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The Cost of Non-Compliance
By David Hoffman, Esq.
We’d rather not look. Perhaps if we avert our eyes long
enough, the unpleasantness will simply disappear. After all,
if we don’t look, we relieve ourselves of the obligation
that comes with seeing.
For more than two decades, it has been my job and my responsibility
to see what others have either refused to acknowledge or, due
to inadequate checks and balances, simply have not noticed.
I have walked the halls of hospitals, nursing homes, and assisted
living facilities throughout the country and collected pieces
of a mosaic, each of which helps construct a vivid pattern of
a caring staff, difficult challenges in ensuring appropriate
care delivery, vulnerable residents and patients, and a payment
system that is not reflective of the needs of these populations.
I realize that health care providers face a variety of challenges:
staff shortages, complex regulations, increased litigation.
And I do believe that most want to provide the best care possible.
Yet, all too often, there is a systemic failure in meeting the
needs of patients and residents. At David Hoffman and Associates,
we can help you meet your challenges and provide quality care.
This is our job and we have a track record of success.
Reform must begin with the recognition of the casualties of
non-compliance. They are sons and daughters, grandmothers and
grandfathers, brothers and sisters. They are our most vulnerable
citizens, and providing quality care that actually goes beyond
compliance is not only a moral obligation but it is good business.
In the last 20 years, including more than a dozen as a federal
prosecutor specializing in health care fraud and abuse, I have
seen the cost of non-compliance, to patients, residents and
providers. I have consulted with hospitals, nursing homes and
assisted living facilities who were under external pressure
to “clean up their act” and threatened with criminal
and civil sanctions. I prosecuted dozens of cases, both civil
and criminal, in which hospitals and long-term care facilities
were forced to pay significant amounts of money in settlements
and fines. It can all be avoided.
We want to help health care providers create a culture where
care and compliance are intertwined. We can evaluate your systems
and design a plan that capitalizes on your organization’s
strengths and improves your weaknesses. And we will continually
monitor your systems and revise them based on clinical outcomes
and regulatory concerns.
I urge all health care providers—owners, administrators,
clinical staff members—to take an honest look at the challenges
before you. The inventory might be alarming and frustrating.
But the failure to see will come with an even greater cost.
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Mr. Hoffman is a member of the Patient
Care Ombudsman team that was appointed by the United States Trustee for
the Central District of California in the Pacifica Hospital of the Valley,
Sun Valley, California case. The Patient Care Ombudsman team is responsible
for monitoring the quality of care at the hospital while it is in bankruptcy.
Mr. Hoffman’s article, “Failing to Care: How Effective Compliance
Prevents Institutional Elder Neglect” appears in the latest issue
of Marquette University School of Law’s Elder’s Advisor. This
article was authored as part of Mr. Hoffman’s participation in the
Marquette University School of Law’s symposium titled The Kindness
of Strangers: Enhancing Lives Through Long-Term Care.
Learn More Copyright by Marquette University.
Upcoming Events:
Learn More
July 16, 2010: Mr. Hoffman will be attending the invitation-only
South Florida Regional Health Care Fraud Prevention Summit hosted by Attorney
General Eric Holder and Kathleen Sebelius, Secretary, U.S. Department
of Health and Human Services in Miami, Florida. This all-day session will
bring together federal, state, and local partners; prosecutors and investigators;
and representatives of both beneficiaries and providers to highlight anti-fraud
efforts, provide information about how patients and companies in the public
and private sector can protect themselves from fraud, and discuss innovative
ways to eliminate fraud in the U.S. health care system.
April 18, 2010: Mr. Hoffman will be speaking at the Health Care
Compliance Association’s 14th Annual Compliance Institute in Dallas,
Texas. Mr. Hoffman will be participating in a panel discussion titled
“How to Find and Address the Real Fraud and Abuse in ‘Quality
of Care’”. Mr. Hoffman will be joined on the panel by representatives
from the government and private industry.
March 12, 2010: Mr. Hoffman will be presenting at the
PA Bar Institute’s 16th Annual Health Law Institute in Philadelphia,
PA. Mr. Hoffman will be discussing “Effective Compliance as a Deterrent
to Neglect.”
December 16, 2009: Mr. Hoffman will
be co-presenting a Health Care Compliance Association sponsored webinar
session entitled: Under the OIG Microscope: Hospice, Homecare, and
LTC Facilities in Close Focus. Mr. Hoffman will be discussing the
implications of the 2010 OIG Workplan on long-term care facilities.
October 14, 2009: Mr. Hoffman will be serving
as a moderator for a panel discussion entitled “Hospice Care: The
New Frontier for Compliance & Enforcement” at The Eastern Pennsylvania
Geriatrics Society’s Fall Program. The panelists include Margaret
Hutchinson, Assistant United States Attorney and Deborah Way, MD, Medical
Director for Hospice of Philadelphia.
September 23, 2009: Mr. Hoffman will be teaching a course entitled
“Government and Third Party Reimbursement” for Nursing Home
Administrators at the University of the Sciences in Philadelphia.
October 12, 2009: Mr. Hoffman will be lecturing at the
Health Care Compliance Association’s Quality of Care Compliance
Conference in Philadelphia. Mr. Hoffman’s presentation is entitled
“How Effective Compliance Assists in Ensuring Patient Safety”.
October 22, 2009: Mr. Hoffman will be co-presenting
with Diane Menio, Executive Director of CARIE, at the 34th National Citizen’s
Coalition for Nursing Home Reform (NCCNHR) Annual Meeting and Conference
in Washington, D.C. Mr. Hoffman’s presentation is entitled “Care
Transition from Hospital to Long Term Care: Why Advocacy is Critical.”
Mr. Hoffman will be discussing results emanating from a state grant awarded
to his firm by the Pennsylvania Department of Aging that focused on patient
advocacy during the hospital discharge planning process.
June 25, 2009: Mr. Hoffman will be speaking at the National
Association of Medicaid Fraud Control Units’ Resident Abuse Training
Program in Baltimore, Maryland. Mr. Hoffman will be discussing Corporate
Integrity, Exclusions and License issues.
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Healthwatch discusses how David Hoffman and Associates helps Healthcare providers and patients all over the country. > Click Here
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