Category: wellness

Celebrating Mother’s Day & Nurses Week Acknowledging The Nurse/Mother & Other Health Care Professionals Whose Work Began & Inspire Project COPE: Coalition On Patient Empowerment

This week’s celebration of “National Nurses’ Week” and the impending celebration Sunday of Mother’s Day is a perfect time to celebrate the career of a nurse and mother whose common sense efforts to take care of her patients and others began and whose insights and example continue to guide and inspire the mission now carried on through PROJECT COPE:  The Coalition on Patient Empowerment:  my mother, Mary Kutina Marcotte Brazda.

Like me, my mother grew up surrounded by health care.  Her father was a dentist who helped found and lead the local community hospital and many other health care services in the region.  His sisters both were nurses with Masters Degrees.  Several other family members were nursing nuns, including some who worked internationally in the efforts of the Catholic nun, Mother Teresa.  Her brother, and subsequently my brother and cousin, became dentists.  Many others on both sides of her, and ultimately my family tree followed family members in to the health care profession, becoming physicians, nurses, occupational therapists, physical therapists, or other health care professionals. In fact I, like one of my sister, was expected to follow in these footsteps and become a physician before my begrudging recognition that an average ability to master scientific book learning and understanding of the intricacies of health care administration and policy could not sufficiently overcome much less skilled practical anatomy abilities diverted me to my current course.

From my earliest memories, I was privileged to experience health care through the eyes of a talented health care provider who viewed herself blessed to work in a profession that she viewed as her vocation.  While she lived, I constantly experienced and witnessed through her and the caregivers she teamed with recurrent and undeniable proof that a deep and abiding love for people and desire to care for patients motivated her and most other nurses, doctors and other health care professionals to join and remain in their professions despite long and often grueling, highly stressful and often underappreciated and under-compensated work.

While mom, like my grandfather and other health care providers I know, never sought accolades and always exhibited great modesty and humility about her contributions, during her life and since her death,  patients and families whose lives she touched frequently share with me stories of her compassionate care and its meaning to their families.  While I treasure each of these stories as valued reminders of the special woman I was blessed to call “Mom,” the following letter from Ralph Simonson that I received as I prepared to celebrate my first Mother’s Day without her two months after her death holds a special place in my heart.  Ralph wrote:

“Subject: Your mother!

My name is Ralph Simonson and I just received a reply from my inquiry to find Mary Kutina! I knew of Loren, since he was somewhere behind me in Great Bend High School. Found him in the internet when looking for Mary. Wrote him a note and asked about her whereabouts and he replied to tell me about her life and your email addresses for me to write to you.

My story is unusual and I know you have never heard of me. In ones old age, you think about your youth and a lot about your life. The summer after I graduated from High School, I contracted polio, 1951. It was late August and of course there was an epidemic back then. I went to the hospital on a Saturday afternoon. Sunday I lost my voice and that is the last I remember for over a week. I had the bulbar type that usually killed you, but if you recovered, you did not usually suffer limb paralysis. The left side of my throat is paralyzed which makes me turn my head to swallow, cannot sing (loved singing in HS), cannot cough and cannot laugh. I have actually survived well and do not notice this much anymore. I just have to watch getting something caught in my throat and if I do, I panic a little since I cannot breathe. I am not complaining, just explaining the situation to you.

I left for college late and had to change schools to get in at the later date. Denver U, which was on the quarter system. Then I finished up at K State. My life proceeded and in the 80’s sometime, I started to hear about “out of body experiences”! I suddenly remembered when I had polio. I received cards from all my friends and after the first week, I read them and it was all news to me. I was in a coma all week and feed intravenously. Fortunately, my father was a business man and had some money. When the seriousness of my condition became known, he hired MARY for my “full time” nurse. He put an A/C in the window and she took care of me.

After 30 some years, I “suddenly” remembered that Wednesday night of the crisis. Believe it or not, the doctors were not on the scene because they did not know what to do and as far as everyone was concerned, it was over and I would not make it. I VIVIDLY REMEMBER BEING ON THE CEILING WATCHING MARY AND MY MOTHER AGGRESSIVELY TENDING TO ME. They were concentrating on getting lemon juice down my throat to keep it clear from the flem that would stop up my breathing. Mary told me later that I was not very nice to my mother by saying bad things about her panic at my condition. I am sure Mary calmed her and kept everything in perspective. She was cool, calm and had things under control. Outwardly at least. I just realized from Loren that she was not a full fledged nurse at that time, but certainly had the training to be an aide, or what ever. I never saw Mary after that. In the last few years, I have thought a lot about that for various reasons. The sad part about it, is that at this very late stage of my life, I realized Mary saved my life and I never thanked her. That thought will never leave me.

I liked your mother and know everyone I have ever talked to has spoken very highly of her. As we age, it is easy to say we all loved her. I hope I have added some good memories of your mom. We never forget our mothers and the older we get, it seems the hungrier we are to hear about their lives. No more words to add that describes my gratitude to Mary Kutina!!!!!

Fondly, Ralph Simonson, Leesburg, Fl. “

Ralph’s experience both beautifully captured the essence of my mother’s tremendous heart and lifelong commitment as a nurse and care provider,.  It also documents the extraordinary power and commitment of the thousands of nurses, physicians and other health care providers that pour their hearts and souls into caring for patients and families in their time of a need that I witnessed across her life, experienced in the years, months, days and final hours before her death from lymphoma and leukemia, and continue to see since.

In a time when cost-motivated government and insurance bean counters constantly attack the professionalism and motives of these critical caregivers, my mother’s example and story reminds us to resist with skepticism those who seek to manage the care out of health care by slurring the motives and professionalism of the physicians, nurses and other health care professionals that work in the trenches to make it work.

A nurse for more than 55 years in the small rural community where she was born and lived most of her life, mom breathed caring whether working as a nurse or living her after hours life as mother, daughter, sister, and neighbor.  Since she cared, she constantly cared for people.

People were mom’s thing.  Her childhood friends remember her as the confident, friendly and fun-loving daughter  of a prominent founding family and the local dentist.  Known for her warm and genuine friendliness and special ability to empathize with and put almost anyone at ease,  she was liked by, and liked everyone regardless of status or condition.

Highly popular, and blessed with an insatiable ability to see and find the good in every experience and every person, her friendly and confident smile allowed few to suspect that she suffered from such severe dyslexia that she didn’t master the alphabet until Fourth Grade.  Her resulting empathy learned from her own learning difficulties invested her with a unique ability to recognize, empathize with and help others with learning or other disabilities throughout her life even after  she overcame her learning challenges to earn her nursing degrees and other subsequently earned advanced education.

In her youth and across her life, her lack of acknowledgement of the significance of her own challenges as compared to others that she knew meant they went unknown and unacknowledged by others.  Instead, people saw her for what she was:  a blessed and confident young woman from a good family who always embraced life and people with an unbridled enthusiasm whether playing sports and music, dancing, singing, organizing gatherings at the lake or volunteering on health, church and other community projects.

Her extraordinary people skills, bright mind, and can-do enthusiasm allowed her to excel at sports, music, and life throughout her youth and collegiate studies.  Although initially drawn to teach physical education, she ultimately pursued a career that was her vocation in nursing.  After fully enjoying several years of college, she returned home to attend attend nurses training.

For 60 plus years after she became an R.N,  mom lived her nursing vocation by caring for patients in public health, hospital, home health and school nursing.  While she loved caring for patients is all contexts, she was particularly passionate about public health and school nursing.

After graduating nursing training, she spent several years delivering basic health care, education and social services to underprivileged families as the county public health nurse.  In the 1950’s when she began her career, the county nurse functioned as both health care provider and social worker.  She and other county nurses spent a large portion of their time traveling throughout the county making “house calls” on rural residents.  While closely coordinating with the area physician(s), county nurses like mom  often provided the primary care if not the only health care many rural families received and coordinated the health care and social services that most of these families received from other caregivers.  A big part of her work involved making house calls to rural families around the county.  Many of the families she cared for were poor and possessed limited education.  She quickly learned effectively delivering health care required a holistic understanding and care of the patient and his or her family and circumstances.

After working several years in the health department, mom reluctantly left her job at my father’s urging as the birth of her second child approached to a stay at home to mother  her growing brood.  During her time as away from her career, however, she was not the typical stay at home mother.  Instead, she swept up and brought along her growing brood of five children as she continued to make volunteer house calls on many area families, and organized and volunteered her services for a multitude of health and other community  projects and fund raisers in her church and the community.

By her mid-thirties, however, my father’s advancing terminal cancer prompted her to return to the regular workforce as a night nurse working in the intensive care unit of the local Catholic hospital where she completed her nurses training.  Along with performing the technical aspects of hospital nursing, her patients and their families often share stories of her listening and helping to troubleshoot problems, bringing meals or treats for family members, fixing patients hair or makeup, sitting with frightened or lonely patients or family member and other acts of spiritual nurturing and compassion that made their hospital experiences more bearable. Because even in the 1960’s hospital administration often complained about nursing staff “wasting” time to perform these acts of special care or compassion for patients, many don’t realize mom often arrived early or stayed after her shift to fit in this compassionate care around her family responsibilities of caring for her dying husband and five children aged 2 months to 10 years of age and various elderly members of the community.  More than once, she shared her confusion about hospital “Administration” questioning the necessity of  her efforts and time  spent comforting frightened or lonely patients during those long hospital nights commenting, “Listening to and calming the fears of a sick or dying patient is caring for the patient.”

Shortly following my father’s death in 1968 and while continuing to raise her five children as a single mother, mom had the opportunity to return to public health nursing.  She rejoined the county health department where along with checking and delivering care through a stream of house calls, administering free health screening and immunizations, coordinating and responding to public health outbreaks, and other aspects of administering and running the health department, mom also expanded the department’s programs to meet new needs she identified in the course of her work.  She was responsible for initiating and coordinating a wide range of preschool and other health screening, charity care, health education, nutrition, prevention and other programs.

A few years later, the local school board invited her to become the district’s school nurse.  As her school nursing hours followed the school schedule of her children, the position offered her the opportunity to continue her public health work with a schedule more suited to her home duties as a single mom.  The offer came with a key condition however.   At the time of the offer, mom was a non-degreed “Registered Nurse” or “R.N.”  Although she completed more than five years of college before attending nursing school, she had not earned a Bachelors Degree in Nursing at the time of the offer.  The job technically required a Bachelors Degree in Nursing in addition to her R.N. credentials.  Familiar with her personality and public health experience, the school board believed she nevertheless was the right woman for the job.  Consequently, the board offered her the position subject to the contingency that she earn her Bachelors Degree in Nursing within two years.

Accordingly, during her initial two years at the school district, mom returned college to complete her Bachelors of Science in Nursing.  Earning her degree at night in the rural community where we lived was no easy feat as the community college at the time did not offer a Bachelors Degree in Nursing.  Consequently, along with the normal challenges of fitting in homework and classes around working full-time and caring for her five children, attending classes required that she commute more than an hour each way across dark, usually empty and often icy Kansas prairie highways to the closest university offering the requisite nursing degree.

To fit everything in and to accommodate her lifelong dyslexia challenges, she “let” my siblings and me read her assignments to her as she drove or performed household duties and took one of us along for the trip to each class.  After finishing her B.S., she continued to take us along as she completed her Masters Degree in Counseling, her Emergency Medicine Technician (EMT) certification and a long list of advanced studies and certification in nutrition, development, diagnosis and assessment, learning disabilities, public health and a host other various other advanced degrees and certifications.  The process infused us with both extraordinary reading skills, an acceptance of staying busy and juggling busy schedules as “normal,” a broad understanding of many aspects of nursing and other aspects of health care and a life long hunger for learning and education.  Somehow, attending class, studying and volunteering with mom always seemed like a treat rather than an obligation.

Throughout it all, mom never stopped seeing or caring for people and never accepted a lack of district or county funding or other resources as an excuse for letting a need go unaddressed.  “No” and “can’t”weren’t in her vocabulary when someone in her care needed care.

While pursuing her education and for the remainder of her life, mom continued to push to improve and expand school and community health programs along with continuing to perform her original school nursing responsibilities.  She expanded the preschool screening program, founded and administered scoliosis, educational disabilities and other screening,  school nutrition, pregnancy prevention and support, and other school health programs.

She also helped organize local doctors and other health care providers to run health fairs and provide free or reduced cost charity care for low income families.  She recruited local community organizations to pay for food and other supplies, eyeglasses, hearing aids and other resources.

Horrified when a child she knew had to undergo surgery as a result of late-diagnosed scoliosis, she took training and founded one the first comprehensive school-based scoliosis screening programs in the nation.  Across the years, she expanded her training, implemented screening and intervention programs, and developed and connected extensive people, knowledge and other resources to identify and mitigate nutrition and hunger, mental health, educational and development disorders and a multitude of  other health challenges impacting her students and their families.

Across these years she also volunteered her services on community and public advocacy activities. Our social life usually involved participating in fun, but service directed church and community activities where having “fun” working for the cause was a way of life.  She also involved us and hundreds of others in advocacy activities seeking to educate and encourage local, state and federal officials to understand and improve health and disability funding and services.

When the State’ Medicaid funding rules obstructed her ability to get children care or other services by failing to fund care or the cost of transportation of her kids the two hours to the big city where the specialists needed practiced, mom conceived, coordinated and initially self-funded, and then eventually convinced local community agencies, churches and business leaders to pay for the needed transportation and cost of care to get the children diagnosed or treated.  She talked the Lions Club, ELKS Club, American Legion, Chamber of Commerce, local physicians and churches and anyone else she could think of to sponsor screenings and care for her kids and their families.

When community fear lead to community backlash and exclusion against a local child infected from a blood transfusion with the HIV virus and his family, mom joined others working with the Kansas legislature to enact legislation protecting students with HIV/AIDs from discrimination in school.  Across the years, she also worked on school nursing delegation, home health, under served community and other health funding, and a host of other key community health reforms.

Through it all, mom always recognized the importance of nurturing the spirit as well as the physical body of those under her care.   Beyond addressing the physical needs of these victims, she cared for people by welcoming them into her office, her home, and her life.

Patients and family that knew she dealt with all patients with judgment free kindness, trustworthiness and patience that acknowledged and preserved their dignity and trust.  No matter how much she had on her plate, mom was never too busy to listen and observe.  Patients, families and others rewarded these efforts by giving her their trust, often opening up to share concerns, fears and information they never would have considered discussing with others.

In the course of her 60 plus year career, mom reported, investigated and testified in thousands of bullying and spousal and child abuse and neglect cases.  While some of the circumstances she reported resulted in criminal or child protective services actions, her action, understanding of the human challenges of poverty, ignorance and other contributing causes of these risks and her practical approach to working with families and community resources and counseling resulted in timely intervention that that prevented or resolved many more potential situations before a child could be harmed.

Across my lifetime, I have heard thousands of stories of how mom cured stress-induced stomach and headaches with a well-timed listening ear and hug, time out or nap in her office, snack, or confidence infusing invitation to participate.

Her calendar was never too busy to listen and comfort a sick, embarrassed or anxious student, parent or staff member.  They were all her people and she was theirs.

Mom’s seemingly bottomless, pocket-ridden purse was famous for its Mary Poppins’ like capacity to hold and subtly produce as needed a fig newton bar, cheese or raisin snack, bandages, soap and wash cloth, personal hygiene items or encouraging reward or sticker.

She once arranged for all seventh grade girls participate in a grooming class conducted by beauty contestant and receive soap and other beauty supplies donated by a local salon to address complaints about the unwashed smells of three class members from underprivileged families without singling them out.

Her office, car and our home always had a collection of new or nearly new clothing and personal care items  she collected and kept available to use to rescue poor children from the stigma and bullying that they often experience because their circumstances leaves them  poorly washed or dressed.

Her purse, desk and car always had a snack for a child who went without breakfast.

Fifty plus years later and diagnosed with leukemia and lymphoma, mom eventually retired from the school district.  Around the age of 68, she started the next phase of her heath care career.  While negotiating the remaining decade of her life as terminally ill, she enjoyed an amazingly productive “retirement” discretely making health care house calls on aging and disabled members of her community under the guise of applying her newly acquired Cosmetology, massage, nutrition and Reiki credentials alongside her advanced nursing, counseling, public health and psychology professional degrees and credentials.

At 76 and toting along her oxygen tank, she joyfully drove her van to do a haircut, massage and health check on the 80 year old neighbor with Parkinson’s Disease, the church member with dementia, and countless others between attending her own chemotherapy and doctors visits.

Like most of our nation’s hard-working physicians, nurses, physicians assistants, nurse practitioners, physical therapists, occupational therapists, and other health care providers, caring for people was not a job for my mother: it was a vocation chosen based on a genuine love of and desire to care for people.

Mom also knew that great health care requires teamwork.  She was proud to be a nurse and respected the fellow nurses, physicians and other members of the health care team she worked with as indispensable and valued teammates.  She viewed their roles as essentially synergistic rather than competitive.  She understood that the effective delivery of quality health care generally requires the knowledge, teamwork and communication between physicians, nurses, and others on the treatment team, as well as the patient, their family and others within the community.

She never forgot that effective health care involves much more than the mere science and technical delivery of health care.  She recognized that health care starts and ends with seeing, listening to and caring for the whole patient taking into account the situation where the patient is at the time without judging how they got there.

Most of all, however, she never forgot that health care starts and ends with caring for people.

While lacking the operational talents to carry on my mother’s work as a nurse, physician or other direct care provider, I am privileged to witness and support thousands of physicians, nurses, therapists and other caregivers in the course of my work every year.  Physicians and nurses I know regularly provide free care and hunt resources for a multitude of uninsured or underinsured patients.  Others advocate for patients and their families afflicted with confusing and intractable health conditions to find answers and solutions.  All listen.

Just a few weeks ago, a physician visiting my family on vacation stepped in to counsel a stranger we encountered at church, who was worried about his uninsured grandmother’s unwillingness to seek medical care for her dangerously high blood pressure.  A nurse and EMT attending a sporting event sprung without thought to action when a rider suffered a serious head injury in the course of the event.

While limited and overextended resources continue to challenge their efforts, my experience overwhelmingly affirms that virtually all of these health care professionals, like my mother, are highly skilled, trustworthy and caring professionals motivated by a genuine desire and commitment to caring for patients, rather than the greed or other unsavory motivations often unfairly attributed to them.  They work long hours.  They endure ever-increasing paperwork, regulation and constricted resources.  They fight to care for patients at work, as well as often spend their “off” time helping patients or others in the community.  They earn and deserve our respect, trust and support.

Today, cost-containment motivated and technology star-struck government and insurance leaders perpetually seek to diminish the need for patient care, dehumanize care, divide and destroy teamwork between caregivers, and vilify nurses, physicians, and other health care providers in the name of the all mighty dollar and self-aggrandizement of their own importance.

Amid these attacks, we all must heed the reminders that the experiences of Ralph and other patients who depend upon our nations’ health care providers like my mother provided to deliver care for their physical and other needs during the critical health care moments of their lives.  We need to celebrate their work and defend their ability to deliver the caring health care we and our families need and should expect as we face our own health care crises ahead.

We all know nurses, physicians and other health care providers that go the extra mile to care for our families, often at the expense of time with their own.  Who’s your health care hero?  Help keep real health care alive by celebrating, thanking, encouraging and standing up for the caring nurses, physicians, therapists and other health care providers that keep the caring in health care.  Stand up against those who unfairly besmirch them and their work.  Celebrate them by sharing their story in the comments below.  Support them in their efforts to preserve and protect their ability to care for patients and their families!

About The Author

Recognized by LexisNexis® Martindale-Hubbell® as a “AV-Preeminent” (Top 1%/ the highest) and “Top Rated Lawyer,” with special recognition  as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Health Care,” “Labor & Employment,” “Tax: Erisa & Employee Benefits”  and “Business and Commercial Law” by D Magazine, the author of this update is widely known for her 29 plus years’ of work in health care, health benefit, health policy and regulatory affairs and other health industry concerns as a practicing attorney and management consultant, thought leader, author, public policy advocate and lecturer.

Throughout her adult life and nearly 30-year legal career, Ms. Stamer’s legal, management and governmental affairs work has focused on helping health industry, health benefit and other organizations and their management use the law, performance and risk management tools and process to manage people, performance, quality, compliance, operations and risk. Highly valued for her rare ability to find pragmatic client-centric solutions by combining her detailed legal and operational knowledge and experience with her talent for creative problem-solving, Ms. Stamer supports these organizations and their leaders on both a real-time, “on demand” basis as well as outsourced operations or special counsel on an interim, special project, or ongoing basis with strategic planning and product and services development and innovation; workforce and operations management,  crisis preparedness and response as well as to prevent, stabilize and cleanup legal and operational crises large and small that arise in the course of operations. Her experience encompasses  helping health industry clients manage workforce, medical staff, vendors and suppliers, medical billing, reimbursement, claims and other provider-payer relations, business partners, and their recruitment, performance, discipline, compliance, safety, compensation, benefits, and training; board, medical staff and other governance;   compliance and internal controls; strategic planning, process and quality improvement; change management;  assess, deter, investigate and address staffing, quality, compliance  and other performance;  meaningful use, EMR, HIPAA and other data security and breach and other health IT and data; crisis preparedness and response; internal, government and third-party reporting, audits, investigations and enforcement; government affairs and public policy; and other compliance and risk management, government and regulatory affairs and operations concerns.

The American Bar Association (ABA) International Section Life Sciences Committee Vice Chair, a Scribe for the ABA Joint Committee on Employee Benefits (JCEB) Annual OCR Agency Meeting, former Vice President of the North Texas Health Care Compliance Professionals Association, past Chair of the ABA Health Law Section Managed Care & Insurance Section, past ABA JCEB Council Representative, past Board President of Richardson Development Center (now Warren Center) for Children Early Childhood Intervention Agency, past North Texas United Way Long Range Planning Committee Member, and past Board Member and Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has worked closely with a diverse range of physicians, hospitals and healthcare systems, DME, Pharma, clinics, health care providers, managed care, insurance and other health care payers, quality assurance, credentialing, technical, research, public and private social and community organizations, and other health industry organizations and their management deal with governance; credentialing, patient relations and care; staffing, peer review, human resources and workforce performance management; outsourcing; internal controls and regulatory compliance; billing and reimbursement; physician, employment, vendor, managed care, government and other contracting; business transactions; grants; tax-exemption and not-for-profit; licensure and accreditation; vendor selection and management; privacy and data security; training; risk and change management; regulatory affairs and public policy and other concerns.

As a core component of her work,  Ms. Stamer has worked extensively throughout her career with health care providers, health plans and insurers, managed care organizations, health care clearinghouses, their business associates, employers, banks and other financial institutions, management services organizations, professional associations, medical staffs, accreditation agencies, auditors, technology and other vendors and service providers, and others on legal and operational compliance, risk management and compliance, public policies and regulatory affairs, contracting, payer-provider, provider-provider, vendor, patient, governmental and community relations and matters including extensive involvement advising, representing and defending public and private hospitals and health care systems; physicians, physician organizations and medical staffs; specialty clinics and pharmacies; skilled nursing, home health, rehabilitation and other health care providers and facilities; medical staff, accreditation, peer review and quality committees and organizations; billing and management services organizations; consultants; investors; technology, billing and reimbursement and other services and product vendors; products and solutions consultants and developers; investors; managed care organizations, insurers, self-insured health plans and other payers; and other health industry clients to establish and administer compliance and risk management policies; comply with requirements, investigate and respond to Board of Medicine, Health, Nursing, Pharmacy, Chiropractic, and other licensing agencies, Department of Aging & Disability, FDA, Drug Enforcement Agency, OCR Privacy and Civil Rights, Department of Labor, IRS, HHS, DOD, FTC, SEC, CDC and other public health, Department of Justice and state attorneys’ general and other federal and state agencies; JCHO and other accreditation and quality organizations; private litigation and other federal and state health care industry investigation, enforcement including  insurance or other liability management and allocation; process and product development, contracting, deployment and defense; evaluation, commenting or seeking modification of regulatory guidance, and other regulatory and public policy advocacy; training and discipline; enforcement, and a host of other related concerns for public and private health care providers, health insurers, health plans, technology and other vendors, employers, and others.and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns.

Past Chair of the ABA Managed Care & Insurance Interest Group and, a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also has extensive health care reimbursement and insurance experience advising and defending health care providers, payers, and others about Medicare, Medicaid, Medicare and Medicaid Advantage, Tri-Care, self-insured group, association, individual and group and other health benefit programs and coverages including but not limited to advising public and private payers about coverage and program design and documentation, advising and defending providers, payers and systems and billing services entities about systems and process design, audits, and other processes; provider credentialing, and contracting; providers and payer billing, reimbursement, claims audits, denials and appeals, coverage coordination, reporting, direct contracting, False Claims Act, Medicare & Medicaid, ERISA, state Prompt Pay, out-of-network and other nonpar insured, and other health care claims, prepayment, post-payment and other coverage, claims denials, appeals, billing and fraud investigations and actions and other reimbursement and payment related investigation, enforcement, litigation and actions.

Heavily involved in health care and health information technology, data and related process and systems development, policy and operations innovation and a Scribe for ABA JCEB annual agency meeting with OCR for many years who has authored numerous highly regarded works and training programs on HIPAA and other data security, privacy and use, Ms. Stamer also is widely recognized for her extensive work and leadership on leading edge health care and benefit policy and operational issues including meaningful use and EMR, billing and reimbursement, quality measurement and reimbursement, HIPAA, FACTA, PCI, trade secret, physician and other medical confidentiality and privacy, federal and state data security and data breach and other information privacy and data security rules and many other concerns.  Her work includes both regulatory and public policy advocacy and thought leadership, as well as advising and representing a broad range of health industry and other clients about policy design, drafting, administration, business associate and other contracting,  risk assessments, audits and other risk prevention and mitigation, investigation, reporting, mitigation and resolution of known or suspected violations or other incidents and responding to and defending investigations or other actions by plaintiffs, DOJ, OCR, FTC, state attorneys’ general and other federal or state agencies, other business partners, patients and others.

Ms. Stamer  also works extensively with health care providers and organizations, legislative and regulatory bodies, health plans, communities and others on health care access, quality, affordability and other process improvement and risk management, aging, disability, education and other related legal and operational concerns, management, and education.  Her work includes the establishment and reform of standards, processes and procedures,  documentation, implementation, audit and enforcement of policies, procedures, systems and safeguards, investigating, and addressing and responding to emerging and other crises and issues,  training and enforcement, and a host of other related concerns. Her clients include public and private health care providers, health insurers, health plans, technology and other vendors, government and community agencies and others.

A former lead consultant to the Government of Bolivia on its Pension Privatization Project with extensive domestic and international public policy and governmental and regulatory affairs experience, Ms. Stamer also is widely recognized for regulatory and policy work, advocacy and outreach on healthcare, education, aging, disability, savings and retirement, workforce, ethics, and other policies.  Throughout her adult life and career, Ms. Stamer has provided thought leadership; policy and program design, statutory and regulatory development design and analysis; drafted legislation, proposed regulations and other guidance, position statements and briefs, comments and other critical policy documents; advised, assisted and represented health care providers, health plans and insurers, employers, professional. and trade associations, community and government leaders and others on health care, health, pension and retirement, workers’ compensation, Social Security and other benefit, insurance and financial services, tax, workforce, aging and disability, immigration, privacy and data security and a host of other international and domestic federal, state and local public policy and regulatory reforms through her involvement and participation in numerous client engagements, founder and Executive Director of the Coalition for Responsible Health Policy and its PROJECT COPE: the Coalition on Patient Empowerment, adviser to the National Physicians Congress for Healthcare Policy, leadership involvement with the US-Mexico Chamber of Commerce, the Texas Association of Business, the ABA JCEB, Health Law, RPTE, Tax, Labor, TIPS, International Life Sciences, and other Sections and Committees, SHRM Governmental Affairs Committee and a host of other  involvements and activities.

A popular lecturer and widely published author on health industry concerns, Ms. Stamer continuously advises health industry clients about compliance and internal controls, workforce and medical  staff performance, quality, governance, reimbursement, privacy and data security, and other risk management and operational matters. Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns. Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.

A Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also shares her thought leadership, experience and advocacy on these and other related concerns by her service in the leadership of the Solutions Law Press, Inc. Coalition for Responsible Health Policy, its PROJECT COPE:  Coalition on Patient Empowerment, and a broad range of other professional and civic organizations including North Texas Healthcare Compliance Association, a founding Board Member and past President of the Alliance for Healthcare Excellence, past Board Member and Board Compliance Committee Chair for the National Kidney Foundation of North Texas; former Board President of the early childhood development intervention agency, The Richardson Development Center for Children (now Warren Center For Children);  current Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee, current Vice Chair of Policy for the Life Sciences Committee of the ABA International Section, Past Chair of the ABA Health Law Section Managed Care & Insurance Section, a current Defined Contribution Plan Committee Co-Chair, former Group Chair and Co-Chair of the ABA RPTE Section Employee Benefits Group, past Representative and chair of various committees of ABA Joint Committee on Employee Benefits; a ABA Health Law Coordinating Council representative, former Coordinator and a Vice-Chair of the Gulf Coast TEGE Council TE Division, past Chair of the Dallas Bar Association Employee Benefits & Executive Compensation Committee, a former member of the Board of Directors of the Southwest Benefits Association and others.

Ms. Stamer also is a highly popular lecturer, symposium and chair, faculty member and author, who publishes and speaks extensively on health and managed care industry, human resources, employment and other privacy, data security and other technology, regulatory and operational risk management. Examples of her many highly regarded publications on these matters include “Protecting & Using Patient Data In Disease Management: Opportunities, Liabilities And Prescriptions,” “Privacy Invasions of Medical Care-An Emerging Perspective,” “Cybercrime and Identity Theft: Health Information Security: Beyond HIPAA,” as well as thousands of other publications, programs and workshops these and other concerns for the American Bar Association, ALI-ABA, American Health Lawyers, Society of Human Resources Professionals, the Southwest Benefits Association, the Society of Employee Benefits Administrators, the American Law Institute, Lexis-Nexis, Atlantic Information Services, The Bureau of National Affairs (BNA), InsuranceThoughtLeaders.com, Benefits Magazine, Employee Benefit News, Texas CEO Magazine, HealthLeaders, the HCCA, ISSA, HIMSS, Modern Healthcare, Managed Healthcare, Institute of Internal Auditors, Society of CPAs, Business Insurance, Employee Benefits News, World At Work, Benefits Magazine, the Wall Street Journal, the Dallas Morning News, the Dallas Business Journal, the Houston Business Journal, and many other symposia and publications. She also has served as an Editorial Advisory Board Member for human resources, employee benefit and other management focused publications of BNA, HR.com, Employee Benefit News, Insurance Thought Leadership and many other prominent publications and speaks and conducts training for a broad range of professional organizations.

For more information about Ms. Stamer or her health industry and other experience and invlvements, see here or contact Ms. Stamer via telephone at (469) 767-8872 or via e-mail here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources here such as

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating  your profile here.

©2018 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™  All other rights reserved.   For information about republication or other use, please contact Ms. Stamer here.

Becoming & Caring For Antique People: A Privilege We All Hope To Experience

Lucky people live long enough to experience caring for beloved aging family or friends, then living through old age.

It’s a privilege most people look fondly forward to and take for granted until something happens that causes them to realize the mixed truth:

Living a long life usually is a blessing that comes with some challenges and costs for those that survive to enjoy it and their caregivers.

Some are the natural consequences of aging, like those humorously shared by 72-year old Mary Maxwell in this video perspective on aging.

While keeping in mind the alternative can help those living through the process cope, the emotional, physical, financial and other wear and tear of being or caring for the elderly is often exhausting. The strain and stress often robs those living with the aging process of their opportunity to enjoy its privilege until too late.

For those of us around them, celebrate the aging experience by helping when you can.

Caring for or living with old age is not something government can handle. While money helps with somethings, the human reality is universal and transcends mere money. Mindless institutionalization of old people absent a purpose for them and the involvement of caring family, friends, caregivers and community wastes the value. The elderly become prisoners trapped in bodies tracked and administered as objects rather than enjoyed and protected as the priceless treasures they’ve become through their life experiences.

Family, friends and communities living and caring for the elderly should always strive to remember having and caring for elderly people is a privilege.

Never forget that getting or knowing someone old is a privilege only a select few enjoy for a limited time.

Celebrate, support and enjoy it by participating. Treat yourself by visiting with the elderly. You’ll be amazed the treasures of history, life wisdom and self discovery you’ll gain.

Volunteer to help with caregiving or help caregivers out by taking on other tasks to give them more time.

Advocate for policies and community efforts that understand, recognize the value of our aging community members.

Your efforts not only benefit the elderly and those caring for them today. They are the foundation for deciding how you and your loved ones will be supported when and if you sometime get to enjoy the privilege of being or caring for a loved one who lives to become old.

About The Author

Recognized by LexisNexis® Martindale-Hubbell® as a “AV-Preeminent” (Top 1%/ the highest) and “Top Rated Lawyer,” with special recognition  as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Health Care,” “Labor & Employment,” “Tax: Erisa & Employee Benefits”  and “Business and Commercial Law” by D Magazine, the author of this update is widely known for her 29 plus years’ of work in health care, health benefit, health policy and regulatory affairs and other health industry concerns as a practicing attorney and management consultant, thought leader, author, public policy advocate and lecturer.

Throughout her adult life and nearly 30-year legal career, Ms. Stamer’s legal, management and governmental affairs work has focused on helping health industry, health benefit and other organizations and their management use the law, performance and risk management tools and process to manage people, performance, quality, compliance, operations and risk. Highly valued for her rare ability to find pragmatic client-centric solutions by combining her detailed legal and operational knowledge and experience with her talent for creative problem-solving, Ms. Stamer supports these organizations and their leaders on both a real-time, “on demand” basis as well as outsourced operations or special counsel on an interim, special project, or ongoing basis with strategic planning and product and services development and innovation; workforce and operations management,  crisis preparedness and response as well as to prevent, stabilize and cleanup legal and operational crises large and small that arise in the course of operations. Her experience encompasses  helping health industry clients manage workforce, medical staff, vendors and suppliers, medical billing, reimbursement, claims and other provider-payer relations, business partners, and their recruitment, performance, discipline, compliance, safety, compensation, benefits, and training ;board, medical staff and other governance;   compliance and internal controls; strategic planning, process and quality improvement; change management;  assess, deter, investigate and address staffing, quality, compliance  and other performance;  meaningful use, EMR, HIPAA and other data security and breach and other health IT and data; crisis preparedness and response; internal, government and third-party reporting, audits, investigations and enforcement; government affairs and public policy; and other compliance and risk management, government and regulatory affairs and operations concerns.

The American Bar Association (ABA) International Section Life Sciences Committee Vice Chair, a Scribe for the ABA Joint Committee on Employee Benefits (JCEB) Annual OCR Agency Meeting, former Vice President of the North Texas Health Care Compliance Professionals Association, past Chair of the ABA Health Law Section Managed Care & Insurance Section, past ABA JCEB Council Representative, past Board President of Richardson Development Center (now Warren Center) for Children Early Childhood Intervention Agency, past North Texas United Way Long Range Planning Committee Member, and past Board Member and Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has worked closely with a diverse range of physicians, hospitals and healthcare systems, DME, Pharma, clinics, health care providers, managed care, insurance and other health care payers, quality assurance, credentialing, technical, research, public and private social and community organizations, and other health industry organizations and their management deal with governance; credentialing, patient relations and care; staffing, peer review, human resources and workforce performance management; outsourcing; internal controls and regulatory compliance; billing and reimbursement; physician, employment, vendor, managed care, government and other contracting; business transactions; grants; tax-exemption and not-for-profit; licensure and accreditation; vendor selection and management; privacy and data security; training; risk and change management; regulatory affairs and public policy and other concerns.

As a core component of her work,  Ms. Stamer has worked extensively throughout her career with health care providers, health plans and insurers, managed care organizations, health care clearinghouses, their business associates, employers, banks and other financial institutions, management services organizations, professional associations, medical staffs, accreditation agencies, auditors, technology and other vendors and service providers, and others on legal and operational compliance, risk management and compliance, public policies and regulatory affairs, contracting, payer-provider, provider-provider, vendor, patient, governmental and community relations and matters including extensive involvement advising, representing and defending public and private hospitals and health care systems; physicians, physician organizations and medical staffs; specialty clinics and pharmacies; skilled nursing, home health, rehabilitation and other health care providers and facilities; medical staff, accreditation, peer review and quality committees and organizations; billing and management services organizations; consultants; investors; technology, billing and reimbursement and other services and product vendors; products and solutions consultants and developers; investors; managed care organizations, insurers, self-insured health plans and other payers; and other health industry clients to establish and administer compliance and risk management policies; comply with requirements, investigate and respond to Board of Medicine, Health, Nursing, Pharmacy, Chiropractic, and other licensing agencies, Department of Aging & Disability, FDA, Drug Enforcement Agency, OCR Privacy and Civil Rights, Department of Labor, IRS, HHS, DOD, FTC, SEC, CDC and other public health, Department of Justice and state attorneys’ general and other federal and state agencies; JCHO and other accreditation and quality organizations; private litigation and other federal and state health care industry investigation, enforcement including  insurance or other liability management and allocation; process and product development, contracting, deployment and defense; evaluation, commenting or seeking modification of regulatory guidance, and other regulatory and public policy advocacy; training and discipline; enforcement, and a host of other related concerns for public and private health care providers, health insurers, health plans, technology and other vendors, employers, and others.and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns.

Past Chair of the ABA Managed Care & Insurance Interest Group and, a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also has extensive health care reimbursement and insurance experience advising and defending health care providers, payers, and others about Medicare, Medicaid, Medicare and Medicaid Advantage, Tri-Care, self-insured group, association, individual and group and other health benefit programs and coverages including but not limited to advising public and private payers about coverage and program design and documentation, advising and defending providers, payers and systems and billing services entities about systems and process design, audits, and other processes; provider credentialing, and contracting; providers and payer billing, reimbursement, claims audits, denials and appeals, coverage coordination, reporting, direct contracting, False Claims Act, Medicare & Medicaid, ERISA, state Prompt Pay, out-of-network and other nonpar insured, and other health care claims, prepayment, post-payment and other coverage, claims denials, appeals, billing and fraud investigations and actions and other reimbursement and payment related investigation, enforcement, litigation and actions.

Heavily involved in health care and health information technology, data and related process and systems development, policy and operations innovation and a Scribe for ABA JCEB annual agency meeting with OCR for many years who has authored numerous highly-regarded works and training programs on HIPAA and other data security, privacy and use, Ms. Stamer also is widely recognized for her extensive work and leadership on leading edge health care and benefit policy and operational issues including meaningful use and EMR, billing and reimbursement, quality measurement and reimbursement, HIPAA, FACTA, PCI, trade secret, physician and other medical confidentiality and privacy, federal and state data security and data breach and other information privacy and data security rules and many other concerns.  Her work includes both regulatory and public policy advocacy and thought leadership, as well as advising and representing a broad range of health industry and other clients about policy design, drafting, administration, business associate and other contracting,  risk assessments, audits and other risk prevention and mitigation, investigation, reporting, mitigation and resolution of known or suspected violations or other incidents and responding to and defending investigations or other actions by plaintiffs, DOJ, OCR, FTC, state attorneys’ general and other federal or state agencies, other business partners, patients and others.

Ms. Stamer has worked extensively with health care providers, health plans, health care clearinghouses, their business associates, employers and other plan sponsors, banks and other financial institutions, and others on risk management and compliance with HIPAA, FACTA, trade secret and other information privacy and data security rules, including the establishment, documentation, implementation, audit and enforcement of policies, procedures, systems and safeguards, investigating and responding to known or suspected breaches, defending investigations or other actions by plaintiffs, OCR and other federal or state agencies, reporting known or suspected violations, business associate and other contracting, commenting or obtaining other clarification of guidance, training and enforcement, and a host of other related concerns. Her clients include public and private health care providers, health insurers, health plans, technology and other vendors, and others. In addition to representing and advising these organizations, she also has conducted training on Privacy & The Pandemic for the Association of State & Territorial Health Plans, as well as HIPAA, FACTA, PCI, medical confidentiality, insurance confidentiality and other privacy and data security compliance and risk management for Los Angeles County Health Department, MGMA, ISSA, HIMMS, the ABA, SHRM, schools, medical societies, government and private health care and health plan organizations, their business associates, trade associations and others.

A former lead consultant to the Government of Bolivia on its Pension Privatization Project with extensive domestic and international public policy and governmental and regulatory affairs experience, Ms. Stamer also is widely recognized for regulatory and policy work, advocacy and outreach on healthcare, education, aging, disability, savings and retirement, workforce, ethics, and other policies.  Throughout her adult life and career, Ms. Stamer has provided thought leadership; policy and program design, statutory and regulatory development design and analysis; drafted legislation, proposed regulations and other guidance, position statements and briefs, comments and other critical policy documents; advised, assisted and represented health care providers, health plans and insurers, employers, professional. and trade associations, community and government leaders and others on health care, health, pension and retirement, workers’ compensation, Social Security and other benefit, insurance and financial services, tax, workforce, aging and disability, immigration, privacy and data security and a host of other international and domestic federal, state and local public policy and regulatory reforms through her involvement and participation in numerous client engagements, founder and Executive Director of the Coalition for Responsible Health Policy and its PROJECT COPE: the Coalition on Patient Empowerment, adviser to the National Physicians Congress for Healthcare Policy, leadership involvement with the US-Mexico Chamber of Commerce, the Texas Association of Business, the ABA JCEB, Health Law, RPTE, Tax, Labor, TIPS, International Life Sciences, and other Sections and Committees, SHRM Governmental Affairs Committee and a host of other  involvements and activities.

A popular lecturer and widely published author on health industry concerns, Ms. Stamer continuously advises health industry clients about compliance and internal controls, workforce and medical  staff performance, quality, governance, reimbursement, privacy and data security, and other risk management and operational matters. Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns. Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.

A Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also shares her thought leadership, experience and advocacy on these and other related concerns by her service in the leadership of the Solutions Law Press, Inc. Coalition for Responsible Health Policy, its PROJECT COPE:  Coalition on Patient Empowerment, and a broad range of other professional and civic organizations including North Texas Healthcare Compliance Association, a founding Board Member and past President of the Alliance for Healthcare Excellence, past Board Member and Board Compliance Committee Chair for the National Kidney Foundation of North Texas; former Board President of the early childhood development intervention agency, The Richardson Development Center for Children (now Warren Center For Children);  current Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee, current Vice Chair of Policy for the Life Sciences Committee of the ABA International Section, Past Chair of the ABA Health Law Section Managed Care & Insurance Section, a current Defined Contribution Plan Committee Co-Chair, former Group Chair and Co-Chair of the ABA RPTE Section Employee Benefits Group, past Representative and chair of various committees of ABA Joint Committee on Employee Benefits; a ABA Health Law Coordinating Council representative, former Coordinator and a Vice-Chair of the Gulf Coast TEGE Council TE Division, past Chair of the Dallas Bar Association Employee Benefits & Executive Compensation Committee, a former member of the Board of Directors of the Southwest Benefits Association and others.

Ms. Stamer also is a highly popular lecturer, symposium and chair, faculty member and author, who publishes and speaks extensively on health and managed care industry, human resources, employment and other privacy, data security and other technology, regulatory and operational risk management. Examples of her many highly regarded publications on these matters include “Protecting & Using Patient Data In Disease Management: Opportunities, Liabilities And Prescriptions,” “Privacy Invasions of Medical Care-An Emerging Perspective,” “Cybercrime and Identity Theft: Health Information Security: Beyond HIPAA,” as well as thousands of other publications, programs and workshops these and other concerns for the American Bar Association, ALI-ABA, American Health Lawyers, Society of Human Resources Professionals, the Southwest Benefits Association, the Society of Employee Benefits Administrators, the American Law Institute, Lexis-Nexis, Atlantic Information Services, The Bureau of National Affairs (BNA), InsuranceThoughtLeaders.com, Benefits Magazine, Employee Benefit News, Texas CEO Magazine, HealthLeaders, the HCCA, ISSA, HIMSS, Modern Healthcare, Managed Healthcare, Institute of Internal Auditors, Society of CPAs, Business Insurance, Employee Benefits News, World At Work, Benefits Magazine, the Wall Street Journal, the Dallas Morning News, the Dallas Business Journal, the Houston Business Journal, and many other symposia and publications. She also has served as an Editorial Advisory Board Member for human resources, employee benefit and other management focused publications of BNA, HR.com, Employee Benefit News, Insurance Thought Leadership and many other prominent publications and speaks and conducts training for a broad range of professional organizations.

For more information about Ms. Stamer or her health industry and other experience and involvements, see here or contact Ms. Stamer via telephone at (469) 767-8872 or via e-mail here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources here such as:

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating  your profile here.

©2017 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™  All other rights reserved.   For information about republication or other use, please contact Ms. Stamer here.

Celebrate National Nutrition Month With Free Resources

March is National Nutrition Month! Check out free government resources here for tips and tools to help you and your employees or patients enjoy the benefits of better nutrition.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources here including:

▪ Review Your Provider Performance Data 

▪ Bill Allowing FDA Emergency Use Authorizations To Protect Military From Biological Warfare Threats Sent to President

▪ OIG Tells Texas Stop Paying Medicaid MCOs For Dead Patients

▪ Michigan Doctor Pleads Guilty To Billing Medicare For Illegally Prescribed Drugs

▪ Anesthesiology Practice Nailed For Improperly Billing For Moderate Sedation

▪ Florida Doctor Sentenced For Multi-Million Dollar Drug & Alcohol Addiction Treatment Health Care Fraud, Money Laundering & Forced Prostitution Scheme

▪ CMS Announces New Medicare Provider Ombudsman

▪ CMS Publishes 2018 Updates To Home Health Prospective Payment Rates & Rules

▪ CMS Publishes 2018 Physician Fee Schedule Rule

▪ Check Your Medicare/Medicaid Compliance Against Against Quarterly Guidance Changes List

▪ CDC Proposed Changes To NIOSH Occupational Health Biological Monitoring Methods for Chemical Exposures

▪ HHS Picks Hargan As Acting HHS Secretary

▪ OCR Gives Health Care Providers, Other Covered Entities Post-Las Vegas Shooting HIPAA Medical Privacy Guidance On Disclosures To Family, Media & Others For Notification & Other Purposes

▪ Novo Nordisk Pays $58M+ For Not Giving FDA-Required Warnings ABout Victoza Cancer Risks

▪ Christus Pays $12.24M Settlement Resolves False Claims Act Charges From “Donations” To New Mexico

▪ Oklahoma Nursing Home Settles HHS HIV Discrimination Charges

▪ HHS Issues Hurricane Irma Relief For Puerto Rico, U.S. Virgin Islands & Florida

▪ HHS Medical Clinic to Provide Healthcare to Hurricane Harvey Victims at Houston Convention Center Starting Wednesday

▪ CMS Proposes Cutbacks To Medicare Bundled Payment Program

▪ CMS Releases 2017 Provider Payment Program Hardship Exception Application

▪ RAISE Act Immigration Visa, Visa Holder Public Benefit Limits Create Potential Health Industry Concern

▪ CardioNet $2.5M HIPAA Resolution Agreement Schools HIPAA Entities To Clean Up Their Acts

▪ Medical Clinic HIPAA Resolution Agreement Shows Need For Current Business Associate Agreements

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here.

NOTICE: These statements and materials are for general informational and purposes only. They do not establish an attorney-client relationship, are not legal advice or an offer or commitment to provide legal advice, and do not serve as a substitute for legal advice. Readers are urged to engage competent legal counsel for consultation and representation in light of the specific facts and circumstances presented in their unique circumstance at any particular time. No comment or statement in this publication is to be construed as legal advice or an admission. The author reserves the right to qualify or retract any of these statements at any time. Likewise, the content is not tailored to any particular situation and does not necessarily address all relevant issues. Because the law is rapidly evolving and rapidly evolving rules makes it highly likely that subsequent developments could impact the currency and completeness of this discussion. The presenter and the program sponsor disclaim, and have no responsibility to provide any update or otherwise notify any participant of any such change, limitation, or other condition that might affect the suitability of reliance upon these materials or information otherwise conveyed in connection with this program. Readers may not rely upon, are solely responsible for, and assume the risk and all liabilities resulting from their use of this publication.

Circular 230 Compliance. The following disclaimer is included to ensure that we comply with U.S. Treasury Department Regulations. Any statements contained herein are not intended or written by the writer to be used, and nothing contained herein can be used by you or any other person, for the purpose of (1) avoiding penalties that may be imposed under federal tax law, or (2) promoting, marketing or recommending to another party any tax-related transaction or matter addressed herein.

©2018 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™ For information about republication, please contact the author directly. All other rights reserved.

Got The Flu? Know What To Do!

Influenza (commonly referred to as the “flu”) continues to threaten many American families.

Highly contagious, the flu can be serious or even deadly. However, the Centers for Disease Control (CDC) is urging Americans to get a flu shot and practice good hygiene to reduce their risk.

Employers can help by arranging for sick leave, allowing sick workers to stay home, and urging workers to get flu shots and practice healthy hygiene.

For more tips and resources from the CDC, see here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources here including:

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here.

NOTICE: These statements and materials are for general informational and purposes only. They do not establish an attorney-client relationship, are not legal advice or an offer or commitment to provide legal advice, and do not serve as a substitute for legal advice. Readers are urged to engage competent legal counsel for consultation and representation in light of the specific facts and circumstances presented in their unique circumstance at any particular time. No comment or statement in this publication is to be construed as legal advice or an admission. The author reserves the right to qualify or retract any of these statements at any time. Likewise, the content is not tailored to any particular situation and does not necessarily address all relevant issues. Because the law is rapidly evolving and rapidly evolving rules makes it highly likely that subsequent developments could impact the currency and completeness of this discussion. The presenter and the program sponsor disclaim, and have no responsibility to provide any update or otherwise notify any participant of any such change, limitation, or other condition that might affect the suitability of reliance upon these materials or information otherwise conveyed in connection with this program. Readers may not rely upon, are solely responsible for, and assume the risk and all liabilities resulting from their use of this publication.

Circular 230 Compliance. The following disclaimer is included to ensure that we comply with U.S. Treasury Department Regulations. Any statements contained herein are not intended or written by the writer to be used, and nothing contained herein can be used by you or any other person, for the purpose of (1) avoiding penalties that may be imposed under federal tax law, or (2) promoting, marketing or recommending to another party any tax-related transaction or matter addressed herein.

©2018 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™ For information about republication, please contact the author directly. All other rights reserved.

Back To School Bullying Reminder

New and resumed interactions that accompany the start of a new school year create new bullying risks.

The federal government and many states have laws and other rules that make bullying illegal or civilly actionable in schools and other locations in the number of circumstances. See e.g Texas Anti-Bullying Laws. While these laws may help deter or partially redress the effects of some bullying under some circumstances, victims of bullying and family, friends, school, business, community and government leaders trying to prevent an address it know it the law rarely provides an adequate tool to stop all bullying, much less provide quick or reliable protection or relief for those targeted by bullies.

Help protect your child and others by educating yourself, your child and family, your teachers and school leaders, and friends that bullying is wrong, how to recognize it and what to do to prevent and remedy it.

STOPBULLYING.gov is one of many free websites that provides valuable resources about bullying, why it’s wrong and harmful, laws and other rules that help to prohibit and regress it and a host of other helpful resources to prevent and help people cope with bullying problems.

The best way to prevent or stop bullying is for everyone to step up and fight it. Step up to stomp out bullying. Teach and require your children and others to treat others with respect and to expect and require those around them to do the same. When someone is being bullied, use the tools from these resources to defend yourself or the other victims in a constructive way. Uniform zero intolerance is the best and most reliable redress and cure for bad behavior.

Practice Pool Safety

Practicing water safety is critical!

Summertime means pool time.  

Splashing around in the water provides a wonderful opportunity to stay cool and have fun … as long as everyone stays safe.

News reports of an Ohio lifeguard saving a toddler the first day on the job is a timely  reminder of the importance of knowing and constantly practicing pool safety when you or someone near you is in or near a pool or other water.

Downing & Near Drowning Very Common

Centers for Disease Control (CDC) data shows the importance of water safety and vigilance:

  • Drowning ranks fifth among the leading causes of unintentional injury death in the United States.
  • 10 people die from unintentional drowning every day on average.
  • Children are particularly African American children 5-19 drown in swimming pools at rates 5.5 times higher than those of whites. This disparity is greatest among those 11-12 years where African Americans drown in swimming pools at rates 10 times those of whites. are children 14 and younger.
  • For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.
  • More than 50% of drowning victims treated in emergency departments (EDs) require hospitalization or transfer for further care (compared with a hospitalization rate of about 6% for all unintentional injuries).
  • Near drownings are a leading cause of permanent brain injury.  These nonfatal drowning injuries can cause severe brain damage that may result in long-term disabilities such as memory problems, learning disabilities, and permanent loss of basic functioning (e.g., permanent vegetative state).

While anyone in or around the water may get into trouble under the right circumstances, the victims overwhelmingly tend to be young children and are mostly males.  According to the CDC:

  • Children ages 1 to 4 have the highest drowning rates. In 2014, among children 1 to 4 years old who died from an unintentional injury, one-third died from drowning, most of which occur in home swimming pools.
  • Male and minorities have a higher likelihood of becoming victims.  CDC statistics show:
    • Nearly 80% of people who die from drowning are male; and
    • African American children 5-19 drown in swimming pools at rates 5.5 times higher than those of whites. This disparity is greatest among those 11-12 years where African Americans drown in swimming pools at rates 10 times those of whites.

Factors Influencing Drowning Risk

CDC data also reveals the main factors that affect drowning risk:

  • Lack of swimming ability,
  • Lack of barriers to prevent unsupervised water access,
  • Lack of close supervision while swimming,
  • Location,
  • Failure to wear life jackets,
  • Alcohol use, and
  • Seizure disorders.

Preventing Drowning Injuries

CDC data also provides helpful tips about steps people can take to reduce the risk of drowning or near drowning deaths and injuries including the following key safety measures:

  • Close supervision and vigilance is critical whether or not an individual can swim. Drowning can happen quickly and quietly anywhere there is water (such as bathtubs, swimming pools, buckets), and even in the presence of lifeguards.
  • Swimming lessons are a key tool to reduce the risk of drowning in young children.  The CDC reports participation in formal swimming lessons can reduce the risk of drowning among children aged 1 to 4 years.
  • Barriers, such as pool fencing, prevent young children from gaining access to the pool area without caregivers’ awareness. A four-sided isolation fence (separating the pool area from the house and yard) reduces a child’s risk of drowning 83% compared to three-sided property-line fencing.

CDC demonstrates that age or location may increase the need for added diligence and supervision.  The data shows that people of different ages drown in different locations.

  • Most children ages 1-4 drown in home swimming pools.
  • The percentage of drownings in natural water settings, including lakes, rivers and oceans, increases with age.
  • More than half of fatal and nonfatal drownings among those 15 years and older (57% and 57% respectively) occurred in natural water settings.
  • In 2010, the U.S. Coast Guard received reports for 4,604 boating incidents; 3,153 boaters were reported injured, and 672 died. Most (72%) boating deaths that occurred during 2010 were caused by drowning, with 88% of victims not wearing life jackets.
  • For persons with seizure disorders, bathtub drowning is not uncommon.  Drowning is the most common cause of unintentional injury death, with the bathtub as the site of highest drowning risk.

The data also makes clear drinking and water sports are a dangerous cocktail.   According to the CDC, among adolescents and adults:

  • Alcohol use is involved in up to 70% of deaths associated with water recreation;
  • Nearly 1/4 of emergency room visits for drowning; and
  • About 1/5 of reported boating deaths.

Alcohol influences balance, coordination, and judgment, and its effects are heightened by sun exposure and heat. Of course alcohol consumption by others around a swimmer who has been drinking undermine the awareness of those that would be available to rescue and impaired swimmer too.
The bottom line:  Alcohol and water don’t mix.

Water Safety To-Do List

In light of the known risks, Americans, and their employers, health plans, health care providers, and communities should take steps to keep themselves and others safe while enjoying pools, lakes and other rivers this Summer.

Practice water safety and urge others to do the same by taking the following common sense steps:

  • Supervise When in or Around Water 

Designate a responsible adult to watch young children while in the bath and all people swimming or playing in or around water.

Supervisors of preschool and other young children should  be close enough to reach the child at all times (@touch supervision”).

Because drowning occurs quickly and quietly, supervising adults should not be involved in any other distracting activity (such as drinking, reading, playing cards, talking on the phone, or mowing the lawn) while supervising children, even if lifeguards are present.

Parents considering authorizing swimming field trips led by childcare providers or allowing their children to swim under the supervision of others should investigate the adequacy and training of staff to meet these guidelines.

  • Use the Buddy System. 

Always swim with a buddy. 

  • Lifeguards

Select swimming sites that have lifeguards when possible.  When hosting a social or workplace event near or involving swimming or other water activities, consider hiring one or more lifeguards to monitor the activity and be prepared to respond in case of an emergency.

  • Seizure Disorder Safety

If you, a worker or a family member has a seizure disorder, provide one-on-one supervision around water, including swimming pools. Consider taking showers rather than using a bath tub for bathing. Wear life jackets when boating.

  • Learn to Swim & Make Sure Others In Or Near The Water Can Swim

Formal swimming lessons can protect young children from drowning. However, even when children have had formal swimming lessons, constant, careful supervision when children are in the water, and barriers, such as pool fencing to prevent unsupervised access, are still important.

  • Learn Cardiopulmonary Resuscitation (CPR)

In the time it takes for paramedics to arrive,  CPR skills could save someone’s life. Many free or low-cost options for learning CPR are readily available from the American Red Cross and others.  If you host people around your pool or other water related event, consider hosting a CPR training at one of your upcoming gatherings.

  • Use Life Jackets, Not Air-Filled or Foam Toys.

Provide an wear Coast Guard approved life jackets in good condition as needed.

Don’t use air-filled or foam toys, such as “water wings”, “noodles”, or inner-tubes, instead of life jackets. These toys are not life jackets and are not designed to keep swimmers safe.

  • Don’t Mix Water & Alcohol

Avoid drinking alcohol before or during swimming, boating, or water skiing.  Do not drink alcohol while supervising children.  Do not serve or control the consumption of alcohol by guests when hosting events involving boating, swimming or other water sports.

  • Guard Against “Hypoxic Blackout”

Teach your children and don’t let swimmers hyperventilate before swimming underwater or try to hold their breath for long periods of time. This can cause them to pass out (sometimes called “hypoxic blackout” or “shallow water blackout”) and drown.

  • Prevent Recreational Water Illnesses

Learn how to and act to prevent recreational water illnesses by following the CDC’s recommended 12 Steps for Prevention of Recreational Water Illnesses.

  • Watch For Hazardous Weather And Conditions

Know the local weather conditions and forecast before swimming or boating. Strong winds and thunderstorms with lightning strikes are dangerous.

  • Practice and Maintain Home Pool Safety

If you have a swimming pool at home, consider the following special safeguards:

  • Install a four-sided pool fence at least four feet high with that completely separates the pool area from the house and yard. The fence should be at least 4 feet high with self-closing and self-latching gates that open outward with latches out of reach of children. Also consider additional barriers such as automatic door locks and alarms to prevent access or alert you if someone enters the pool area.
  • Remove floats, balls and other toys from the pool and surrounding area immediately after use so children are not tempted to enter the pool area unsupervised.
  • Stay vigilant at all times.  Supervise your family and guests.  Require adult guests to provide touch supervision for their children in the pool.   Hire a lifeguard during parties or at other times when your ability to provide touch supervision isn’t sufficient.
  • Don’t swim or allow others to swim after or while consuming alcohol.

Keep in mind that a drowning or near drowning of a family member or guest in your pool presents both a substantial legal exposure as well as risks an irreversible personally devastating experience for all involved.  Don’t let fun get ahead of common sense or safety.

  • Practice Natural Water Safety

If you are in and around natural water settings:

  • Use U.S. Coast Guard approved life jackets regardless of the distance to be traveled, the size of the boat, or the swimming ability of boaters.
  • Know the meaning of and obey warnings represented by colored beach flags. .
  • Watch for dangerous waves and signs of rip currents such as water that is  discolored  choppy, foamy, or filled with debris and moving in a channel away from shore.
  • If you are caught in a rip current, swim parallel to shore. Once free of the current, swim diagonally toward shore.

Also plan ahead and take some common sense steps to prepare for the possible need for a timely rescue before pushing off the boat from the shore or entering the water. Among other things:

  • Let at least a couple people not participating know where you are, where you are going, what you plan to do and when you should be back or checkin;
  • Confirm that at least one cellphone has service and keep it with you and working;
  • Consider using the share my location or other feature on your cellphone or other device to help emergency or other rescue personnel find you in the event of an emergency;
  • Discuss safety rules with all participants before getting started;and
  • Enforce safety throughout the activity.

Remember and remind guests that a drowning or near drowning isn’t worth the risk.

  • Be Prepared: Know CPR & Plan Ahead

Since seconds matter when a drowning or near drowning happens, be prepared for a possible emergency before anyone gets in the water.  At minimum:

  • Know CPR and encourage others to do the same;
  • Prominently your address and keep a telephone available in your pool area; Drop a locator pin on your cell phone or otherwise take note of your location if you were on natural water.

Cooling off in the pool or lake can be a fun way to stay comfortable in the summer. Plan ahead and practice water safety as you and your friends enjoy the fun.

When A Loved One Needs Assistance With Daily Living

While living in a well-run assisted-living or other support of residential living arrangement can provide many positive social, safety and healthcare benefit for patients with declining physical or cognitive abilities, most elderly and disabled individuals dread and resist moving from their home to an assisted living or other supportive care living environment.

When transitioning a patient to an assisted living or other care environment, caregivers often must override and understand what preference by the patient to live independently in order to provide support to patient needs to be safe.

Like the surrender of driving privileges, the loss of choice that results from compulsory relocation to a new living environment for an elderly or disabled person forces the patient concurrently to confront his declining functionality and his declining self-determination.

Recognizing this, caregivers should seek to involve the patient as much as possible in making the new living arrangements.

Talking about the possibility of a future need her assisted living care well in advance at the onset of disabling condition can help.

Planning ahead can help patients and their families to be prepared to pick up a facility where the patient may already have friends for siding will be familiar with the staff or the facility reputation.

Many assisted-living providers also sponsor social or other community out reach events for members of the community living independently.  Others offer daycare or other intermittent care opportunities.  Still others may offer temporary assisted-living or stay arrangements following episodes of chemotherapy or other intensive inpatient care.  Participation in these opportunities for involvement gives a patient an opportunity to try out the facility in their services before the patient actually needs to relocate as well as gives the family and the patient the opportunity to check out the facility before making a choice.

When relocating the patient to an assisted living or other facility, careful planning can help ensure that the patient’s room and other living quarters are as home like as possible.  To the extent that space allows, try to bring to the facility some furniture, photographs and other special possessions that will make the new living space feel more like home.

It often also helps if family members participate in the daily flow of activities such as going to lunch or dinner or participating in social gatherings often on for the first few weeks to help encourage the patient to participate in acclimatize them to the new opportunities and friendships.

The best way to head off problems is to detect issues early and intervene.  Even after the patient as well settled family members and friends should drop by often and at varying times to check on the patient’s physical and emotional status, keep the patient engaged and to check up on the care and service that the patient is receiving.

Family members and friends should learn and watch for signs of abuse or neglect.  Many excellent sources of education and resources are available through state Agency responsible for oversight in care of the aging and disabled like this list of elder neglect warning signs  published by the State of Idaho.

To help safeguard your loved one, make sure you and others with a close relationship to the patient check in on the patient regularly.  Set aside time to check in on the patient as well as to talk to the patient to detect signs of abuse, neglect, deterioration in the patient’s physical, cognitive or emotional status or other signs of possible concern.  Even something so seemingly minor as a recurrent failure at the facility staff timely to assist the patient to make her bed or with other schedule services should be monitored and addressed.  Beyond the actual assistance with the performance of the designated chores, the interactions scheduled with staff to perform these chores are critical monitoring activities for the facility.  Failing to timely perform the services means the facility is not keeping on top of their monitoring and other care duties for the patient and should be addressed.

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Despite an endless stream of well-meaning market and governmental reforms over the past 25 years, the U.S. health care system is in crisis. American patients, their families and other caregivers, their employers, their health benefit programs, their health care providers, the communities and even our federal health care budget increasingly are burdened and overwhelmed by the mounting obstacles to caring for our ill, disabled, and aging citizens within our health care system and the extraordinary expense of maintaining and using that system.

As Congress takes up reform again, it is critical that Americans act to protect their own and their families’ health care and control the financial burdens of health care by getting informed, providing clear and consistent direction to Congress and other reformers and taking other actions to empower and care for themselves and their loved ones within our evolving health care system.

©2017 Cynthia Marcotte Stamer. Non-exclusive right to republish licensed to Solutions Law Press, Inc. For information about republication of this or other materials and programs of the author, email the author here.   All rights reserved.