Episode 21: Louisville attorney Parker Wornall joins Jim to discuss the work he does for healthcare providers. His healthcare practice management focus includes physicians, dental offices, foot and ankle practitioners, APRN practices, chiropractors, mental health practioners, adult day-care practices and others.
There are legal aspects to establishing a practice, developing the internal forms and processes, HR-related policies, regulatory compliance issues, planning for growth and eventually a sale or wind-down of the practice.
Parker handles both transactional and litigation matters. Ideally, he enjoys getting involved in the early stages to protect the healthcare provider and the practice. He works to help avoid potential legal exposure.
Healthcare Practice Entity Startup
There are both strategic and practical considerations for the entity structure. This could include PLLCs, LLCs, PSCs and others. There are issues surrounding non-provider members (e.g. investors, directors, practice business manager). Due diligence for the proper structuring of shares may also need to be considered.
Parker has a network of colleagues in related fields, such as CPAs, who can also add valuable perspectives.
A key aspect of healthcare practice management involves a thorough review of forms, policies and procedures is extremely important. While COVID has highlighted some of the compliance requirements from governmental agencies, there are always the day-to-day issues related to the Department of Labor, Kentucky wage and hour and/or Federal wage and hour laws, the Fair Labor Standards act and more.
There are disparities between some of the Kentucky regulations and the Federal DEA regulations. Testosterone clinics (nurse practitioner clinics) can run afoul of the various regulations because of the various requirements.
Employment Law Issues for Healthcare Providers
Your practice will often include individuals who are there to help run/manage the business. Some may be salaried, while others could be 1099-based. You may need to perform adequate reviews of credentials. How you work with your employees and practitioners may also require guidance from your general counsel.
Non-compete and other restrictive covenants may come into play in the hiring of employees. Parker can work to either defend the covenant or to prove why one may be invalid. This can also include the protection of trade secrets (enforceable under the Kentucky Uniform Trade Secrets Act and Defend Trade Secrets Act of 2016). The 3 common types of restrictive covenants in Kentucky are:
- Non-Compete Agreements
- Non-Solicitation Agreements
- Confidentiality Agreements
Having properly drafted and executed contracts in place, before they are tested, is a smart option to reduce your legal expenses should an action need to be filed or defended.
Insurance Coverage Issues
Parker can help communicate the needs of the practice and its business plan to insurance professionals to ensure the risks are fully considered and adequately quoted. Often, business specialists tend to look at the issues from a single perspective (e.g. insurance agents, CPAs, etc.). In the role of general counsel for the healthcare practice, Parker can coordinate with each of the business partners to provide clarity and to maintain a focus on the overall business plan for the practice.
Hiring and Firing in a Healthcare Practice
Parker is very familiar with cases involving the Kentucky Human Rights Commission and the EEOC. At times, these cases can also end up in litigation.
An interesting issue recently surfaced deals with older employees who were either working from home or off work due to COVID. If the practice is ready for them to come back to work, but they refuse, you may have exposure to actions under the Age Discrimination and Employment Act, the Federal Civil Rights Act and the Kentucky Civil Rights Act. Each situation is unique and often complex. Having proper contract verbiage and documentation can reduce the risk of litigation to the practice.
These can involve in-house HR professionals, or out-sourced HR resources. However, some of instances may require the professional to see the advice of legal counsel to determine the best way to approach or handle a particular investigation. Again, having well-drafted, comprehensive contracts can shield the practice from potential adverse legal actions.
Medical Licensure Defense
Parker has significant experience defending the licenses of healthcare providers. Most of the licensure issues are handled before the licensing boards. Parker has successfully defended both doctors and nurses, as well as other medical providers.
Kentucky Certificate of Need Applications
Many healthcare providers are required to apply for a Certificate of Need (CON) if they plan to expand a practice or start a practice. Ambulatory surgical centers, adult day healthcare programs and others are typically required to show a need exists and how their expansion would impact that community need. Parker can guide the application process. He will represent the provider at the hearing. In some cases, existing practices may want to prevent the expansion of a competitive practice.
Sale, Dissolution or Wind-Down of a Healthcare Practice
Healthcare providers may decide it’s time to transition the ownership of the practice. In some instances, the provider receives an unsolicited offer to purchase. Parker can help in the due diligence of the sale or purchase of the practice. These transactions are highly complex and involve much more than often appears on the surface.
There are multiple ways to engage Parker for your healthcare practice. Fees and billing arrangements can be arranged to best meet the needs of the practitioner or practice at large.
To contact Parker regarding his healthcare practice management focus:
Phone: (502) 805-2303
Thank you for taking the time to listen to this episode. From more information on business-related issues, visit my website at www.JimRayConsultingServices.com.
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Until next time, remember, if you need help with your small business, Let’s Grow For It!