, or antiseptic towelettes, must be provided.

Soap and Running Water

When using antiseptic hand cleansers or towelettes, the hands must be washed with soap and running water as soon as feasible. Not only must the employer provide the hand washing facilities, he or she must also ensure that employees in fact do wash their hands immediately or as soon as feasible following contact with blood or other potentially infectious material [OPIM].

The employee must also wash his or her hands immediately after removal of gloves or other personal protective equipment [PPE]. It is the employer’s responsibility to ensure that hand washing occurs. OSHA states that hand washing must be strictly enforced by the employer.

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Assessment

How has OSHA affected your hospital, medical practice or healthcare facility?

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Conclusion

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OSHA and Workplace Pathogen Control

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Engineering and Medical Work Practice Controls

By Patricia A. Trites; MPA, CHBC, CHCC, CMP™ (Hon)
Dr. Charles F. Fenton, III; JD, FACFAS
Hope Rachel Hetico; RN, MHA, CMP™

Engineering and medical practice controls are methods used to isolate or remove bloodborne pathogen hazards from the workplace. These practices should be used to eliminate or minimize employee exposure by removing the hazard or isolating the employee from the exposure. However, where occupational exposure remains after institution of these controls, personal protective equipment [PPE] must be employed, as described below.

Engineering Controls

Engineering controls can be described as those an employer purchases and makes available to protect his or her employees. Examples are sharps containers, eye-wash stations, spill-kits, and safer needle systems. It is the employer’s responsibility to implement and maintain a system for ensuring engineering that controls are used. The engineering controls must be examined and maintained or replaced on a regular schedule to ensure their effectiveness. Conducting only an annual review of the engineering controls is inappropriate under the OSHA Standard.

Healthcare Work Practice Controls

Unlike engineering controls, healthcare work practice controls depend upon the behavior of the employee to reduce exposure. Examples are hand washing, utilizing universal precautions, and wearing appropriate PPE. Even with properly implemented work practice controls, exposure can still occur. Some of the engineering and work practice controls that must be addressed (if applicable to the specific healthcare organization) within the employee control plan [ECP] include:

  • hand washing facilities and practices,
  • treatment of sharp instruments,
  • separation of food from contamination,
  • certain procedures in the treatment of contamination,
  • sterilization, and
  • care of equipment.

Assessment

These engineering controls must be examined and maintained or replaced on a regular schedule to ensure their effectiveness. Conducting only an annual review of the engineering controls is inappropriate under the OSHA Standard.

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Conclusion

How has OSHA affected your practice? Or, is it so 1999?

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The Federal False Claims Act

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Understanding Qui Tam

[By Dr. Charles F. Fenton III; Esqfenton]  

A civil war era law, titled the False Claims Act (qui tam [in the name of the king]), is increasingly popular with prosecutors who pursue inappropriate billing mishaps by physicians.  

Why the False Claims Act? 

The FCA rose to prominence because in 1990, the healthcare industry accounted for about 10% of all false claims penalties recovered the federal government. By 1998, the healthcare share was almost 40%. Today, it may be even more. 

The “Act”  

The False Claims Act allows a private citizen such as your patient, your employee, or a competing doctor to bring a health care fraud claim against you, on behalf of and in the name of the United States of America. The “relator” who initiates the claim is rewarded by sharing in a percentage of the recovery from the health care provider. 

Essentially, the “Act” allows an informant to receive up to 30% of any judgment recovered against government contractors (Medicare, Medicaid, CHAMPUS, prison systems, American Indian reservations or the VA systems, etc).   

With a low burden of proof, triple damages, and penalties up to $10,000 for each wrongful claims submission, these suits are the enforcement tools of choice for zealous prosecutors pursuing health fraud.   

Assessment  

All that must be proven is that improper claims were submitted with a reckless disregard of the truth. Intentional fraud is irrelevant to these cases, even if submitted by a third party, such as a billing company. 

It is imperative that the attending physicians review all bills before they are submitted to any state of federal agency. The Federal False Claims Act is a federal law that has been on the books since the days of the civil war and which recently has become a tool to battle health care fraud.  

So, what do you think about the Federal FCA?

Conclusion

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