In the Trenches:
My Year of Conducting "Mock" Agency Inspections of Medical Practices
"So, you're a consultant now? Why no longer practicing law?" I hear those questions almost daily nowadays. My response is always the same: "Nope. I'm still a lawyer, and boy do I miss sitting at my desk." The truth is ... I absolutely understand why physicians keep asking me. I've spent the past year doing something a tad unusual for a healthcare lawyer - conducting on site "mock" agency inspections of medical practices and licensed facilities. Physicians invite me to come to their offices, go through them from top to bottom, point out the good and the bad, remove non-compliant items, educate their staffs, and, overall, get things in tip top shape. All of this is done as a preventative and cost-saving measure with an eye toward minimizing administrative and financial risk, promoting regulatory compliance, and improving patient health and safety.
The idea to start offering "mock" inspections came to me a year ago after leaving yet another hearing before a state administrative agency where my physician client had been aggressively criticized about areas of non-compliance in his medical practice. My client faced very serious consequences for not only his wallet due to heavy fines but also for his professional license. I kept arguing that many of the standards my client was being held to during the hearing were not written in the agency's regulations, which was met with a repeated and resounding agency response of, "He should know better." Really? Should my client have known better? Why? What resources were out there for my client? With all that is expected of physicians in the current healthcare environment and with all of the pressures facing practitioners on a daily basis, how is it reasonable to expect him to know every single non-regulated rule governing his practice? I couldn't answer any of those questions in the affirmative and knew deep down that something needed to be done about it. What if doctors could have a friendly outsider come in to review compliance measures and to educate staff before agency investigators surprise them? Something had to be done. So, I did it.
I'm happy to say, these inspections have been incredibly productive. I am starting to see real change for the better implemented in medical practices and a growing awareness of regulatory requirements and "expectations". Physicians and their staffs are engaged with me in this collaborative process, and the right questions are being asked - in addition to, "when did you stop practicing law?" But in all seriousness, I'm extremely proud of my clients for hearing me, actually listening, challenging me and the 'powers that be', telling their peers, and adapting to the strictures of our current healthcare environment. I work collaboratively with medical practices to identify areas of vulnerability and to either remove them altogether or to find the most reasonable, cost-effective ways of achieving regulatory compliance within a budget. I believe that doctors feel a level of comfort and relief having me come to their offices and always know I am just a phone call or text away. Their staffs receive a very detailed placard indicating what to do and how to react if they are ever met with an unfortunate "surprise" at their office - because, and I have seen it before, that is always the pivotal moment when they panic, lose the ability to think clearly, and often make the wrong decision to simply let inspectors in instead of waiting for an advocate to be present on their side. Together, we work as a team to level the playing field, to enforce their rights, and to make sure that no bounds are crossed during an ambush inspection.
With hundreds of mock agency inspections under my belt, I've learned a few things too:
Your Office Staff is an Extension of YOU: While the responsibility of compliance falls on the practitioner, I have been surprised at the amount of office staff/staff members who were unfamiliar with proper policies and procedures. Share this information with staff, and put them to work to help the cause. Who's purging expired medications? Who's running and logging sterilizers? Who's in charge of updating policies and manuals? It takes a village, people. Also, I have heard staff members shouting the names of patients in ear shot of other patients (a HIPAA no-no) and be what I will call "less than professional" to people who call the office or to patients at the glass window. It takes one unhappy patient to report the office to an agency. Just one.
All it takes is one violation observed by one patient or one disgruntled former employee to ignite a fishing expedition as to all these areas during an ambush.The numbers are on the rise, and I have my suspicions as to why.In the past month, not only have I been called to intervene in an ambush of a client's office while mock inspecting another client's office, but also have had agency investigators ambush yet another client's office while I was mock inspecting it.You can't make these stories up.
Finding problems. Creating solutions. Taking on Goliath one practice at a time. We fight together.
What a long strange trip it's been.
Gallagher Campanella LLC provides comprehensive legal solutions to clients in New Jersey, New York, and Pennsylvania
Attorneys Nan Gallagher and Gina Campanella
Nan Gallagher and Gina Campanella, are partners in thier full-service healthcare law firm, Gallagher Campanella LLC, with offices in Wyckoff and Morristown, New Jersey as well as in Manhattan. They represent a broad spectrum of clients ranging from individual practitioners and medical practices to organized medical-dental staffs and societies. For more on Gallagher Campanella LLC, go to GCHealthLaw.com or e-mail them at nan@GCHealthLaw.com or gina@GCHealthLaw.com
© 2018 New Jersey Association of Osteopathic Physicians and Surgeons
The Journal is the official magazine of the New Jersey Association of Osteopathic Physicians and Surgeons (NJAOPS). NJAOPS is the sixth largest state affiliate of the American Osteopathic Association. NJAOPS represents the interests of more than 4,700 active osteopathic physicians, residents, interns and medical students. Founded in 1901, NJAOPS is one of the most active medical associations in New Jersey with 12 county societies.