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Auburn Community Hospital (ACH) is the First in the U.S. to Implement Abbott’s Newest & Most Advanced Laboratory Technology

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Auburn Community Hospital (ACH) is the first institution in the United States to integrate Abbott’s Alinity h‐series into the ACH Core Laboratory. This cutting‐edge hematology automation system is set to transform the capabilities of the Auburn Laboratory. The new system will facilitate the seamless measurement of complete blood counts, a crucial healthcare test widely ordered for patients.

In addition to conducting complete blood counts, this new system will have significant benefits for our physicians and patients allowing for increased specificity in the screening of numerous disorders such as infections, anemia, immune system diseases, and blood cancers. Not only will the Lab offer complete blood counts but will do this with increased accuracy, speed, and efficiency, and places the ACH Core Lab on the level of the largest and most prestigious healthcare institutions and clinical laboratories in the world.

The ACH Laboratory has been working with Abbott on securing this new technology for over two years and has a long and established relationship with Abbott. The ACH Core Lab has been recognized by the Joint Commission and the Department of Health for its high level of performance, including an exceptionally high volume of tests performed annually, and maintaining operations during the pandemic while carrying out thousands of tests and allowing necessary surgeries to continue, while keeping patients and employees safe.

This new system is particularly important to ACH because the hospital will open a comprehensive cancer center Spring 2024 and will be breaking ground soon for the Auburn Heart Institute. “These patient groups, known for their complex blood samples, pose challenges in analysis and this advanced technology promises enhanced accuracy and efficiency which will allow for healthcare professionals treating cardiology patients or cancer patients better data to care for patients right in our own backyard,” stated Ronald Kirshner, MD, and Chair of the Auburn Heart Institute.

Dr. John Riccio, former Chief Medical Officer and Lab Director says, “This is truly an innovation that we’ve been waiting on for a long time.  For Abbott to choose us to be their partner in release of this new technology is phenomenal.”  This new system was approved by the U.S. Food and Drug Administration (FDA) in August 2023.

Neal Nash, managing director for Abbott shared, “Our longtime partnership with Auburn made for the right choice to unveil the next line of laboratory technology.  When you launch something new, it’s the first time you’re doing it and you’re installing the first one, you want to make sure you’ve got the right partner who is going to work with you hand-in-hand who’s going to make sure it’s going to go very well.”

By securing this latest technology the ACH Lab will have the capability to process 119 CBCs per hour, and the Alinity HS slide maker stainer automates and standardizes the formerly manual blood smear creation process. This innovation holds particular significance in labs where time, resources, and staff are under strain. The Abbott Alinity systems are also designed for efficiency, conducting more tests in less space, delivering faster test results, and minimizing human errors—all contributing to improved care for a greater number of patients.

Dr. James Syrett, Auburn hospital’s chief medical officer, provided an example of a patient who requires regular blood transfusions. “Using the old system, this patient would need to wait two hours for results before receiving the transfusion. Now, with Abbott’s Alinity h-series technology, the results will be available in 20 minutes.” 

“This investment by ACH is significant because it is another example of how a rural community hospital can be a model for other institutions who are committed to offering the best care for patients. Our lab, now equipped with cutting‐edge technology, empowers physicians with swift and accurate information, facilitating timely communication with patients eagerly awaiting results,” affirmed Scott Berlucchi, President & CEO of ACH.

John Bagenski, Technical Director of the ACH Core Laboratory, expressed excitement, stating, “We are thrilled to be the inaugural laboratory in the country integrating this state‐of‐the‐art hematology testing technology. ACH and Abbott share a longstanding commitment to enhancing patient care at every life stage. With the implementation of the Abbott system in Auburn, we are positioned to elevate the standard of quality care in our community and across New York state.”

Jessica Giacona, ACH Core Laboratory Supervisor stated that “Securing this new system is humbling because we are the first laboratory in the country to integrate this technology into our facility, and it is meaningful recognition of the quality of our lab and the amazing team that works here.”

Bagenski, Giacona, and the team collaborated with Abbott for several months, seamlessly integrating the new system into the ACH lab and undergoing comprehensive training on the Alinity‐h system at Abbott’s Training Center in Dallas, Texas.

Auburn Community Hospital (ACH) is a not‐for‐profit, 99‐bed acute care facility with a mission to provide compassionate quality care to our community. ACH is the sole provider of acute and general hospital services in Cayuga County and the surrounding areas located in the Finger Lakes region of Central New York including one of the highest rated 80‐bed Long Term Care and Rehabilitation Center in the state.

Call Out:

Auburn Community Hospital – Core Lab

 

  • First in the U.S. to be Awarded Abbott Laboratories Newest & Most Advanced Laboratory Technology. (Alinity-h)
  • Offer complete blood counts with increased accuracy and efficiency.
  • Increased specificity for the screening of numerous disorders including infections, anemia, immune system diseases, and blood cancers.
  • Places the ACH Core Lab on the level of the largest and most prestigious healthcare clinical laboratories in the world.

When to Report a Potential Medical Malpractice Claim: Protecting Yourself and Your Practice

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by Jenn Negley

Peace of mind is paramount for healthcare providers. However, some physicians hesitate to report potential medical malpractice claims to their insurance carriers for fear of jeopardizing their coverage. This article aims to clarify the importance of timely reporting and dispel common misconceptions.

Understanding “Claims-Made” and “Occurrence” Policies and Incident Triggers

With a claim-made policy the carrier defends incidents reported during the policy period, even if the incident itself occurred earlier (within the retroactive date). Crucially, both the incident report and the claim itself must happen while the policy is active.

An Occurrence policy protects you from any incident that “occurs” during the policy period, regardless of when a claim is filed. Meaning, the carrier you are insured with when the incident occurred covers you for the claim and is who you need to report to.

Why Early Reporting Matters

Delaying an incident report can have serious consequences. If a potential claim later materializes, the insurer may deny coverage due to non-disclosure. Even when switching insurers, a past unreported incident could negatively impact future coverage options.

What is an Incident? What is a Claim?

An incident is any event that could potentially lead to a future claim. This includes situations causing injury, potential injury, or even dissatisfaction with a service. Claims come in two forms: formal and informal.

  • Formal claims: Receiving a legal document, a demand letter from an attorney, or even a seemingly innocuous request for medical records by a patient’s lawyer (unless unrelated to your care).
  • Informal claims: Verbal threats of litigation, requests to waive fees, or patient harassment.

Examples of Incidents to Report:

  • Patient deaths
  • Birth injuries
  • Serious injuries
  • Disfigurement
  • Loss of limbs
  • Sensory impairment
  • Verbal threats
  • Patient family harassment

Additional Reporting Recommendations

Report any instance involving:

  • Demands for money
  • Legal threats
  • Lawsuits naming you
  • Notices of intent to sue
  • Requests for arbitration or depositions

Protecting Yourself After Reporting

Once you report an incident, communication is key:

  • Only discuss the case with your claims manager, a lawyer representing you, protected peer-review attendees, or your spouse.
  • Never alter medical records, even for seemingly minor corrections.
  • Do not include claim correspondence in patient records.
  • Maintain copies of all claim-related documents in a secure location.

A Word on “Background” Interviews

Be wary of requests from plaintiff attorneys to discuss a case you’re not directly involved in. These seemingly casual interviews can be traps leading to future lawsuits against you. Always contact your insurer and request legal representation for such inquiries.

By understanding reporting requirements and taking proactive steps, healthcare providers can protect themselves and ensure their medical malpractice insurance provides the valuable protection they deserve.

For more information, please contact Jenn Negley, Vice President, Risk Strategies Company at 267 251-2233 or JNegley@ Risk-Strategies.com.

Sidebar:

Risk Strategies, National Health Care malpractice team by the numbers:

  • Supports over 6,000 clients representing over $200,000,000 in physician premiums.
  • Representing every major medical malpractice insurance carrier in the market. In New York, we represent MLMIC, EmPro(PRI), The Doctors Company (TDC), HIC, MedPro RRG, Coverys RRG, ProAssurance RRG, TDC RRG, AMS RRG.
  • Specialists with over 25 years’ experience in medical malpractice insurance
  • Programs designed for independent physicians and self-insured programs as well as large practices and hospitals.

New Rule to Determine Worker Status Under the Fair Labor Standards Act

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by Allison B. Cherundolo

A new final rule from the United States Department of Labor (“DOL”) went into effect on March 11, 2024 that changes how to determine whether a worker is an employee or an independent contractor under the Fair Labor Standards Act (“FLSA”). Rescinding the 2021 rule under which two key factors – control over the work and opportunity for profit or loss – carried greater weight, the final rule applies a six-factor test to ensure that an employer’s classification of its workers complies with the protections of the FLSA, primarily appropriate minimum wage payments and entitlement to overtime.

The six-factor test applies a “totality of the circumstances” analysis of the “economic realities” of the work relationship meaning that each factor is weighed equally on a case-by-case basis. The DOL has stated that its intent is not to give one factor a predetermined weight over the others. Thus, no single factor listed is determinative.

The following provides an overview of each of the factors that must now be considered in classifying workers as employees or independent contractors.

  1. The Opportunity for Profit or Loss for the Worker

When evaluating the opportunity for profit and loss, an employer should consider facts such as whether the worker determines or can meaningfully negotiate the charge or pay for the work provided; whether the worker accepts or declines jobs or chooses the order and/or time in which the jobs are performed; whether the worker engages in marketing, advertising, or other efforts to expand their business or secure more work; and whether the worker makes decisions to hire others, purchase materials and equipment, and/or rent space. The more of these things a worker does the more likely it is that they would be determined an independent contractor as opposed to an employee.

  1. Investments of the Parties

This factor considers whether the worker’s investments “support an independent business and serve a business-like function, such as increasing the worker’s ability to perform different types of or more work, reducing costs, or extending market reach” – and how that compares to the employer’s investment in the business overall.

  1. The Degree of Permanency of the Work Relationship

A work relationship that is “definite in duration, non-exclusive, project-based, or sporadic based on the worker being in business for themselves and marketing their services or labor to multiple entities” would weigh towards classification as an independent contractor whereas a work relationship that “is indefinite in duration, continuous, or exclusive of work for other employers” would weigh in favor of classification as an employee.

  1. The Nature and Degree of the Employer’s Control Over the Work

When considering this factor, an employer should evaluate whether it sets the worker’s schedule, supervises the performance of the work,…explicitly limits the worker’s ability to work for others, uses technological means to supervise the performance of the work, reserves the right to supervise or discipline workers,…places demands or restrictions on workers that do not allow them to work for others or work when they choose [, and/or] controls economic aspects of the working relationship…, including control over prices or rates for services and the marketing of the services or products provided by the worker. The more control an employer exercises over a worker the more likely this factor will favor classification as an employee as opposed to an independent contractor. Notably, control within legal requirements for safety, quality, and customer/patient standards may not necessarily dictate an employer-employee relationship.

  1. The Degree to Which the Work is an Integral Part of the Employer’s Business

This factor considers not whether the worker is an integral part of the organization, but whether the work being performed is “critical, necessary, or central” to the company’s primary business. The less critical the work is to the organization, the more likely this factor favors classification as an independent contractor.

  1. The Worker’s Skill and Initiative

The final factor focuses on the worker’s use of specialized skills. Where “those skills contribute to business-like initiative” this factor will favor classification as an independent contractor. However, where workers rely on the company for training to perform the work this factor will favor classification as an employee.

Allison Cherundolo is a partner at CCB Law, a boutique law firm focused on providing counsel to physicians and healthcare professionals. She can be reached at 315-477-6282 or acherundolo@ccblaw.com.

Thirty-five years and Growing

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What’s next for CPS Recruitment? Strong presence in advanced manufacturing

By Martha Conway 

CPS Recruitment was founded in 1989 by Laurie Liechty under the names Contemporary Personnel Staffing and Professionals Incorporated. These companies were joined under the name CPS Recruitment in 2015. When Liechty was preparing to sell the business and retire, she approached Susan Crossett about doing some consulting work for her to help prepare for the transition. This consulting opportunity brought their relationship full circle, since Crossett’s first professional job out of college was in staffing and recruitment. She began her career as a recruiter at the J.W. Willard agency, hired by Liechty herself.

Crossett was born, raised, and educated in Central New York. A graduate of C.W. Baker in Baldwinsville, she earned her bachelor’s degree in political science and a master’s degree in public administration from Syracuse University. For the past four years, she has been the leader of CPS Recruitment headquartered in Liverpool, which is celebrating its 35th anniversary this year.

Crossett worked in recruitment for about 18 months before taking a position with Associated Builders and Contractors (ABC). While at ABC, Crossett honed her lobbying skills representing contractors’ issues before the state Legislature. From there, she continued her lobbying career working for the Manufacturers Association of Central New York (MACNY). As a result of her legislative work on Workers’ Compensation issues, Crossett was then appointed to serve as the First Special Assistant to the Workers’ Compensation Board Chairman. Building upon her lobbying career, Crossett transitioned to Carrier Corporation, representing the company in the states where Carrier had manufacturing facilities. Working closely with Niagara Mohawk on a new electric supply contract for Carrier led to her being recruited to work for Niagara Mohawk, heading up their government affairs department. Crossett had several roles at National Grid, ultimately as the officer responsible for U.S. economic development and community investment. After leaving National Grid, Crossett worked for the Sisters of Saint Francis of the Neumann Communities overseeing their incorporated ministries, including hospitals and long-term care facilities among others. She also consulted on energy matters for clients of Harris Beach, LLC.

Crossett did her homework during the consulting project with Liechty, saw the long-established business as a good turnkey investment and put in a successful offer against other contenders. She took the helm of CPS Recruitment Jan. 4, 2020 – right before the COVID lockdown.

“We had just had the best month in the history of the company,” Crossett said. “Then COVID hit, and the state mandated the vast majority of our clients to shut down operations. Our business experienced an immediate slowdown and companies stopped hiring.”

Through perseverance and tenacity, Crossett and her team made sure CPS Recruitment recovered. She expanded the business, adding staff to locations in Buffalo, Binghamton, Washington, D.C., and Charlotte, N.C. Over the years, the firm has grown to 30 people.

“We are a local company supporting local businesses while also growing outside of our region,” she said, explaining that CPS Recruitment also serves national clients.

“I can’t take a lot of credit for building the team,” Crossett said. “The team was in place when I bought the company. It’s one of the reasons I wanted to buy it; I felt it would be a nice fit for me. There are people with more than 20 years of history here, and the average length of employment among our employees is greater than 10 years.”

She said the reason the team is so successful is their commitment to clients and candidates, and she is doing whatever she can to cultivate that environment.

“Letting team members have the ability to do what they do best is the most important thing I can do,” Crossett said. “We set goals together, then I let them go.”

Crossett gives her staff the support and tools they need to do their jobs and provides a flexible hybrid work environment allowing for work-life balance.

Crossett said she embraces a collaborative leadership style. She is transparent about acknowledging areas that aren’t her strength and relies on her partnerships with her team – as well as industry colleagues – to help her promote an atmosphere of continuous learning and growth. She said she has held ‘team mix-up’ events where different staff are grouped together to brainstorm ideas for continuous improvement.

“They came up with some really great ideas, decided what they wanted to accomplish and developed plans for how to go about it,” Crossett said. “Everyone works very well together.”

Crossett said that teamwork doesn’t just evidence itself in theory or tabletop exercises, either. She said CPS Recruitment has had a number of situations where clients needed to ramp up staffing levels in a very short span of time.

“Rather than the client needing to hire additional human resources staff to fill hundreds of positions, our team bands together and works to get it done,” she said. “We all work to consistently exceed client expectations and satisfy their growth needs.”

Crossett said there is tremendous satisfaction in not only supplying staff to meet employers’ needs, but also in helping a wide array of people to find jobs.

“From placing a senior vice president to helping someone find their very first job – we work with a lot of new Americans to help them find jobs,” she said. “It’s incredibly gratifying.”

CPS Recruitment searches for potential candidates for short- and long-term temporary assignments as well as direct hires; their areas of expertise include software and hardware engineers, accounting professionals at all levels, supply chain professionals, administrative and call center roles, IT, technology and engineering, project management, supply chain, healthcare, warehouse fulfillment and manufacturing positions from production to senior management.

Crossett said she is bullish on the future of the region, as manufacturing is making a big come-back.

“We have already begun growing our specialized vertical in advanced manufacturing,” she said. “We have always served the manufacturing industry, but we are preparing additional dedicated recruiters – getting them the information and training they need – to focus on this specialty. I can’t emphasize enough the need for more workers in our region so we can match talent needs with skills needed.”

CPS Recruitment uses a variety of strategies to find the specialized staff they seek.

“We attend and host job fairs, connect with job-training programs, do extensive networking and sourcing, utilize all the major job boards and niche sites, such as ThisisCNY.com, and post to the major social media outlets, including Facebook, Instagram and LinkedIn,” she said.

Partnering with CPS Recruitment provides employers and employees with the opportunity to ensure a good fit before either party commits to permanent employment.

“We can also provide help for project work,” Crossett said, “and these employees work until the project is done. This is an ideal situation for people who only want to work for a limited time, or, say, only want to work winters. There are professionals who may want to work on certain projects that can expand their resume, but not necessarily commit to a single company and doing the same thing for many years.”

CPS Recruitment, through relationship-building and team development, has cultivated a network of long-term relationships that has positioned them as a trusted partner to their clientele.

“One of the ways we do this is by really listening to our clients’ needs,” Crossett said. “We take the time to truly understand the nuances of the job, and we do the same thing for potential employees. We work with firms of all sizes, and they appreciate that we are all trying to do a good job for them. Being here 35 years later, we must have gotten a lot of things right.”

Crossett believes there are clients who are familiar with one facet of what CPS Recruitment does but aren’t aware of the other services they provide.

“Professional staff may not know we do temporary and contract work.” she said. “There are a lot of different aspects of the business. We pride ourselves in being partners with our clients and candidates, rather than just having transactional relationships. Our efforts to be an extension of the team on the client side and to truly partner with candidates has served us very well, and if we don’t have anything that seems like a good fit on one side or the other, we’re honest about that and tell them we’ll keep looking. These efforts cultivate the relationships that truly set us apart from others.”

For more information, call 877.457.2500 or visit cpsrecruiter.com/.

Embracing Growth Together:

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Empowering Talent and Embracing Opportunities in CNY Manufacturing

Meghan Durso, Senior Human Capital Manager, TDO

In Central New York (CNY), the manufacturing industry isn’t just a sector; it’s the heartbeat of our community, pulsating with endless possibilities for those seeking meaningful careers. Yet, amidst the bustling production lines and innovative technologies lies a treasure trove of untold opportunities waiting to be discovered.

Did you know that right here in CNY, millions of gallons of life-saving cancer drugs are crafted, alongside the assembly of luxurious 24k gold elevators? Every night, two million pounds of food journey from Syracuse to nourish countless families. And that’s just the tip of the iceberg. From cutting-edge military technology to the meticulous craftsmanship of electronic components, our region is a hub of excellence and innovation.

What sets us apart, however, isn’t just our impressive output—it’s our people. Our talent pool thrives on innovation and a commitment to quality, shaping not only the present but also laying the foundation for our future successes.

As we navigate the evolving landscape of manufacturing, it’s crucial that we adapt our approach to talent acquisition and development as well. Here are some key strategies I’ve observed leading to success:

Fostering Genuine Connections: Beyond conventional interviews, it’s essential to foster genuine connections with candidates. By offering insights into our facilities, allowing job shadowing, and engaging in meaningful discussions, we can ensure alignment not just in skills but also in values and purpose. Remember, hiring is not a race; it’s a journey of discovery, where investing time and intentionality pays off in the long run.

Cultivating Loyalty: In a world where job insecurity looms large, transparency and support are paramount. By openly communicating growth plans and investing in skill development, we can create an environment where employees feel valued and committed for the long haul. Let’s aim not just for a workforce but for a community of dedicated individuals who see their future intertwined with ours.

For more information on this topic, please contact Meghan Durso, Senior Human Capital Manager, TDO at Meghan@tdo.org or visit online at www.TDO.org to learn more about the services available at TDO.

 

 

Succession Planning…

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Earl R. Hall, Executive Director – Syracuse Builders Exchange

Succession planning is never easy and generally not a topic construction industry employers want to think about – until they have to.  In my tenure as Executive Director of New York’s largest construction industry Association, I have assisted employers during their succession planning exercise, which has provided perspective on our members and what options they evaluate as they prepare to assure their business continues. 

Hanging up one’s hard hat for the last time should be a rewarding experience.  Whether you are a business owner, superintendent, foreman or journeyman, reflecting on your career and the industry you leave behind will generate a wide range of emotions.  For business owners, knowing you have a succession plan will provide peace of mind, financial security, and a sense of accomplishment, especially if family is involved in the plan.

Professionals such as accountants, attorneys, bankers, and investment advisors should be engaged during the due diligence process.  Obtaining professional advice is essential in developing a plan, identifying potential options, and avoiding unforeseen issues which might adversely impact the execution of a succession plan.   Additionally, such advisors will help one navigate how to implement the succession plan and what role, if any, the business owner will have during and/or after the transition.

Understanding the assets and liabilities of the business is essential, keeping in mind the company’s greatest assets may be the leadership team and employees.  Identifying potential successors to transition the business in many cases comes from within, so explore such options with those within the company, including employees and family members.  Communicating with those employees and/or family members will provide valuable feedback relative to interest in exploring a succession plan.  From there one can determine whether or not a business consultant or broker may be necessary to identify additional external options.

When to begin exploring a succession plan may vary depending on a range of unique facts and circumstances, so developing a plan with an adequate time frame is essential to obtain goals and objectives.  Planning for the unexpected is being proactive, so working with the company’s executive leadership team, family members and professionals will provide an initial strategic road map for the future.  While there is no certain age to begin succession planning, one should always have at a minimum a business plan in place which would address the “unexpected” event that would impact the ownership of a business.

While the process of succession planning may be similar for all construction industry employers, those employers’ signatory to one or more construction collective bargaining agreements must be aware of potential issues.  Such issues may impact one’s ability to sell the business and/or transition the business to family members.

Union contractors will need to evaluate the termination dates of all collective bargaining agreements and determine how such agreement may or may not impact a succession plan.  Generally, in a business transition or new ownership situation, existing collective bargaining agreements are also transitioned to the new owners of the business, unless the agreements have been properly terminated. Obtaining advice from an attorney familiar with the construction industry and labor agreements will be critical to assist in the decision-making process.

In determining whether or not terminating one or more collective agreements is necessary to effectuate the succession plan, one should consider the impact of any employer withdrawal liability relative to a signatory union’s pension fund or funds.  Determining the employer’s unfunded withdrawal liability should be done by requesting the union pension fund actuary calculate the employer’s withdrawal liability in the event such is triggered by terminating the collective bargaining agreement.  This disclosure may impact the decision-making process or impede one’s ability to implement a preferred or potential succession plan.

Developing a succession plan can be an arduous exercise; however, it is necessary if the desire is to continue the business in the unlikely event of an unexpected matter or while considering retirement.  Surrounding yourself with a great support team of professionals and other invested individuals who care about the employer will pay dividends during the succession planning process.

Why Insurance Rates Are Increasing and What To Do About It

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Pierre Morrisseau

Please excuse the pun, but the insurance industry is in the midst of a “perfect storm.”

After rates across all classes have been relatively flat for a number of years, insurance carriers are facing dramatic increases in both risk and cost of claims forcing them to dramatically increase premiums to meet state and federal reserve requirements, and in some cases, to even remain solvent.

Let’s take a closer look at what is driving costs to insurance premium increases.

Weather: Climate change and major losses around the globe from severe winter storms, severe summer storms and flooding, vast wildfires, hail, tornadoes and of course, hurricanes impacting ever-larger coastal and city populations. According to the National Centers for Environmental Information, the U.S. sustained 377 climate disasters since 1980 where damages exceeded $1 billion. The total cost of these 377 events exceeded $2.6 trillion. As populations swell in severe weather zones, so, too, has the cost of insurance soared. By comparison, all of the 1990s (1990-1999) saw 57 weather disasters costing over $327 billion, or about $32 billion per year. Last year alone, there were 28 ranked storm disasters costing $93 billion.

Severity and Cost of Auto Accidents: According to Kelly Blue Book, the average price of a new car in 2023 was $48,008. The severity rate for auto accidents has increased for the first time in decades as the cost and complexity of vehicles increases. Distracted drivers increase the frequency rate of accidents adding to the dramatic increase in vehicle insurance rates.

Inflation: Homes, autos, home contents, repair costs all have risen dramatically since the pandemic amidst supply chain disruptions, employment stresses, general inflation, all of which impact the cost of claims.

Social Inflation: Liability risk has soared due to a less well understood phenomenon defined as social inflation (the belief that someone must pay), resulting in massive liability settlements and dramatically increased legal activity.

Investment in Lawsuits: Driven by social inflation, lawsuits have increased. Organizations with deep pockets are the targets. Have you noticed the amount of advertising by Attorneys? This is often funded by outside investors who will provide capital in exchange for a stake in the settlement. The result is larger settlements but much of that may not be going to claimants.  This has quickly become big business. In Florida, one of the primary drivers of increased property insurance was a law that allowed homeowners to sign their rights to the claim to contractors who, working with attorneys, threatened suit against insurance companies if they failed to pony up.  Homeowners were actively solicited by contractors, driving up insurance costs of claims to twice as much or more of what they would have been. According to the Insurance Information Institute, 79% of all homeowner’s insurance lawsuits are in the state of Florida alone.  Consumers pay for these increases. 

Reinsurance Markets: Reinsurance is the insurance that insurance companies buy to spread their risk. Reinsurers, too, are under severe cost pressure, drastically increasing rates that must be added to the carriers’ own premiums. In addition, they have reduced the available limits, reduced coverage of specific triggers like wind and flood in high-risk areas, limited the types of buildings and locations that carriers can insure and limited the amount of reinsurance available. This has resulted in insurance companies changing their underwriting criteria and charging more or limiting the ability to provide coverage.

So, what should you do? First, know the basis of your risk. If it is your personal insurance – the age of your roof and your ability to prevent water damage claims is critical. Modern technology can detect any water flow and turn your system off before damage is incurred. Dash cams have become an important defense in proving your innocence in car accidents.  For businesses, it is important for underwriters to know how you are controlling risk as it can significantly affect the cost. Are you able to tell them your story? Will the insurance carrier and broker work with you to improve your risk management systems and support your business goals? There are other important steps that you should explore with your insurance broker that can help mitigate insurance costs increases.

 

Paramedicine: Creating a First Line of Access and Follow-up in our Communities.

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Definition: Community paramedicine is a relatively new and evolving healthcare model. It allows paramedics and emergency medical technicians (EMTs) to operate in expanded roles by assisting with public health and primary healthcare and preventive services to underserved populations in the community.” Rural Health Information Hub

Recently I wrote about new models developing in primary care. From telemedicine to urgent care, access for certain conditions can be met as an adjunct to the traditional primary care physician .

Paramedicine has been developing in many states since 2009. Every community has different needs, and Paramedicine programs look different from community to community.

What these programs have in common is identifying what will help the existing health care system in that area by addressing unmet needs.

A scan of existing programs suggests common focus areas include:

911 triage to prevent dispatching an ambulance crew.

Chronic Care management in the home, in collaboration with home care, hospice, health departments or primary care practices.

Preventing readmissions or ER visits by offering some chronic care education services in the home and facilitating communications with providers.

Helping patients get to the right setting and identifying resources to support them.

Immunizations.

Supporting the frail elderly in remaining at home with extra support.

In NYS there are pilots underway to look at Paramedicine as part of the health landscape. In others states these programs have long been a successful part of health care. Florida in particular has a compete manual for ambulances to approach certification and to train ALS paramedics.

The current demonstrations in NYS were funded by the Mother Cabrini Health Foundation, awarding grants to the Iroquois Association and the NYS Home Care Association. These pilots are about to expand from three to six. They have worked best in areas where a champion within the department takes lead in the community collaboration. Gary Fitzgerald the CEO of Iroquois notes, “EMS providers can be used more effectively in our communities.”

I spoke with the pilot in Jefferson County that is working in collaboration with their Health Department and home care agency. Paul Barter, the Jefferson County EMS Director was enthusiastic about the impact of their pilot program in Jefferson County. He stressed how excited his providers are in helping patients better understand their disease, medications, and have a better quality of life. A review of their data tells them they are reducing calls to 911 and transports to emergency rooms.

These pilots are particularly important in areas where primary care has contracted, or the local ER has closed. Workforce shortages have also hit Ambulance Corps and foundations and the Health Department should look at investments and incentives to help EMS providers expand through Incentives, including scholarships and tax credits.

There are so many positives to community based care in improving health outcomes. Paramedicine is one part of a growing system of options for communities to consider. The NYS Health Deportment should make these programs a permanent option in the NYS Healthcare landscape.

References:

https://www.ruralhealthinfo.org/topics/community-paramedicine

https://www.flexmonitoring.org/sites/flexmonitoring.umn.edu/files/media/bp34.pdf

https://paramedicnetwork.org/mce/

https://emsa.ca.gov/community_paramedicine/

https://www.iroquois.org/

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com

 

 

 

New Rule to Determine Worker Status Under the Fair Labor Standards Act

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By: Allison B. Cherundolo, CCB Law

A new final rule from the United States Department of Labor (“DOL”) went into effect on March 11, 2024 that changes how to determine whether a worker is an employee or an independent contractor under the Fair Labor Standards Act (“FLSA”). Rescinding the 2021 rule under which two key factors – control over the work and opportunity for profit or loss – carried greater weight, the final rule applies a six-factor test to ensure that an employer’s classification of its workers complies with the protections of the FLSA, primarily appropriate minimum wage payments and entitlement to overtime.

The six-factor test applies a “totality of the circumstances” analysis of the “economic realities” of the work relationship meaning that each factor is weighed equally on a case-by-case basis. The DOL has stated that its intent is not to give one factor a predetermined weight over the others. Thus, no single factor listed is determinative.

The following provides an overview of each of the factors that must now be considered in classifying workers as employees or independent contractors.


1. The Opportunity for Profit or Loss for the Worker

When evaluating the opportunity for profit and loss, an employer should consider facts such as whether the worker determines or can meaningfully negotiate the charge or pay for the work provided; whether the worker accepts or declines jobs or chooses the order and/or time in which the jobs are performed; whether the worker engages in marketing, advertising, or other efforts to expand their business or secure more work; and whether the worker makes decisions to hire others, purchase materials and equipment, and/or rent space. The more of these things a worker does the more likely it is that they would be determined an independent contractor as opposed to an employee.

2. Investments of the Parties

This factor considers whether the worker’s investments “support an independent business and serve a business-like function, such as increasing the worker’s ability to perform different types of or more work, reducing costs, or extending market reach” – and how that compares to the employer’s investment in the business overall.

3. The Degree of Permanency of the Work Relationship

A work relationship that is “definite in duration, non-exclusive, project-based, or sporadic based on the worker being in business for themselves and marketing their services or labor to multiple entities” would weigh towards classification as an independent contractor whereas a work relationship that “is indefinite in duration, continuous, or exclusive of work for other employers” would weigh in favor of classification as an employee.

4. The Nature and Degree of the Employer’s Control Over the Work

When considering this factor, an employer should evaluate whether it sets the worker’s schedule, supervises the performance of the work,…explicitly limits the worker’s ability to work for others, uses technological means to supervise the performance of the work, reserves the right to supervise or discipline workers,…places demands or restrictions on workers that do not allow them to work for others or work when they choose [, and/or] controls economic aspects of the working relationship…, including control over prices or rates for services and the marketing of the services or products provided by the worker. The more control an employer exercises over a worker the more likely this factor will favor classification as an employee as opposed to an independent contractor. Notably, control within legal requirements for safety, quality, and customer/patient standards may not necessarily dictate an employer-employee relationship.

5. The Degree to Which the Work is an Integral Part of the Employer’s Business

This factor considers not whether the worker is an integral part of the organization, but whether the work being performed is “critical, necessary, or central” to the company’s primary business. The less critical the work is to the organization, the more likely this factor favors classification as an independent contractor.


6. The Worker’s Skill and Initiative

The final factor focuses on the worker’s use of specialized skills. Where “those skills contribute to business-like initiative” this factor will favor classification as an independent contractor. However, where workers rely on the company for training to perform the work this factor will favor classification as an employee.

Oneida Health Pursues Another 125 Years of Exceptional Care

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By Becca Taurisano

From investments in facilities, technology, and medical staff to strategic partnerships, Oneida Heath is committed to providing the best quality outcomes and patient experience today and in the future.

THE EARLY YEARS

From the very beginning, Oneida Health’s mission has been driven by the community’s need for exceptional care, close to home. In 1894, a railroad accident in Oneida brought to light the need for immediate health care services. With a makeshift treatment room established at the Presbyterian Church to treat the railroad victims, the concept of delivering organized healthcare services in the community was born.

In 1899, Oneida Mayor, J.M. Goldstein donated a plot of land on Williams Street and Oneida Health opened the doors to its first hospital, a four-bed city-operated facility. After an expansion a few years later, it was clear more was needed and the first Broad Street Hospital was built in 1906, followed by a new 80-bed Board Street facility in 1938. 

Over the next 30 years, the Broad Street Hospital continued to expand to meet the needs of the community driving the need for a new site. In 1972, a 126-bed hospital opened its doors at 321 Genesee Street which serves as the hospital’s primary location today. Two years later, the Broad Street facility was converted into a skilled nursing facility, marking the beginning stages of Oneida Health’s healthcare system.

“Since 1899, the growth of Oneida Health has been a reflection of the needs of our community,” says Michael Kallet, Chair, Board of Trustees of Oneida Health. “From our humble beginnings to today, our organization continues to be driven to provide convenient access to the highest quality of care possible.”

TRANSFORMATION TO AN INTEGRATED HEALTH CARE SYSTEM

With the hospital location firmly established on the hill overlooking Genesee Street and a skilled nursing facility downtown, the city-owned and operated healthcare system in Oneida continued to deliver care for the next 20 years without much change. It wasn’t until the 1990s that Oneida Health started to expand its services beyond the hospital and skilled nursing
facility.

Throughout the 1990s and 2000s, Oneida Health saw tremendous growth in services offered with the expansion of outpatient locations. This transformed Oneida Health into an integrated healthcare system.

“To best care for your community, you need to invest in providing preventative care,” says Kallet. “As an organization, we recognized this as the next step to meet the needs of our community by supporting population health and preventing more intensive and costly care
down the road.”

Recognizing the need for primary and preventive care services, Oneida Health opened its first outpatient office in Camden in 1991 marking the beginning of what is now a six-location primary care network with 18 primary care providers. To support access to diagnostic services, Oneida Health expanded its lab and imaging services with the development of five outpatient lab draw locations and two outpatient imaging centers.

In addition to the expansion of primary care, Oneida Health recognized the need for increased access to specialty services close to home. “The need for increased access to specialty services in healthcare has grown with the advancement of medicine,” says Felissa Koernig, President and CEO of Oneida Health. “Developing and nurturing a network of preventative and specialty services is instrumental to improving care in our communities.”

This commitment has created an integrated healthcare network offering specialty services that include: Allergy; Breast Surgery; Cardiology; Convenient Care; Ear, Nose, and Throat; Gastroenterology; Neurology; Obstetrics and Gynecology; Oncology; Orthopedics; Podiatry;

 Pulmonology; Sleep; Vascular; and Wound Care.

A LEADER IN COMMUNITY HEALTHCARE:WORLD CLASS TECHNOLOGY

Along the way, Oneida Health has taken a strategic approach to providing convenient access to services with leading-edge technology. “As a rural healthcare organization, it is not enough to provide patients convenient access to healthcare services,” says Koernig. “Our mission is to provide patients with the best healthcare services, and to achieve this you need to pair
talented medical staff and the best technology.”

Oneida Health has had a history of investing in state-of the-art technology to support the diagnosis and treatment of its patients. In 2002, Oneida Health was the first hospital in Central New York (CNY) to introduce computeraided mammography. This was later followed by being among the first in CNY to invest in 3D mammography, the new gold standard in early breast cancer detection. With continued new investments in advanced imaging over the last decade which includes a 3-Tesla MRI and Advanced PET/CT, to name a few, Oneida Health has become a destination for imaging services.

From instituting robotic surgery in 2012 to providing TrueBeam radiotherapy, the most advanced linear accelerator and radiosurgery treatment system available, 

Oneida Health ensures providers have access to the best technology when it comes to treating patients. 

“It’s a common misconception that the best technology exists only in big cities,” says Kallet. “At Oneida Health, we have taken every step to ensure our talented Medical Staff has access to the best technology to treat their patients.”

 

STRATEGIC PARTNERSHIPS

For rural-based healthcare networks, the ability to develop highly specialized service lines can often be hindered by a lack of expertise and their ability to recruit Medical Specialists. Oneida Health has leveraged key strategic partnerships to help bridge the gap and bring
highly specialized care to Oneida.

In 2017, Oneida Health opened the William L. Griffin Medical Oncology Center followed by the Dorothy G. Griffin Radiation Oncology Center, both centers are members of the Roswell Park Care Network. The collaboration provides the Oneida region with quality cancer care that meets National Cancer Institute (NCI) guidelines, creating local access to some of the latest treatment options from a nationally ranked cancer center.

In response to an increase in diabetic patients with difficulty healing wounds, Oneida Health recently partnered with Restorix, an expert in wound care and hyperbaric medicine, to open the Wound Care Center in 2018. By developing this partnership, Oneida Health was able to bring in a high level of expertise in this specialized area to become operational in a very short time frame.

“Anytime we offer a service, we should be among the best in the area providing it, otherwise why would patients choose us,” says Koernig. “Strategic partnerships with Roswell Park, Restorix, and other healthcare systems have allowed us to leverage expertise in a collaborative effort to provide the highest quality of care on day one.”

NATIONALLY RECOGNIZED CARE

Oneida Health prides itself on exceptional care, always and has received numerous awards for high-quality care and patient experience for many years. Some of the most impressive recent highlights include:
The region’s only 5-star rated hospital by the Centers for Medicaid and Medicare (CMS) for quality care in 2021

Ranked in the top 2% of hospitals nationally for patient safety and patient experience by Healthgrades in 2019.

Women’s Choice Award for Best 100 Hospitals for Patient Experience four years in a row, 2020-2023.

A five-star recipient for Vaginal Delivery from Healthgrades for 5 years in a row (2015-2019)

“As an organization, we have a history of being committed to excellence,” says Koernig. “Awards at the national and state level are a testament to the talented Medical Staff we have at Oneida Health and their dedication to providing patients with the highest level of care at every visit.”

BUILT ON COMMUNITY SUPPORT

From a four-bed hospital to an integrated healthcare network, Oneida Health today includes a 101-bed acute care hospital, stateof-the-art robotic surgery center, 160 bed extended-care facility, multiple primary and urgent care offices, comprehensive lab and imaging services, outpatient and inpatient therapy, and a variety of specialty services providing care to approximately 29 communities with a population of over a 100,000 throughout Madison and Oneida counties.

The incredible growth and success the organization has seen over the last 125 years would not be possible without significant community support throughout its history.

Recent donations have helped support technology, expansions, and renovations of facilities like the William L. Griffin Medical Oncology Center, the Alice M. Gorman Imaging Center, the Dorothy G. Griffin Radiation Oncology Center, and the expansion of the Emergency Department and Operating Rooms including the Chapman Foundation main hospital entrance.

“So much of what we’ve achieved has been made possible 

by our generous donors,” says Kallet. “From the original land donation by the mayor to our most recent donations  by the Griffin Foundation for the expansion of oncology, these contributions to our mission have elevated our network to what it is today.”

Support from community groups has been essential as well, from the Oneida Health Foundation to individual volunteers and groups like the Oneida Health Auxiliary. Their combined efforts have provided valuable resources to Oneida Health’s success.

“Community-based organizations have provided their support throughout our 125 years because they believe in our vision,” says Koernig “From a single volunteer fulfilling hours of service to large financial gifts from area nonprofits, these generous acts have helped make our patient care exceptional. I extend our thanks to everyone in the community who has contributed so selflessly
over our organization’s history.”

THE NEXT 125 YEARS

As the future of healthcare changes, Oneida Health plans to stay agile to adapt to the ever-changing healthcare landscape.

“As an organization, we need to continue to look for opportunities to deliver care where it is needed and how patients want to receive it,” says Koernig. “Our ability to connect patients digitally with their providers and patient information is going to become more
essential as we move forward.”

While the method of delivering care may be changing, Oneida Health’s approach to patient care looks to remain consistent. “Our commitment to providing the highest quality of care and patient experience will continue to set us apart and remain an important reason why patients will choose us for years to come,” says Koernig.

The future of Oneida Health will continue to rest on its most important asset: its people. “As a healthcare organization, we will need to continue to recruit the highest level of talent while providing an environment where healthcare providers and professionals can thrive. 

Investing in our people will ensure we’re providing care for the next century and beyond,” adds Koernig.