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FEBRUARY 2015 I HEALTHCAREPROVIDER.COM $4.95 PROVIDER CERTIFICATION ACCREDITING AGENCY CERTIFIES UPSTATE UNIVERSITY HOSPITAL AS ‘COMPREHENSIVE STROKE CENTER’ UPWARD PATH BINGHAMTON FIRM THAT HELPS PREVENT MEDICAL FRAUD IS POISED FOR GROWTH THE LIST SKILLEDNURSING FACILITIES A publication for and about health-care providers in CNY ST. JOSEPH’S HOSPITAL HEALTH CENTER’S KATHRYN RUSCITTO HEALTH CARE CEO TALK: SPONSORED BY:

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Digital Edition of the 2/16/15 HealthCare Provider

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FEBRUARY 2015 I HEALTHCAREPROVIDER.COM $4.95

PROVIDERPROVIDERPROVIDERPROVIDERPROVIDER

CERTIFICATIONACCREDITING AGENCY CERTIFIES UPSTATE UNIVERSITY HOSPITAL

AS ‘COMPREHENSIVE STROKE CENTER’

UPWARD PATHBINGHAMTON FIRM THAT HELPS

PREVENT MEDICAL FRAUD IS POISED FOR GROWTH

THE LISTSKILLEDNURSING

FACILITIES

A publication for and about health-care providers in CNY

ST. JOSEPH’S HOSPITAL HEALTH CENTER’S

KATHRYN RUSCITTOHEALTH CARECEO TALK:

SPONSORED BY:

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FEBRUARY 2015

NEWS

EDITOR-IN-CHIEFAdam Rombel

[email protected]

ASSOCIATE EDITORMaria J. Carbonaro

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STAFF WRITERSEric Reinhardt

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Norman [email protected]

CREATIVE DIRECTORErin Zehr

[email protected]

RESEARCH DIRECTORNicole Collins

[email protected]

CONTRIBUTING WRITERSBenjamin Fang

Ellen [email protected]

COLUMNISTSGerald J. Archibald

SALES

Mary [email protected]

Dony [email protected]

MARKETING BBB Marketing Inc.

CIRCULATION

Circulation Management(315) 579-3927

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PUBLISHER EMERITUSNorman Poltenson

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Health-Care BRIEFS

SYRACUSE — St. Joseph’s Hospital Health Center has been re-designated by Baby-Friendly USA, Inc. as a “Baby-Friendly Hospital.”

This designation represents the “gold standard” of care for infant feeding and is a global initiative sponsored by UNICEF (United Nations Children’s Fund) and WHO (World Health Organization), accord-ing to a news release from St. Joseph’s.

As a baby-friendly hospital since 2009, all members of the

St. Joseph health-care team who care for mothers and infants have undergone extensive training in lactation support. The hospital is also staffed with lactation consul-tants who are board-certified by the International Board of Lactation Consultant Examiners. St. Joseph’s

also has a designated lactation room so patients, visitors, and employees can have convenient and private places to breastfeed or pump, the release noted.

Other important

practices of baby-friendly hospitals include encouraging skin-to-skin contact between mothers and newborns and having the newborn stay in the mother’s room instead of the hospital’s nursery. Both practices encourage bonding and improve the newborn’s ability to breastfeed. Studies also show that immediate skin-to-skin contact helps newborns maintain their temperatures better and normalize heart and breathing rates.

Currently, 229 of the 3,200 U.S. hospitals and birthing centers hold the “Baby-Friendly” designation, ac-cording to the release.

St. Joseph’s again obtains “Baby-Friendly Hospital” designation

ROME — Rome Memorial Hospital says it will open a new women’s health practice in March to provide obstetrical and gynecological services.

The hospital has hired Dr. Diana Wallace as physician for the new practice. Wallace comes to Rome from St. Luke’s-Cornwall Hospital in Newburgh, where she special-ized in obstetrics and gynecology (OB/GYN), accord-ing to a Jan. 30 news release from Rome Memorial Hospital.

The women’s health practice will be affiliated with the hospital. In addition to Wallace, the practice’s staff will include an office manager, nurse, and an employee to handle billing, ac-cording to Cassie Evans Winter, vice president of communica-tions and marketing at Rome Memorial.

“We are very pleased that Dr. Diana Wallace has made the

decision to relocate to Rome to provide care to women for every stage of life,” Basil J. Ariglio, president and CEO of Rome Memorial, said in the news release. “Patients will find her warm, personable, genuine and very down to earth. Her caring, outgoing personality

complements her commitment to providing quality medical care.” Wallace earned her bachelor’s degree in cardiopulmo-nary science and a master’s degree in applied anatomy

and physiology at Boston University.

She taught for 10 years before pursuing her medical degree at Universidad Autónoma de Guadalajara in Jalisco, Mexico. Wallace completed clinical training at Sound Shore Medical Center in New Rochelle, and her residency at St. Luke’s Hospital & Health Network in Bethlehem, Pennsylvania.

Rome Memorial Hospital to open new women’s health practice in March

PROVIDER

Tully Hill awarded three-year accreditation

TULLY — CARF International an-nounced that Tully Hill Chemical Dependency Treatment Center has been awarded a three-year accreditation for its detoxification, inpatient treatment, inten-sive outpatient treatment, and outpatient treatment programs.

It’s the fourth consecutive three-year accreditation that the international accred-iting body, CARF, has awarded to Tully Hill.

It’s the highest level of accreditation and shows the organization’s substantial conformance to the CARF standards, ac-cording to a news release. To earn the three-year accreditation, organizations must go through a rigorous peer-review process. They must demonstrate to a team of surveyors, during an on-site visit, their commitment to offering programs and services that are measurable, accountable, and of the highest quality, the release stated.

Tully Hill Corp. is a not-for-profit organi-zation with offices at 5821 Route 80, Tully. It has been providing treatment services in the Tully area since 1990.

CARF International is an independent, nonprofit accrediting body that was founded in 1966 as the Commission on Accreditation of Rehabilitation Facilities.

Wallace

2 HEALTHCARE PROVIDER I FEBRUARY 2015

Business JournalNews Network

Business JournalN e w s N e t w o r k

Business JournalNews Network

Business JournalNews Network

Business JournalNews Network

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BY eric [email protected]

SYRACUSE — Upstate University Hospital has earned certification as a “compre-hensive stroke center” from Milford, Ohio–based DNV GL Healthcare Inc. (DNV), a hospi-tal accreditation organization.

DNV notified Upstate of the designation Jan. 16, and the hos-pital held a ceremonial event to acknowledge the certification on Jan. 20.

DNV Healthcare is a wholly owned subsidiary of Norway–based Det Norske Veritus, a global organization with 8,600 employees in more than 100 countries.

The designation reflects the highest level of care and treat-ment that hospitals can provide

for serious stroke events.Upstate University Hospital is

the only hospital in Central New York to earn such a designation from DNV for its stroke care, according to a Jan. 20 news re-lease from the hospital.

Kaleida Health in Buffalo is the only other hospital in New York state that DNV has des-ignated as a comprehensive stroke center.

The certification is a “great honor” because it is a “long process,” says Dr. Julius Gene Latorre, medical director of the stroke program at Upstate.

“We started gathering our data sometime between September and October. And that’s the data from the last year or so. And then we applied in November,” says Latorre. He spoke with HCP on Jan. 30.

A hospital has to demonstrate that it has data indicating that it’s taking care of patients, he adds.

“You have to show that you are … monitoring the quality of care that you deliver and that you’re able to continue provid-ing the quality care that you’re able to evaluate your perfor-mance,” says Latorre.

In its evaluation, a hospital has to find out if it executed the care of the stroke patient prop-erly, if it was “appropriate,” and did the care “benefit the patient or not,” says Latorre.

“For Upstate to be certified as a stroke center, it’s kind of like a stamp of approval that we are doing a very good job,” he says.

The comprehensive stroke

Accrediting agency certifies Upstate University Hospital as ‘comprehensive stroke center’

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Dr. Gregory Eastwood, interim president of Upstate Medical University, left, presents Dr. John McCabe, CEO of Upstate University Hospital, with the of-ficial certificate from DNV Healthcare signifying that Upstate has met the standards to be designated as a comprehensive stroke center. Upstate says it is the only hospital in Central New York to earn this designation.

see certification, Page 20 4

Key nuMBers6

Jan. 20:hospital held a ceremonial

event to acknowledge certification

61 hour:

amount of time in which hospital must

complete diagnostic tests on an incoming

patient

FEBRUARY 2015 I HEALTHCARE PROVIDER 3

The certification is a “great honor” because it is a “long process,” says Dr. Julius Gene Latorre, medical director of the stroke program at Upstate.

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BY eric [email protected]

SYRACUSE — Le Moyne College and the St. Joseph’s College of Nursing will use additional grant funding in their part-nership that results in a bachelor’s de-gree for nurses.

The collaboration, which started about a decade ago, also now includes several partners using the same education model around New York state.

The education model involves partner-ships between four-year and two-year programs.

The Robert Wood Johnson Foundation (RWJF) has awarded a $300,000, two-year grant in Phase II of its Academic Progression in Nursing program (APIN).

Le Moyne’s nursing program and the St. Joseph’s College of Nursing partnered for the first $300,000 APIN grant award-ed to the Guilderland, New York–based Foundation of New York State Nurses, Inc. in 2012.

The foundation used the RWJF grant to support the efforts of the Future of Nursing New York State Action Coalition to implement the Institute of Medicine’s (IOM) recommendation that 80 percent of practicing registered nurses (RNs) hold a bachelor’s degree by 2020.

The Foundation of New York State Nurses’ website lists the coalition as a “collaborative partner.”

The IOM’s recommendation was part of a report on the future of nursing that the Institute and RWJF issued in 2011.

“It’s 80 percent of nurses who will ob-tain a bachelor’s degree or higher [in that time],” says Susan Bastable, director of the Le Moyne College nursing program.

She spoke with CNYBJ on Jan. 28.The Washington, D.C.–based Institute

of Medicine is an independent, nonprofit organization that “works outside of gov-ernment to provide unbiased and au-thoritative advice to decision-makers and the public,” according to its website. The IOM is the health arm of the National Academy of Sciences.

Securing APIN grantThe Foundation of New York State

Nurses and the Future of Nursing New York State Action Coalition advised

Bastable and Marianne Markowitz, vice president and dean of the St. Joseph’s College of Nursing, to pursue the APIN grant for use in 2012.

“If we get it, we will replicate that model in New York,” Bastable says, paraphras-ing what the coalition had told her about its plan.

Bastable, a registered nurse who start-ed Le Moyne’s nursing program in 2005, worked with Markowitz in implement-ing a 1+2+1 model after launching Le Moyne’s program.

Locally, it involves students taking classes during the first year at Le Moyne, the middle two years at St. Joseph’s, and the final year back at Le Moyne, according to Bastable.

“It allows for a student to be able to graduate in three years and earn their registered-nursing license and then con-tinue their education in year four, full time … and have their baccalaureate degree in four years,” says Markowitz. She spoke with HCP on Feb. 3.

A bachelor’s degree involves more time and coursework, she adds.

“They have more coursework in the-ory courses like family health, physical assessment; more course work in the higher levels of liberal arts like psychol-ogy and sociology and English,” says Markowitz.

The foundation forwarded the RJWF funding to Le Moyne and the St. Joseph’s College of Nursing for administrative purposes and to compensate the schools for operating the program.

“It pays for all of our … marketing of the program,” says Bastable.

It also funds a position focusing on data analysis from all the programs the collaboration is establishing in New York. The data includes diversity, gender, re-tention, graduation, and licensing rates.

The grant also pays for Bastable and Markowitz to make site visits to the universities that have become partners under the grant funding in what they’re calling the New York State Nursing Education Collaborative (or NYSNEC).

“Prior to this grant being received, there were a couple of schools in the state that had already tried to replicate … our model because it was on our web-site,” says Bastable.

The other schools involved include Daemon College in Buffalo, which has three associate-degree partners and SUNY Polytechnic Institute in Marcy, which is partnering with the St. Elizabeth College of Nursing, says Bastable.

“They, too … get money to help fund their marketing brochures,” she adds.

RWJF eventually decided it wanted to fund a second phase of grants in the APIN program. Le Moyne and St. Joseph’s met and exceeded the benchmarks.

“They literally asked us if we would … apply for Phase II,” says Bastable.

The Foundation of New York State Nurses has secured about $600,000 in separate grants to help pay for replication of this 1+2+1 model throughout New York, she says.

The two education leaders have also explained the model to groups in New Jersey and Vermont, says Markowitz.

The grant’s first phase produced “significant” progress, including a 23

Le Moyne, St. Joseph’s College of Nursing alliance gets grant boost

4 HEALTHCARE PROVIDER I FEBRUARY 2015

Bastable

Markowitz

See Boost, page 20 4

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FEBRUARY 2015 I HEALTHCARE PROVIDER 5

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Health-care jobs are prominent on trending jobs list for CNY, Southern Tier

The New York State Department of Labor on Jan. 20 is-sued a list of the top five trending jobs for this year in regions around the state, based on what employers are telling the agency are the positions they are struggling to fill.

In Central New York (Cayuga, Cortland, Madison, Onondaga, and Oswego counties), the following job titles (and their annual median wage) are likely to see greater than normal growth through the end of 2015, the Labor Department said:

• Industrial-machinery mechanic ($49,620)• Certified nursing assistant ($27,630)• Electrician ($52,870)• Welder ($36,710)• Registered nurse ($59,130)In the Southern Tier (Broome, Chemung, Chenango,

Delaware, Schuyler, Steuben, Tioga, and Tompkins coun-ties), these five job titles (and their annual median wage) are likely to see higher than normal growth through the end of 2015:

• Heavy and tractor-trailer truck drivers ($37,290)• Nursing assistants ($28,480)

BY BENJAMIN FANGContributing [email protected]

The Central New York and Southern Tier job markets are hardly booming, but for some jobs, candidates are in demand. The health-care field has a few of those positions.

ANNUAL MEDIAN WAGES

Registered

Nurses in Central New York:

$59,130

Registered Nurses

in the Southern Tier:

$65,660SEE JOBS, PAGE 20

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6 HEALTHCARE PROVIDER I FEBRUARY 2015

BY NormaN [email protected]

BINGHAMTON — Background checks for employment and medical-fraud avoidance purposes are a hot topic.

The U.S. Equal Employment Opportunity Commission has brought suit for the im-proper use of background checks of employ-ees against high-profile defendants such as BMW North America and Dollar General.

Attorneys have also brought class-action law suits against employers that fail to fol-low the requirements of the Fair Credit Reporting Act (FCRA). Recent settlements of FCRA alleged violations include K-Mart, which agreed to pay more than $3 mil-lion; US Xpress, which paid $2.75 million; Domino’s Pizza, which paid $2.5 million; and Swift Transportation, which paid $4.4 million to settle the claims of 10,000 appli-cants seeking employment. Whole Foods and Disney are contesting their suits.

The rash of law suits has captured the attention of employers, who are not only concerned that they have to conduct

these investigations to protect against ac-cusations of an “unsafe workplace,” but also have to conduct them in a manner that complies with strict federal and state regulations.

The legal exposure of all employers is a bonanza for agencies such as Evolution Consulting, LLC (Evolution), headquartered at 49 Court St. in downtown Binghamton. Founded in 1994 by Anthony (Tony) P. Elwood, Evolution began as a one-man specialty drug-screening and background-investigation firm.

“Tony started this business in his home,” says Tia Allen, the company’s vice president of operations. “Early on, he used to drum up [drug-screening] business by watching trucks drive down the street and record-ing the [company’s] contact information. His more than two decades of training and experience in law enforcement with the New York State Police were instrumental in growing the business.

“The company grew rapidly beginning in 2009 when it expanded into the medical-fraud area. In 2011, Elwood created his

second corporation — OIG Compliance Now, LLC. (OIGCN) — as a third-party administrator to help health-care employers prevent Medicaid/Medicare fraud in their organizations and to protect themselves against the loss of reimbursements from government health-care programs.

Today, the two companies employ 45 peo-ple in one location at the Metro Center where they lease about 9,000 square feet. Both firms are privately owned. The Business Journal estimates that the companies gener-ate about $5 million annually in consolidated revenue. Evolution and OIGCN together serve several hundred clients.

Background checksThe idea of negligent hiring dates back

to 1908 when the legal precedent was es-tablished that employers have an affirma-tive duty to provide a safe workplace. The concept included the hiring and retaining of safe employees. It wasn’t until the late 1970s, however, that negligent-hiring claims became common as a cause of action in cases of workplace violence. Employers soon learned to screen not only employees, but also prospective business partners, ven-dors, board members, and even volunteers. Background checks also became highly regulated with the passage of the FCRA in 1970, which was followed by myriad fed-eral and state rules. The law now provides consumers with a number of provisions to protect their privacy rights, including not just the obtaining and use of information but also the distribution of this information by consumer-reporting agencies.

“It’s no surprise, then, that background-checking in the workplace has exploded in the last 10 years,” says Allen, “with employ-ers finally realizing that the cost of these background checks is small when com-pared with exclusion from reimbursement and defending a law suit plus paying dam-ages, fines, and penalties. Since 9/11, the threat of terrorism [by a lone wolf] has only added to employers’ concerns. Background screening is here to stay, and it’s not just for sensitive or high-level positions; it’s for ev-erybody, including minimum-wage workers and volunteers.”

The National Association of Professional Background Screeners estimates that the industry’s revenues are in the multi-billion-dollar range. Evolution’s first big contract was with Ascension Health — a leading

Binghamton firm that helps prevent medical fraud is poised for growth

Tia Allen, vice president of operations at Evolution Consulting and OIG Compliance Now in Binghamton, anticipates substantial growth in 2015. The companies specialize in background checks and sanctions screening for government health-care programs.

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FEBRUARY 2015 I HEALTHCARE PROVIDER 7

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VNA Homecare names Cheryl Manna COOBY JOURNAL [email protected]

SYRACUSE — VNA Homecare announced it has promoted Cheryl Manna to chief operating officer (COO).

In her new role, Manna will be respon-sible for overseeing day-to-day operations at the Syracuse–based home health-care agency, which has more than 2,000 pa-tients.

“…Manna will play a key role in po-sitioning VNA Homecare for continued marketplace success,” Kate Rolf, presi-dent and CEO of VNA Homecare, said in a news release. “She brings a diverse set of leadership skills, extensive operations expertise, and a successful track record that we will leverage across the system.”

Most recently, Manna was director of managed care operations for VNA Homecare Options, LLC, which is VNA Homecare’s managed long-term care program. She was responsible for the

operations of the plan, including the pro-vider network, member services, trans-portation, billing, and claims, the release stated.

Manna joined VNA Homecare in 2013, bringing 26 years of home health-care experience to the organization. She is a graduate of SUNYIT.

VNA Homecare has 500 total employ-ees, including 480 in Central New York, according to CNYBJ Research. The orga-nization expected to generate $32 million in revenue in 2014. n

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St. Joseph’s Ruscitto talks electronic medical records, finances, physician network

BY ERIC [email protected]

SYRACUSE — St. Joseph’s Hospital Health Center’s leader believes its new elec-tronic medical-record sys-tem will help improve the hospital’s annual financial performance in the coming years.

HEALTH CARECEO TALK

Kathryn Ruscitto,

St. Joseph’s Hospital Health

Center’s presi-dent and CEO,

in the hospital’s main lobby.

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St. Joseph’s last May launched SJLinked, an electronic health-record (EHR) system across its entire organiza-tion, including the hospital, clinics, and the primary-care offices of St. Joseph’s Physicians.

The health-care organization has used electronic records since 1999, but the system-wide EHR means all providers are on the “same screen, ensuring con-sistency and improving coordination of care,” St. Joseph’s said in a news release in May 2014.

St. Joseph’s collaborated with Verona, Wisconsin–based Epic Systems to design SJLinked. Nearly 200 employees from various units worked with Epic for 18 months to build and test the customized EHR platform.

SJLinked enables St. Joseph’s doctors and nurses to share test results, medica-tion lists, physician notes, and other infor-mation across hospital units, ambulatory services, and in-transitions between care settings.

The system connects “everything we do,” from the primary-care office through the hospital back out to the com-munity, says Kathryn Ruscitto, president and CEO of St. Joseph’s Hospital Health Center.

“Over time, I’m told by other CEOs they see their capture of revenue in-crease by almost 5 percent on an annual basis,” she says.

Ruscitto spoke with HealthCare Provider on Feb. 5.

The electronic records could prevent repeat tests and/or duplicating proce-dures in the course of a patient’s treat-ment.

“It improves the quality of care, has less impact on the patient, and, over time, produces better financial performance,” Ruscitto says of SJLinked.

St. Joseph’s expected to finish 2014 with annual revenue of nearly $634 mil-lion, according to information it provided for the Jan. 26 CNYBJ Progress Edition. The health-care organization is project-ing revenue of more than $660 million in 2015.

SJLinked allows St. Joseph’s personnel to attribute, “without handwriting,” every aspect of a given patient’s care.

Ruscitto conceded that implementa-tion of the new EHR system resulted in reduced productivity because “every-body has to slow down, learn the sys-tem.” She expected 2014 to be a “bumpy” year.

“Now we’re expecting to really realize the benefits going forward and every

year, it’s going to have a bigger payback for us because we will have gone from hand writing, hand attributing, to every-thing being automated,” says Ruscitto.

The system “immediately” codes and produces the patient bill, so it’s “more accurate, less bouncing back, less audit related to it,” she adds.

Its previous software vendor informed St. Joseph’s that it was “pulling the plug” on the system, something the organiza-tion didn’t anticipate happening.

“The last thing I wanted to do was rip [up] and replace a technology system the same year we were opening a new tower, but we had no choice,” she says.

Physicians and ACQA

St. Joseph’s and Excellus BlueCross Blue Shield, Central New York’s largest health insurer, are collaborating on an ACQA, which is short for account-able cost and quality arrangement.

An ACQA — which is designed to “achieve enhanced care coordination, improve patient sat-isfaction and outcomes, and reduce health-care costs” — will benefit Excellus members who are under the care of St. Joseph’s-affiliated physicians, the organi-zations said in a news release they issued last Aug. 27.

Ruscitto describes ACQA as “private insurance.”

The ACQA is Excellus’ version in this market of what the state and federal gov-ernments are offering through the health-care exchanges under the Affordable Care Act, she noted.

The organizations believe they can deliver “better” health-care quality and avoid “unnecessary” costs by “improving access to primary care medical services (to manage chronic illnesses such as dia-betes and reduce the need for emergency room visits), improving medication ad-herence rates and limiting duplication of services,” according to the Aug. 27 news release.

The ACQA assesses quality perfor-mance through the use of national quality measures, which include performance

thresholds for diabetes, blood pressure, and coronary-artery disease.

With its collaboration with Excellus, St. Joseph’s has formed a clinically inte-grated network (CIN) of physicians, says Ruscitto.

Physicians that currently work for the hospital are now branded as St. Joseph’s Physicians.

Ruscitto says “more and more” physi-cians want to be part of that network, so the hospital will “continue to offer that

option.” “But we also have a number of inde-

pendent physicians who want to stay in-dependent, so we’re joining together with them to create the clinically-integrated network [CIN],” she adds.

The clinically-integrated network in-volves all the physicians coming together to jointly begin to understand how to improve quality and reduce cost.

“The first product we will offer through the CIN is ACQA. [It] won’t be the only, but it will be the first,” says Ruscitto.

The group will also work to “better manage care” for the Medicaid and Medicare populations.

“It will be physicians, in a governance role, talking together and saying … why is orthopedics doing it this way and car-diac surgery doing it this way. How do we get a better common platform for how a patient moves, and when we share a pa-tient in common, how do we do a better job?,” she adds.

As of Jan. 1, about 300 physicians have enrolled to offer the AQCA product, says Ruscitto. n

eric reinhardt/business journal news network

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Onondaga Community College offers medical-billing and coding training BY ERIC [email protected]

ONONDAGA — Onondaga Community College (OCC) is offering training for those in-terested in the field of medical billing and coding.

“We’re offering this class to help people get the training, get the credentials, and then obtain em-ployment,” says Barbara Dennehy, OCC’s coordinator of lifelong learning.

The training will also prepare the participants to take the national cer-tification exams, should they choose to take the exams, she adds.

Dennehy spoke with CNYBJ on Jan. 29.

During the past year, orga-nizations in Central New York

posted nearly 300 related open-ings, according to a Jan. 13 news release from OCC.

Michael Metzgar, OCC’s associate vice president for economic & workforce develop-ment, who uses labor-market analytical software for real-time

data, provided the figure, according to Dennehy.

She calls it a “fast-growing” field in the na-tion’s health-care industry.

Training will include the new federally mandat-ed coding stan-dards that take effect in October 2015, OCC said.

The average starting salary in the Syracuse area is $24,700, according to the school.

The training lasts 300 hours for nine months from March 9

through Dec. 9, says Dennehy. “It’s broken down into two

parts: medical coding and medi-cal billing. The first part, medi-cal billing, will be 120 hours and it’s both classroom lecture and then simulated billing with software in a computer lab,” she adds.

The coding instruction in-cludes 140 hours of classroom work and 40 hours in the lab.

Each service that a health-care provider offers has a code for medical-claim reimburse-ment purposes.

“Coders will go through patient charts and assign the proper codes to the services that were provided,” she says. The services could include an exam or laboratory work.

Medical coders and billers work “hand in hand,” says Dennehy.

Billers prepare the insurance claims for reimbursement.

Training participants will learn about completing the

forms and then processing insurance claims for reim-bursement. They’ll also learn about the insurance-industry standards for the processes in-volved, she adds.

They work in physician offices, hospitals, and nursing homes.

“Every medical office needs someone with the knowledge of coding and billing,” says Dennehy.

The course also prepares stu-dents for one of three national certification exams, which OCC recommends.

Students would have to reg-ister for and take the exam on their own, the school said. The exam is optional and not re-quired for employment.

OCC held a Feb. 3 informa-tion session for those interest-ed in enrolling in the training course.

“They certainly can stop by our office or give us a phone call and we can walk them through that and answer any questions that they have,” Dennehy says.

Tuition for the full 300-hour program is $2,700, which in-cludes all books and materi-als. OCC will hold classes on Monday and Wednesday eve-nings from 5:45 p.m. to 9:45 p.m. in Mulroy Hall. n

Dennehy

BY JOURNAL [email protected]

AUBURN — Syracuse Orthopedic Specialists (SOS) announced recently it has begun a partnership with Urgent Care of Auburn (for-merly Insource Urgent Care) to provide “con-venient” access to orthopedic care for patients in Auburn and surrounding locations.

Kevin Lake, currently a physician’s assis-tant with SOS, now sees patients Thursday afternoons at Urgent Care of Auburn, lo-cated at 37 West Garden St., Suite 105.

Urgent Care of Auburn (www.urgent-careofauburn.com) opened about one-and-a-half years ago, led by medical director, Mark McSwain, M.D. He is board-certified

in both internal medicine and pediatrics, and has been providing primary care in the Auburn area for 12 years.

“This partnership [with SOS] is a logical step for Urgent Care of Auburn, and more importantly offers greater patient conve-nience,” McSwain said in a news release. “Our patients now have easier access to some sub-specialties of orthopedics that aren’t currently avail-able in the Auburn area, and are introduced to SOS through the familiarity of Urgent Care of Auburn.”

Many patients of Urgent Care are elderly and “do not feel comfortable driving into

Syracuse or beyond for orthopedic care, and this partnership offers a solution,” Nicole Chidsey, community relations coor-dinator at SOS, added in an email.

Lake will be able to treat current and new patients at Urgent Care of Auburn with spe-cialty orthopedic treatments that have been previously unavailable to patients there. While patients may initially receive orthope-dic treatment at Urgent Care with Lake, they may need to receive follow-up care at anoth-er SOS location, the release stated. SOS also has offices in Camillus, Baldwinsville, Cicero, Clay, DeWitt, Fayetteville, Liverpool, North Syracuse, Onondaga Hill, and Syracuse, ac-

cording to its website.Lake joined SOS in

2011. He previously worked as a certified athletic trainer for

nearly a decade, providing care and cov-erage for numerous athletic teams and events. Lake earned his master’s degree in the physician-assistant program at the Medical College of Ohio. n

Syracuse Orthopedic Specialists partners with Urgent Care of Auburn

10 HEALTHCARE PROVIDER I FEBRUARY 2015

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T heir training and education make physicians highly skilled at what they do, but a hole may exist in their

knowledge that has nothing to do with patient care.

All those years of training do not prepare doctors to navigate the legal thickets when it’s time to accept a posi-tion and sign an em-ployment contract.

That lack of knowl-edge can lead to costly mistakes. You have worked hard to get where you are; now it’s

time to reap the rewards of all that hard work. Contract hazards loom, though, that can make a long-term dent in a doctor’s income-earning potential.

When the person you are dealing with tells you that you have been given the “standard” contract, he or she either is misrepresenting the situation or is misinformed. Doctors make five “deadly” mistakes when they sign a con-tract without the proper legal assistance.

1 Relying on the offer letter Since the letter offering employ-ment is signed by the new employer, many doctors believe

the language is binding. That’s not the case. In fact, the offer letter that you were given has no legal effect once you sign an employment agreement. Virtually every physician employment contract has lan-guage that says the signed employment agreement supersedes any prior negotia-tions or documents. So, make sure any promises in the offer letter are covered in the contract.

2 On call, all the timeDoctors can end up being thephysicians who are always on callon the weekends, holidays, or

after hours if they are not careful about contract language. The number of doc-tors in a practice ultimately can affect how much “call coverage” falls to each person, but it’s prudent to include clear and concise language regarding what is expected of you in your employment agreement.

3 Not grabbing malpractice by the tail

Many health-care employerscarry a type of malpractice insur-

ance known as “claims made” coverage. Those policies cover a claim only when it’s made during the policy period. If a doc-tor leaves employment, and a malpractice claim is filed later, the doctor isn’t cov-ered. Physicians can continue coverage by purchasing what’s called a “tail” policy, but those policies can be extraordinarily expensive. It’s important that an employ-ment agreement addresses payment for tail coverage after you leave.

4 You can’t work thereProvisions that place restrictionson where you can work when youleave employment are called “re-

strictive covenants” and many physicians learn the hard way that those covenants can have an enormous impact on their careers.

Often, the covenants say a doctor can’t practice medicine within a certain geo-

FEBRUARY 2015 I HEALTHCARE PROVIDER 11

Actuarial and Employee Benefi t Plan Consulting

For more than 30 years, Harbridge Consulting Group has assisted employers in managing their bene� t plans.

OUR SERVICES INCLUDE:

One Lincoln Center • Syracuse, NY 13202 • (315) 703-8900 • www.bpas.comOne Lincoln Center • Syracuse, NY 13202 • (315) 703-8900 • www.bpas.com

Actuarial and Employee

Benefit PlanConsulting

For more than 30 years, Harbridge Consulting Group

has assisted employers in managing their benefit plans.

Our services include:

One Lincoln Center, Syracuse, NY 13202 (315) 703-8900

Five ‘Deadly’ Mistakes Doctors Make When They Sign Employment Contracts

VIEWPOINT:

DENNIS HURSH

SEE MISTAKES, PAGE 19

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12 HEALTHCARE PROVIDER I FEBRUARY 2015

New York tackles Medicaid reform with DSRIP

N ew York state, at Gov. Andrew Cuomo’s direction, continues to implement the most dramatic

health-care reform of any state in the coun-try. The state’s reform initiatives directly affect the 25 percent of New Yorkers (6 mil-lion citizens) who are eligible for Medicaid.

Beginning with the 79 recommendations of the Cuomo-appointed Medicaid Redesign Team (MRT) in 2011, the state Department of Health has been on an ambitious Medicaid-reform track to try to control the more than $50 billion of annual New York state (NYS) Medicaid expendi-tures. In March 2014, the state negotiated

an agreement with the federal Centers for Medicare and Medicaid Services that re-quires transformation of the NYS Medicaid program from a fee-for-service (or FFS) to a value / performance-based reimbursement system, commonly referred to as pay-for-performance (P4P). Most health-care ex-perts acknowledge that a transformation of this magnitude should take up to 10 years. New York continues to focus on a 3-5 year implementation plan, with 2015 representing a key transition point toward satisfying the transformational objectives.

As you know, we can’t do anything in health care without creating a few more acronyms. The Delivery System Reform Incentive Payment Program (DSRIP) serves as the umbrella description for the process of Medicaid reform. Under the DSRIP agreement between the state and federal governments, NYS can receive up to $8.5 billion of performance incentive pay-ments ($6.5 billion for non-governmental service providers). The primary objectives of the DSRIP implementation over the next five years are as follows:n Reduce/Eliminate avoidable hospital

emergency room visits by 25 percentn Reduce avoidable hospital in-patient

admissions by 25 percentn Reduce hospital readmissions by 25

percentReducing hospital utilization is the same

objective that spawned the implementation of managed-care insurance plans some 40 years ago, following the federal Health Maintenance Organization (HMO) Act of 1973. Managed care for the employed popu-

lation covered by HMOs essentially failed in its objective, which has led us to the proliferation of consumer-directed health plans, employer self-insurance, and medical cost shifting from employers to employees.

The stated goals of the DSRIP initiative are addressing a monumental challenge. The foundation structure of DSRIP is dependent upon the success of Performing Provider Systems (PPS). A PPS is a coalition of re-gional health and human-service providers linked to a lead hospital/health system.

The stated goals of DSRIP are:n Promote community-based collabora-

tion among health and human-service pro-viders working in concert with the PPS lead health-care systems. n Improve clinical performance, quality,

and service outcomes to achieve primary P4P objectives.n The $6.5 billion of DSRIP performance

incentives will require a 25 percent reduc-tion in “avoidable hospital use” over the next five years (i.e., primarily ER visits and hospital admissions/readmissions)

The success of the DSRIP initiative will be dependent upon the unprecedented co-operation and collaboration of hundreds of health and human-service providers in each of the 11 PPS regions of the state.

Last August, 88 applications were submit-ted for consideration and state approval to form PPS organizations. After approving 42 of the applications, coupled with con-solidation of certain applicants, we now have 25 PPS organizations being formed in response to the DSRIP initiative. Each of these 25 fledgling PPSs generally involves hundreds of community-based network providers who will have to learn quickly to “play in the sandbox” together.

The DSRIP design structure identified more than 35 project initiatives for the PPS entities to address in their recently submit-ted Project Plan Applications (December 2014), in the following areas:n Health-care system transformation

projectsn Clinical-improvement projects empha-

sizing care coordinationn “Population Health” focused on a pre-

ventive-care agendaThe entire DSRIP initiative is proceeding

at a break-neck pace. For example, the PPS Project Plan initiatives submitted in December require each PPS to select up to 10 initiatives from the 35 identified by the DSRIP team, These applications are being evaluated in the first quarter of 2015 with approval of project plans and grant awards in April.

As a taxpayer, it is hard to argue with the concept and stated objectives of the DSRIP initiative. The timing and coordination of Project Plan implementation, along with provider collaboration, will be a critical component of success. For many health and human-service providers, these project ini-tiatives represent a seismic restructuring of the service-delivery system which has been carefully developed by NYS over the past 50 years since the enactment of Medicaid and Medicare legislation in 1965.

As a nonprofit board and/or manage-ment team member, the DSRIP PPS ini-tiative will require timely evaluation and decision-making processes. Organizations that serve one or more of the high-cost vulnerable populations will be most signifi-cantly affected:n Elderly — nursing-home residents/

home-care servicesn Mental health — Community-based

integration coupled with case management to avoid hospital utilizationn Substance abuse — Rehabilitation

intoxication in community-based program sitesn Intellectual/developmentally disabled

— provide services in the least-costly, com-munity-integrated location emphasizing in-dependence and self-sufficiencyn At-risk youth — increased use of foster

care in the home while diverting services away from institutional-based services

Services to these vulnerable populations will require effective strategic positioning of your organization to achieve success in this transformational restructuring of Medicaid service delivery. n

. Gerald J. Archibald, CPA, is a partner in charge of the management advisory ser-vices at The Bonadio Group. Contact him at [email protected]

gerald j. archibald

Nonprofit Management

“As you know, we can’t do anything in health care without creating a few more acronyms. The Delivery System Reform Incentive Payment Program (DSRIP) serves as the umbrella de-scription for the process of Medicaid reform. “

Page 13: 021615 hcp flip

Nashville–based Pinnacle made the an-nouncement in a news release posted on its website Feb. 4.

Davie, Florida–based BHG is a provider of financing for health-care professionals across the U.S. The firm’s financial head-quarters are located at 201 Solar St. in Syracuse. It employed about 70 people there, as of last June, according to a June 20, 2014, article in The Central New York Business Journal.

BHG’s loan originations are sourced through a variety of distribution channels and primarily sold through an online-auc-tion process to a network of about 200 community banks, according to the Pinnacle

news release. BHG generated revenue of about $98

million in 2014, with pretax income of about $49 million, Pinnacle said.

As part of the investment, Pinnacle will get to name one member of BHG’s four-person board of directors.

BHG’s other three founders and execu-tive officers will retain a 70 percent owner-ship interest in BHG and have contractually agreed to remain with the firm for an “ex-tended period of time,” Pinnacle said.

BHG’s reputation in the medical com-munity, growth trajectory, and “solid” lead-ership make for a “strong” partnership,” M. Terry Turner, Pinnacle’s president and CEO, said in the news release.

Pinnacle Financial Partners provides a range of banking, investment, trust, mort-gage and insurance products and services designed for businesses, their owners, and individuals.

Launched in 2000, Pinnacle currently has about $6 billion in assets, as of Dec. 31, 2014, according to its news release. n

FEBRUARY 2015 I HEALTHCARE PROVIDER 13

Healthcare A Division of Research & Marketing Strategies

866-567-5422 | www.RMSresults.com ASK. LISTEN. SOLVE.

Holding Healthcare to a Higher Standard We understand in this ever-changing healthcare environment that your

focus is to provide quality patient care while optimizing operations. RMS Healthcare can act as an extension of your organization in providing operational support, consulting and research services to guide you in your

transformation journey. We specialize in: ● Patient-Centered Medical Home (PCMH) Recognition

● Pay for Performance (P4P) Program Optimization ● Community Health Needs Assessment (CHNA) ● Patient Satisfaction Surveys (CAHPS®) ● HIPAA Compliance Training ● Practice Assessment ● Practice Management

Tennessee firm acquires 30 per-cent stake in Bankers Healthcare Group for $75 million

BY JOURNAL [email protected]

Pinnacle Financial Partners, Inc. (NASDAQ: PNFP) announced that its sub-sidiary, Pinnacle Bank, has acquired a 30 percent inter-est in Bankers Healthcare Group, LLC (BHG), a pri-vately held company with operations in Syracuse, for $75 million.

Page 14: 021615 hcp flip

14 HEALTHCARE PROVIDER I FEBRUARY 2015

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THE LISTResearch by Nicole [email protected] (315) 579-3911Twitter: @cnybjresearch

ABOUT THE LISTInformation was provided by representatives of listed organizations and their websites. Other groups may have been eligible but did not respond to our requests for information. Organizations had to complete the survey by the deadline to be included on the list. While The Business Journal strives to print accurate information, it is not possible to independently verify all data submitted. We reserve the right to edit entries or delete categories for space considerations.

WHAT cOnSTITUTES THE cnY REgIOn?Central New York includes Broome, Cayuga, Chemung, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, Seneca, St. Lawrence, Tioga, and Tompkins counties.

nEEd A cOpY OF A LIST?Electronic versions of all our lists, with additional fields of information and survey contacts, are available for purchase at our website, cnybj.com/ListsResearch.aspx

WAnT TO BE On THE LIST?If your company would like to be considered for next year’s list, or another list, please email [email protected]

nOTES:1. Medicare.gov Five-Star Overall Ratings combines three sources of data: health inspections, staffing, and quality measures.

Page 15: 021615 hcp flip

FEBRUARY 2015 I HEALTHCARE PROVIDER 15

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THE LISTResearch by Nicole [email protected] (315) 579-3911Twitter: @cnybjresearch

ABOUT THE LISTInformation was provided by representatives of listed organizations and their websites. Other groups may have been eligible but did not respond to our requests for information. Organizations had to complete the survey by the deadline to be included on the list. While The Business Journal strives to print accurate information, it is not possible to independently verify all data submitted. We reserve the right to edit entries or delete categories for space considerations.

WHAT cOnSTITUTES THE cnY REgIOn?Central New York includes Broome, Cayuga, Chemung, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, Seneca, St. Lawrence, Tioga, and Tompkins counties.

nEEd A cOpY OF A LIST?Electronic versions of all our lists, with additional fields of information and survey contacts, are available for purchase at our website, cnybj.com/ListsResearch.aspx

WAnT TO BE On THE LIST?If your company would like to be considered for next year’s list, or another list, please email [email protected]

nOTES:1. Medicare.gov Five-Star Overall Ratings combines three sources of data: health inspections, staffing, and quality measures.

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16 HEALTHCARE PROVIDER I FEBRUARY 2015

The 5 fastest-growing health-care occupationsBY NICOLE [email protected]

H ealth-care support occupations are expected to grow by 28.1 percent, or by 1.2 million jobs, by 2022 from 2012 levels.

Health-care support jobs are growing more than any other major occupational group, according to the U.S. Bureau of Labor Statistics (BLS). The projected national growth rate of all occupations is 10.8 percent for the 10-year period.

Of the 20 occupations with the highest projected percent change of employment during this pe-riod, more than half are health-related. Below is a breakdown of the projected top five fastest growing health-care occupations from the BLS.

Personal-Care Aidesn Number of jobs in 2012: 1,190,600n Projected job growth, 2012-2022: 49%n Employment change, 2012-2022: 580,800n Median Pay, 2012: $19,910

Home Health Aidesn Number of jobs in 2012: 875,100n Projected job growth, 2012-2022: 48%n Employment change, 2012-2022: 424,200n Median Pay, 2012: $20,820

Diagnostic Medical Sonographersn Number of jobs in 2012: 58,800n Projected job growth, 2012-2022: 46%n Employment change, 2012-2022: 27,000n Median Pay, 2012: $65,860

Occupational-Therapy Aidesn Number of jobs in 2012: 30,300n Projected job growth, 2012-2022: 42%n Employment change, 2012-2022: 12,900n Median Pay, 2012: $53,240

Physical-Therapy Assistantsn Number of jobs in 2012: 71,400n Projected job growth, 2012-2022: 41%n Employment change, 2012-2022: 29,300n Median Pay, 2012: $52,160

How the health-care sector uses mobile devicesBY NICOLE [email protected]

R esults from a recent Spok survey of more than 600 health- care organizations across the

globe found that 44 percent of them have a documented mobile strategy. That’s up 10 percent from a year ago. Among the health-care facilities that didn’t have a strategy, 33 percent are ac-tively in the process of developing one.

Spok, a Springfield, Virginia—based communications firm, started conducting the “Mobility Strategies in Healthcare” survey in 2010 to iden-tify trends in mobile-device usage in

hospitals, as well as to see how far along hospitals are in devising their strategies.

Hospitals say improving efficiency and facilitating communication with doctors and nurses are the main driv-ers for using mobile devices, while se-curity and costs remain top concerns.

The 2014 report says the key take-away from the results is that “different devices fit better for different roles, so standardization is highly unlikely. Having a platform with the ability to effectively communicate with a diverse array of devices is essential.” See below for a breakdown of mobile devices sup-ported by health-care organizations. n

73% Smartphones

53% Tablets

53% Tablets

63% In-house pagers

54% Wide-area pagers

44% Wi-fi phones

7% Others

Source: Mobility Strategies in Healthcare 2014 survey from Spok, Inc.

The Business Journal News Network Call (800) 836-3539 today to subscribe

Page 17: 021615 hcp flip

FEBRUARY 2015 I HEALTHCARE PROVIDER 17

The Business Journal News Network and Berkshire Bank announce the most exciting event coming to the Mohawk Valley. On April 30th we will recognize Mohawk Valley’s most dedicated and visionary leaders. Entrepreneurs who have built thriving corporations and who have also generously supported our community, both fi nancially and with their time and talent.

Visit bizeventz.com to register or for more information

Thursday, April 30, 2015

Stanley Theatre, Utica

Mohawk ValleyAWARDSPresented By:

Thursday, April 30, 2015

Stanley Theatre, Utica

Mohawk ValleyAWARDSPresented By:

LEGACY

Announcing the 2015 honorees!Nick & Fred Matt

F.X. Matt Brewing Co./Saranac

Greg HardenHarden Furniture

Charles, Bill & Brian GaetanoCharles A. Gaetano Construction Corp.

Kirk & Mark HinmanRome Strip Steel Co., Inc.

Event Details:Event date: April 30, 2015Location: Stanley Theatre, UticaTime: 6:00 pm-8:30 pm

6:00 pm-7:30 pm: Enjoy delicious food stations, open bar, networking & live music! (Please note: this is not a sit-down dinner, it is open-seating)7:30 pm-8:30 pm: Awards Program, Dessert & Photos

Cost: $75/ticketBlack Tie Optional

Page 18: 021615 hcp flip

delta medical

BRIDGET ARQUETTE, nurse practitioner, has joined the staff of the adult primary care practice of Delta Medical. She earned her bachelor’s and mas-ter’s degrees in nursing as an adult nurse prac-titioner from Syracuse

University College of Nursing. Arquette also earned a post-master certificate as a family nurse practitioner through the Community General Nurse Practitioner Program in Syracuse.

lORettO

DIANA FARNETI has been named chief nurs-ing officer for skilled nursing at Loretto. Most recently, she served as director of critical care and cardiac services for six years at St. Joseph’s Hospital Health System. Farneti

previously was director of patient care ser-vices at Carolinas Medical Center Mercy in Charlotte, N.C., and worked for many years at Community General Hospital in Onondaga. She received her master’s de-gree in nursing from SUNY Health Science Center.

mOhawk valley health system

Mohawk Valley Health System (MVHS) has named SANDRA FENTIMAN manager of communications and marketing at St. Elizabeth Medical Center and Community Outreach for MVHS. She had been manager

of marketing, public relations, and govern-ment affairs at SEMC since 2006. Before joining SEMC, Fentiman was director of alumni and media relations at USC The Business College, Utica; director of public relations and development assistant at Folts

Homes, Herkimer; and business editor and bureau reporter at the Observer-Dispatch. Fentiman holds a bachelor’s degree in plant science from the University of New Hampshire, and an associate degree in lib-eral arts and humanities from Schenectady County Community College.

ERIN GIGLIOTTI has been named manager of communications and marketing at Faxton St. Luke’s Healthcare (FSLH) and media spe-cialist for MVHS. She had been a communica-tions specialist at FSLH since 2008. Before join-

ing FSLH, Gigliotti was an event manager at the Selva Group in Saratoga Springs, and previously worked at Upstate Cerebral Palsy as an event specialist. She holds a master’s degree in information design and technology from SUNYIT Utica/Rome in Marcy and a bachelor’s degree in public relations from the S.I. Newhouse School of Public Communications of Syracuse University.

THOMAS SOJA has been named vice presi-dent, legal & compli-ance for MVHS. His department respon-sibilities include legal services, corporate compliance, claims management, and in-ternal audit. He previ-

ously was general counsel for Mohawk Valley Network, Inc. and its affiliates and general counsel for St. Luke’s Memorial Hospital Center from 1995 through 2000. Soja graduated from Albany Law School. He received his bachelor’s degree in gov-ernment from Cornell University, College

of Arts and Sciences. TRACI BORIS has

been named assistant vice president, legal & compliance for MVHS. She was previ-ously legal counsel for St. Elizabeth Medical Center (SEMC). Boris graduated from Albany

Law School and completed her bache-lor’s degree in political science at SUNY Oneonta. HEATHER HAGLUND has been

named assistant gen-eral counsel of MVHS. She previously served as assistant general counsel at SEMC for more than five years. Haglund has more than 15 years legal experi-ence and earned her juris doctorate from

Syracuse University College of Law and her bachelor’s degree from the University of Michigan. Haglund also earned a mas-ter’s degree in health care administration from the New School for Social Research in Utica and an associate degree from the Community College of the Air Force.

NANCY RICCI has been named corporate compliance officer of MVHS. She has been an employee at FSLH for 18 years, serving most recently as corporate compliance officer and privacy officer. Ricci earned her master’s de-

gree of jurisprudence in health law from Loyola University Chicago School of Law and her bachelor’s degree in accounting from Utica College of Syracuse University.

DAVID CARLSON has been named director of internal audit and pri-vacy officer for MVHS. He has been an em-ployee at SEMC since 1987, holding various positions within the fi-nance department and serving as the compli-

ance officer since 2003. Carlson previously held the positions of internal auditor and privacy officer. He received his bachelor’s degree in accounting from Utica College.

JOHN D. THOMAS II, M.D. has been named medical director of rehabilitation services for MVHS. He has served as medical director for rehabilitation services at St. Elizabeth Medical Center since 1998; in addition, he serves as assistant to the chief medical officer at SEMC. Thomas attended Hamilton College in Clinton, and the University of the Northeast Medical School in Tampico, Mexico. He completed

Arquette

HealtH-Care Career

NEWS

See HEALTH-CARE CAREER NEwS, page 23 4

18 HEALTHCARE PROVIDER I FEBRUARY 2015

Farneti

Fentiman

Gigliotti

Soja

Boris

Haglund

Ricci

Carlson

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FEBRUARY 2015 I HEALTHCARE PROVIDER 19

graphical area. If that area is too large, the physician could be forced to move to con-tinue practicing. I try to obtain a restricted area of no more than a five-mile radius around the office location of the employer, though in rural areas a larger area may be reasonable.

5 Relying on inexperienced counsel

Most physicians do not get thebest deal when negotiating for

themselves. Faced with massive student debt, they naturally tend to focus entirely on the pay. In effect, they mortgage their future in return for what strikes them as a massive paycheck now.

That’s why it’s best to hire an expe-rienced physicians’ attorney to review and negotiate the contract. The beauty of using a lawyer is that you are no longer the one making the requests for changes in the agreement. If questioned about issues, you can always just blame the

lawyer. n

Dennis Hursh is an attorney who has pro-vided legal services to physicians for more than three decades and is the author of “The Final Hurdle: A Physician’s Guide to Negotiating a Fair Employment Agreement” (www.TheFinalHurdle.com). He is manag-ing partner of Hursh & Hursh, P.C., a law firm based in the Harrisburg, Pa. area, focusing on serving physicians and medical practices.

MISTAKES: Most physicians do not get the best deal when negotiating for themselves Continued from page 11

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SUBMISSIONS OPEN! Deadline: March 13, 2015

How to Qualify for the 2015 CNY’s Best Places to Work:

(Qualifying counties are: Broome, Cayuga, Chemung, Chenango, Cortland, Herkimer, Je� erson, Lewis, Madison, Oneida, Onondaga, Oswego, Seneca, St. Lawrence, Tioga and Tompkins)

Is YOUR organization one of Central New York’s Best Places to work?

Stay Tuned:Event details coming soon.

Page 20: 021615 hcp flip

BOOST: Grant’s first phase produced “significant” progress Continued from page 4

20 HEALTHCARE PROVIDER I FEBRUARY 2015

center designation, the “high-est-level” designation available, Upstate said, signifies that it “meets the most exacting stan-dards” for treating the “most complex” stroke cases at any time.

“…Most importantly, this comprehensive designation underscores the team ap-proach that Upstate takes to treating stroke. From EMS providers to nurses, to phar-macists to surgeons, to techni-cians and social workers, all of these highly trained medical professionals mobilize at the first notification that a patient is en route with a possible stroke,” Dr. John McCabe, CEO of Upstate University Hospital, said in the hospital’s news release

Meeting guidelinesHospitals must meet dozens of

guidelines to receive the DNV’s comprehensive stroke center des-ignation, according to Upstate.

They must document rapid assessment of stroke patients in the emergency department and administer clot-busting drugs within 60 minutes, says Latorre.

Hospitals also must have a specific stroke team in place, con-sisting of neurologists and neuro-surgeons, diagnostic radiologists, and other critical-care specialists within 10 to 15 minutes, he adds.

They must also complete diag-nostic tests within 60 minutes of patients’ arrival to the emergency department and must have special imaging available and complete CT scans for candidates treated

with tPA within 45 minutes. tPA is short for tissue plasminogen activator, which is the only treat-ment for ischemic strokes that the U.S. Food & Drug Administration has approved, according to the website of the American Heart Association.

In addition, hospitals must have a dedicated Neuro-ICU (intensive care unit) staffed with board-certified physicians in neurocritical care and must provide rehabilitation, physical therapy, and speech services, Upstate said.

Hospitals must also maintain community programs to educate the public on stroke-prevention efforts and warning signs and symptoms of stroke.

They must participate in clini-cal research aimed at improving

stroke care of patients.An interdisciplinary stroke

committee oversees Upstate’s stroke care, the hospital said. The committee includes staff from neurology, neurocritical care, neurosurgery, emergency department, area EMS provid-ers, radiology, physical medicine and rehabilitation, laboratory services, neuroscience nursing, cardiology, pharmacy, and spiri-tual care, according to Upstate.

Accreditation and certifi-cation in health care provide “much more than recognition,” Yehuda Dror, president of DNV Healthcare, said in the Upstate University Hospital news release.

“These programs help estab-lish standards of excellence and best practices that directly im-pact patients’ lives,” he said. n

CerTifiCaTiOn: Hospitals must participate in clinical research aimed at improving stroke care Continued from page 3

percent admission increase in the program at Le Moyne, and employers offering tuition reim-bursement, flexible hours, and other benefits for RNs seeking to continue their education, ac-cording to Le Moyne College.

Hiring requirementA “growing number” of New

York hospitals are now requir-

ing registered nurses (who have an associate degree) to obtain a bachelor’s degree within five years after they’re hired, accord-ing to Le Moyne.

Though not yet legislatively mandated in New York, the New York State Assembly ap-proved the “BSN in 10” leg-islation in 2014, but it never reached the Senate floor for a

vote. It is expected that state lawmakers will vote on it again this year.

BSN in 10 is short for bach-elor of science in nursing in 10 years, meaning it would require a nurse with an associate degree to earn a bachelor’s within 10 years, she adds.

“Because the Institute of Medicine came out with such a

strong backing … even though it’s not mandated by law, it’s be-coming a mandate because the hospitals are saying we won’t hire [candidates] unless you have a bachelor’s degree,” says Bastable.

She believes the model, which involves both the associ-ate and the bachelor’s degree, is “the best of both worlds.” n

•  Personal-care aides ($23,200)•  Customer-service representatives    ($31,380)•  Registered nurses ($65,660)The lists are based on occupational sur-

vey data and regional needs projected by the state Labor Department’s regional analysts, the agency said in a news release.

These jobs are in demand despite a tepid overall job market in Central New York and the Southern Tier. The Syracuse metro area lost 1,800 total jobs between December 2013 and this past December, the most jobs lost of any New York state metro area, according to Labor Department data released Jan. 22.

The Binghamton metro area gained 500 jobs over the same 12-month span, an in-crease of 0.5 percent. But, that’s still shy of

the state’s 1.2 percent job growth.Karen Knapik-Scalzo, the state Labor

Department’s regional labor-market analyst for Central New York, says the list looks at short- and long-term projections for job openings. The top five trending jobs are a sampling of employer-reported shortages, she says.

In CNY, health care and skilled manufac-turing workers are in demand, according to Knapik-Scalzo. “Those two industries were the two largest ones in terms of need,” she says.

The list also helps apprenticeship pro-grams and community colleges determine where to focus their training, Knapik-Scalzo says.

The Southern Tier is not seeing much

growth in the private sector, which is making it difficult for people to find jobs and keep their skills up to date, says Christian Harris, the agency’s regional labor-market analyst for the Southern Tier. Many potential work-ers lack the soft skills — getting to work on time, problem solving and communication — that are needed for many of these in-demand jobs, Harris says.

Health-care services is an industry where an aging population demands more workers, he adds.

The New York Labor Department encour-ages job seekers to visit the Jobs Express website (www.jobs.ny.gov), a database of job openings sorted by occupation and region throughout the state. Businesses can also post job listings on the site. n

JOBS: Aging population boosts demand for health-care jobs Continued from page 5

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FEBRUARY 2015 I HEALTHCARE PROVIDER 21

voice for Catholic health care in the U.S. that employs 330,000 health-care associates nationwide.

Evolution offers a menu of services from which clients can choose. “Pre-employment back-ground checks include Social Security number verification, criminal and civil records search, government-watch search, sex-offender registry check, military DD214 verification, professional licenses, references, verification of education and employment, and comprehensive sanction screening,” says Allen. “A la carte services include specialty crimi-nal searches (e.g., state police criminal records), e-verify (memo-randum of understanding), motor-vehicle record search, financial/credit profile, international back-ground checks, education GPA verification, international degree verification and equivalency, and corporate-criminal investigations. However, we do not conduct pri-vate investigations (e.g., matrimo-nial or property disputes).”

Evolution has added other services, such as professional caregiver/nanny checks, tenant-screening for property managers, and DNA paternity testing. Every health-care background check in-cludes OIGCN sanctions screen-ing and validation.

Evolution attracts clients from the corporate world, professional organizations, educational institu-tions, and anyone else who has exposure as an employer.

Sanctions screeningFraud perpetrated against gov-

ernment-sponsored, health-care programs is rampant. Estimates just for Medicaid fraud range as high as $70 billion annually. “The Department of Health and Human Services Office of Inspector General (OIG) has a mission to root out fraud, waste, and abuse in the department’s programs,” asserts Allen. “The OIG has the authority to exclude individuals and entities from participating in federally funded programs, in-cluding Medicaid, Medicare, the State Children’s Health Insurance program, and all federal, health-care programs.

Any conviction for program-re-lated crimes, health-care fraud, pa-

tient-abuse, failure to repay [Health Education Assistance] loans, fraud against non-health-care programs, license suspension or revocation, and a misdemeanor health fraud are all grounds for exclusion. No payment for any items or servic-es can be made to an excluded provider under these programs. Submitting any claims in which any portion is attributed to an ex-cluded individual or entity can be considered fraudulent and subject to strict monetary penalties.

The burden for compliance is squarely on hospitals and other health-care providers. To com-pound the problem, they must review not only federal lists of ex-cluded parties but also lists from multiple states. It’s no surprise that sanction-screening require-ments are a high priority now for corporations and institutions with both the Centers for Medicare and Medicaid Services and individual states mandating monthly screen-ings. OIGCN sanction-screening services help clients develop a proactive approach to screening compliance so that when they are audited, they can avoid fines/pen-alties,” Allen continues.

OIGCN’s target clients include hospitals, physician practices, se-nior-living centers, home-health-care agencies, educational institutions, clinical laboratories, third-party billing companies, durable-medical-equipment com-panies, hospice facilities, ambu-lance suppliers, pharmaceutical/biologic/device manufacturers, government agencies, and other providers of health-care prod-ucts and services. Evolution and OIGCN have clients across the U.S., Canada, Puerto Rico, and the Virgin Islands.

Technology“Technology has increasingly

become integral to the screening business,” notes Allen. “You need enterprise-level software that can integrate with multiple databas-es, including client and vendor platforms. This is no longer a manual, fax-based process with people handling a lot of paper. We want to develop software and systems that truly meet the needs of our clients and supersede what is available by the government

alone. OIGCN researches and up-dates more than 300 screening sources on a weekly basis. We have invested more than $500,000 to develop and maintain our pro-prietary software and systems. To give you an idea of the size of the health-care fraud problem, we currently store 425,000 names of excluded parties in our secure database. We have embraced technology not only to manage the volume of data to be screened for excluded individuals but also to make the process easier for our clients.

For example, we have the ca-pability to screen a list of 30,000 names and complete our investi-gations in five business days. For Evolution clients, we just devel-oped an online consent form that has forced fields and even includes the capability for the applicant to provide a ‘wet’ signature using a computer mouse or a finger on a smart phone. But it’s not just about the machine technology; there is also the human technology. We need to develop employees who exhibit a variety of traits: They must be persistent, cooperative in solving problems, capable of deter-mining the truth, adept at research and detail oriented, committed to continual learning, and enjoy talk-ing on the phone. This is one of those industries where you have to be on the job to learn it … All of our training is done internally with our own investigators and techni-cians,” Allen continues.

CompetitionEvolution and OIGCN are thriv-

ing in a highly competitive field. “There are a number of nation-

al [and even international] firms that offer background checks and act as third-party administrators for sanction screenings. Names like PreCheck, GoodHire (10,587 clients), Pinkerton (founded in 1850), PrivateEyes, MBI [Worldwide], Amrop (84 offices in 56 countries), and HireRight [Has 45,000 customers includ-ing one-third of the Fortune–500 companies] come to mind,” Allen says. “What makes us unique is that we are a licensed, private-investigative firm that also com-pletes sanction-screening. It’s not enough just to gather large vol-

umes of data; you have to have the investigative culture to know what to do with it. That’s what lets us utilize our technology, tools, and huge data repository to provide accurate information to help guide our clients in making intelligent hiring decisions. Add to this our accurate and timely reporting; our knowledge of com-pliance; competitive pricing; and outstanding customer service: That’s how we compete.”

Elwood, 61, the CEO of Evolution, spent more than two decades with the New York State Police before he retired. Among his responsibilities as a trooper, he was a certified drug-recogni-tion expert capable of detecting drugs and alcohol in a person’s system through observation only, without the need for any type of chemical test. He is a licensed, pri-vate investigator who has multiple certifications. Elwood attended Broome Community College, ma-joring in psychology with a minor in sociology.

Allen, 46, was born in Endicott. She received her bachelor’s de-gree in chemistry from Canisius College in 1990, a master’s de-gree in chemistry from Princeton University, and has completed her course work for a Ph.D. She worked as a chemist at Wyeth Pharmaceuticals, Inc. and later held positions as an executive re-cruiter at Korn Ferry in New York City and at Lamalie (now Amrop International). Allen re-turned to the Binghamton area in 2001 to open her own executive-coaching and recruiting business. In 2009, she became global di-rector of resources at Universal Instruments in Binghamton. Her move to Evolution occurred in 2011. At that time, the company employed 15 people. In her spare time, Allen is active in greyhound rescue, home improvement, and is an avid baker.

Evolution and OIGCN rely on local professionals for a variety of support services: Community Bank, N.A. for financing: Hinman, Howard & Kattell, LLP, and Levene, Gouldin & Thompson, LLP for legal work; Payco for payroll services; The Partners

EVOLUTION: Fraud perpetrated against government-sponsored, health-care programs is rampant Continued from page 6

See evolution, page 23 4

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22 HEALTHCARE PROVIDER I FEBRUARY 2015

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an internship at St. Vincent’s Hospital in New York City and a residency in physi-cal medicine and rehabilitation at Strong Memorial Hospital.

st. joseph’s hospital health center

St. Joseph’s Hospital Health Center has ap-pointed ANTHONY G. MINA to the position of executive operations officer — Acute Care Enterprise. The hospi-tal said it created this position to support its growing physician

enterprise. Mina brings 23 years of se-nior-level experience managing multi-spe-cialty/multi-site physician practices. Most recently, he was the executive director of Upstate Health Providers, P.C. at Upstate University Health System. Mina earned an MBA and health-care management degree from The University of Phoenix and a bachelor’s degree in professional studies from the School of Business Management at Clarkson University.

slocum-dickson medical group

ANTHONY LAPINSKY, M.D. has joined Slocum-Dickson Medical Group PLLC in the spe-cialty of orthopaedic spine surgery. He com-pleted his fellowship in adult reconstruc-tive spinal surgery at Beth Israel-Deaconess

Medical Center in Boston, and his fellow-ship in pediatric orthopaedics and sco-liosis surgery at the Texas Scottish Rite Hospital in Dallas. Lapinsky completed his orthopaedic surgery residency at the Naval Medical Center in San Diego, Calif. and completed his internship in general surgery at the Naval Medical Center in

Portsmouth, Va. He earned his doctor-ate in medicine at SUNY Health Science Center in Syracuse and graduated with a bachelor’s degree from Cornell University. Lapinsky served as a general medical of-ficer in the U.S. Navy and a lieutenant colonel in the U.S. Army Reserves. He earned an Army Commendation Medal for his service in Operation Enduring Freedom in Afghanistan in 2010. In ad-dition, Lapinsky was a clinical associate professor of medicine for several years at the University of Massachusetts Medical School Department of Orthopedics and Rehabilitation.

united methodist homes

RONALD A. PATTI, JR. has been hired as the new administrator of United Methodist Homes’ James G. Johnston Memorial Nursing Home at the Hilltop Campus in Johnson City. He earned a bachelor’s de-gree from Spurgeon College in Lakeland, Fla. and completed the long-term care nurs-ing home administration continuing-educa-tion program at Marywood University. Patti has more than 20 years experience as a nursing-home administrator, most recently at Ware Presbyterian Village in Oxford, Pa.

valley health services

Valley Health Services (VHS) in Herkimer has named BETHANY WILLIAMS chief finan-cial officer and promot-ed AMANDA HEIN to director of rehabilita-tion services. Williams served as vice president of finance/assistant controller at Upstate Cerebral Palsy. She graduated from Utica College of Syracuse University with a bachelor’s degree in accounting. Hein has been an employee at VHS since 2010, most recently as inpa-tient rehab coordinator. Previously, she

earned substantial ex-perience in the field of physical therapy in the skilled nursing-facility setting. Hein received her bachelor’s degree in clinical science and her master’s degree in physical therapy from Ithaca College.

vna homecare

AIDA MARIANI has been named the new development manager at VNA Homecare. She has more than 15 years experience in development, marketing, event plan-ning, media, and public relations. Mariani graduated from Utica College of Syracuse University with a bachelor’s degree in public relations, journalism, and political science, and also worked there as an ad-junct faculty member. Mariani also has 10 years experience in media relations and marketing at Faxton St. Luke’s Healthcare as the communication specialist/media coordinator. Starting in 2011, she held the position of director of development and communications at The Arc, Oneida-Lewis Chapter in Utica. CHRISTOPHER PORTNER is the new director of plant operations at VNA Homecare. From 2001 to 2007, Portner owned and oper-ated Portner’s Electrical Service. Later, in 2007, he assumed the position of main-tenance mechanic at St. Luke’s Home in Utica. Prior to VNA Homecare, Portner worked at the Rome and Chittenango Centers for Rehabilitation and Healthcare, where he served as the plant operations director. ROBERT BLEHAR has joined VNA Homecare as the new regional director of provider relations. He brings more than 15 years experience to the agency. After earning his master’s degree in business management, Blehar spent 10 years at AXA Equitable as the director of employee benefits and financial analysis. He was vice president of benefits and payroll op-erations at Support Services Alliance in Oneida for the past five years. n

health-care career news Continued from page 18

FEBRUARY 2015 I HEALTHCARE PROVIDER 23

Mina

Lapinsky

Williams

Hein

Insurance & Financial Services for risk management and invest-ments; Davidson Fox & Co., LLP for accounting; and ICS Solutions Group for computer support.

Allen is optimistic about con-tinued growth for the companies.

“We are a finalist with Premier [Inc.], a group-purchasing or-ganization (GPO) with 100,000 customers, including 2,700 hos-pitals, and $46 billion in buying power. Premier currently has four sanctions-screening vendors on

its contact list, and I’m optimis-tic that … Evolution and OIGCN will be added. This alone could more than double our business. In anticipation, Tony and I are already talking about buying our own building with adequate room

to expand. Longer-term, with the U.S. Department of Justice find-ing more employer liability and government adding more regula-tions and oversight to corporate operations, demand for our ser-vices will only continue to grow.”

eVOlUtIOn: Allen is optimistic about continued growth for the companies Continued from page 21

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