OCTOBER | 2019
Clients and friends:

Each month as we sit down to compose this letter it seems that we have more changes to share. We embrace these transformations, as it means that we are open to new ideas, that our attorneys and staff are embracing development and are passionate about the work we do. The model we have created for the firm enables growth and development – what remains constant are our values and commitment to our clients. It is there that we are fueled to innovate for you, our team, families, and communities.

This month, we announced a new compliance service that will be instrumental in helping you, as clients, navigate CMS’ November 28th deadline to create or update a Compliance and Ethics Program pursuant to Phase 3 of the Requirements of Participation (RoP). We are also excited to embark on a new endeavor and will be launching our first SHG podcast detailing the elements and goals of CMS' compliance requirements this month. Though these changes may seem daunting, we are here to decode the regulations and aid in your program implementation.

We welcomed three new attorneys to our team this month: Jason Greenberg who lives and practices in Maryland and brings general civil litigation, bankruptcy, and collections experience; Sarah Mulligan, a North Carolina attorney with 10+ experience, including extensive work in bankruptcy, wills and trusts; Charlotte Mastoridis, referred by one of our own – Nikoleta Tzaferos, who lives and works in New Jersey, and is pending admission in Rhode Island and Connecticut. Given the success we’ve already experienced with the law clerk role, we’ve added a second law clerk to our team: Maureen Patrigani, who is currently completing her final year of law school at Suffolk University Law School in Boston where she is certified as a Student Attorney under Massachusetts Rule 3:03. Finally, Melissa Wintermore joins us in our South Carolina office as our Executive Assistant. 

In addition to our growth as a whole, our employees are always pursuing personal and professional growth. Andrea Kirksey, our Firm Administrator, recently returned from San Antonio where she studied with Brenè Brown to become a Certified Dare to Lead™ Facilitator. We’re excited that’s she’s brought this work, not just to SHG, but is able to bring it to you, your teams, and your organizations, as you can read below. 

Thank you for continuing on this ever-changing journey with us,

  • Stay connected with our founding partners
  • Upcoming events
  • SHG training and education opportunities
  • Stay informed about the state of long-term care industry in America
  • Join SHG in our efforts to spread kindness
Nominations will be accepted for SHG's Season of Giving .

Members of Team SHG head to Worcester to host an exhibit at the 2019 Massachusetts Senior Health Care Association Annual Meeting and Trade Show.

SHG Attorneys Billie Orr and Stacy Schaub will be sharing best practices during our free monthly webinar Improper Transfers, Penalties, & Undue Hardship Waivers at 1:00 PM EST.
We value your opinions! Please help us to better meet your needs by providing feedback on our 2019 webinar series.

Once you complete the survey your name will be entered into a drawing for a package of Stotler Hayes themed goodies including a wireless bluetooth speaker and a Rocket Book!
We believe that knowledge is power. Whether you are new to this business or a long-term care veteran, we can make your job easier by sharing our best practices.

During this month’s free best practices webinar SHG Attorneys Billie Orr and Stacy Schaub will be sharing tips for tackling Improper Transfers, Penalties, & Undue Hardship Waivers .  

Register for this  free webinar   today and we’ll see you Friday, November 15th at 1:00 PM EST!
SHG is excited to launch its first podcast Conquering the New CMS Rules: Is Your Compliance and Ethics Program Ready?  a 30-minute discussion of the upcoming, November 28 deadline for LTC provider compliance and ethics program implementation. Sign up here to receive a link to the podcast to be sent later this month.


Prior to joining Stotler Hayes Group, LLC, (“SHG”) I worked at various organizations – in health care, law, and accounting – a few undergoing deep, cultural transformations. My experiences working through the changes taught me a lot about myself and pushed me to continue being a courageous leader in the face of challenging situations. In essence what was intended to be an organizational transformation sparked the beginning of my quest to live wholeheartedly, embrace vulnerability and tackle hard things, for the right reasons.

Then in April 2015, I had the fortune of joining SHG as the General Counsel and HR Director. What I saw in the organization, the leaders, and the team was inspiring and uniquely special. My passion for culture and organizational development paired with the talent, commitment to top-notch service, and forward-thinking approach to leading a law firm was a superb match.

After hearing Dr. Brené Brown’s Ted Talk on Vulnerability a few years ago, I was hooked and on fire to learn more. I absorbed each of her books and listened to all of her other Ted Talks…….multiple times. Dr. Brown’s work is derived from thousands of interviews, years of data compilation and analysis, and based on wholly qualitative research. Her teachings apply to every type of work, all types of organizations - from law firms to long term care companies; her work has the potential to reach all corners of lives, professional and personal lives – from the boardroom to the classroom and the dining room table.

My quest for infusing Dr. Brown’s teachings into the work I love at SHG kept nudging me at my core. Fortunately, the managing partners at SHG are innovative and passionate about the individuals on their team. With their support and understanding of my desire to marry these two worlds, I applied for, and was accepted into, the Dare to Lead™ Facilitator Certification program. Last month I traveled to San Antonio, Texas for the in-person training segment of my year long journey toward achieving the Certified Dare to Lead™ Facilitator Certification. The training was taught by Dr. Brown herself and included approximately 100 like-minded colleagues from all corners of the globe. 

There is so much to tell you about the need to bring Dare to Lead into your workplaces, homes, and communities. Dare to Lead is eye opening and impactful from a personal and professional level. What may genuinely surprise you is that by employing these principles, you will no doubt see positive gains to your bottom line. [1] Vulnerability is good for business and Dare to Lead is an investment in your leadership team. [2]  It provides tools for bringing courage back to your company, creating a meaningful culture, building brave leaders, and learning how to cultivate trust. In an industry where turn-over is at an all-time high, expenses are securitized for corners to cut, and profits are evaluated as a basis for selling business sectors, Daring to Lead is critically important. Research has proven that a positive change to organizational culture can improve employee productivity, increase performance and accountability, reduce absenteeism and turnover, and dramatically improving morale, which come together to skyrocket your net profitability.
I am truly excited to be able, as a Certified Facilitator, to bring this work to you, your teams, and your organizations. I’ll be kicking off the SHG webinar series in 2020 with a Dare to Lead presentation, but, in the meantime, if you are interested in hosting a team workshop, lunch-n-learn, or individual coaching, please reach out to me at akirksey@stotlerhayes.com .   Remember, “The willingness to show up changes us. It makes us a little braver each time.”

[1] An HBR study  showed that the top 10 companies in the Global Empathy Index increased in value more than twice as much as the bottom 10 and generated 50% more earnings.  
[2] Research suggests that inauthentic people may be as much as 20 percent less productive than employees who feel comfortable presenting their authentic selves to the world.

Skilled Nursing Facilities have until November 28, 2019 to adopt and implement a compliance program that meets the elements set out by the Center for Medicare and Medicaid Services (CMS). Beginning on that date, state survey agencies will start assessing nursing homes’ compliance programs as an additional condition of participation in Medicare and Medicaid. Issued in 2016 as part of CMS’s revised Part 483 of Title 42 (“Requirements for States and Long Term Care Facilities”), the CMS compliance program elements are functionally identical to those from the Office of Inspector General for Health and Human Services (OIG). [1]  Already the standard for effective compliance programs, the OIG elements are used to measure an organization’s culpability when federal fraud and abuse laws are violated. Specifically, the OIG considers “the existence of an effective compliance program that pre-dated any governmental investigation when addressing the appropriateness of administrative sanctions.” Read More

Long-term care residents and providers in Kansas are in the midst of some potentially very positive developments as the State undertakes some major changes to the way Medicaid applications are processed. Over the last several years, the Kansas long-term care community took some serious hits due to a severe backlog of Medicaid cases, which caused numerous residents to go without Medicaid coverage and providers to rack up hundreds of thousands of dollars in unpaid bills. Those affected by these issues in the Sunflower State did not take it sitting down and it appears the powers that be were listening to their cries. Read More
This past August, we shared some information on our  blog  about the importance of knowing your state’s Filial Responsibility laws (or lack thereof) and the potential impact of using these laws to help with Medicaid collection issues. To help with your efforts,  this chart  includes the filial responsibility laws for those states that have them, as well as the relevant court cases from those states.

If you have specific questions about how your state’s filial responsibility law could improve your collection outcomes, please  contact us .

 The New York State Department of Health (DOH) is planning to radically change how it calculates Medicaid nursing home reimbursements. DOH’s new method will alter the way the state calculates the average Case Mix Index (CMI) of Medicaid nursing home residents in order to save the Medicaid program $246 million, half of which will come from the state’s forfeiture of the federal matching funds. However, according to a  statement  sent to the DOH by the Nursing Home Acuity Workgroup, the $246 million in savings will also lead to an cut in average Medicaid nursing home rates of $9.50 per day, per patient. These newest cuts will be in addition to the current Medicaid shortfall of $65 per patient per day,  according  to Stephen Hanse, President and CEO of New York State Health Facilities Association. The state’s nursing homes should start preparing if they are going to minimize any impact to their revenue streams. Read more
We are celebrating this holiday season by giving a total of $5,000 to charity. 
It’s important to us that our charitable donations reflect not just our values and beliefs, but also the ideals and organizations that are important to you – our clients.
Clients are welcome to nominate charitable organizations. Organizations can be local or national and no organization is too small (or too big) for consideration, however, nominees must be a 501c(3). 

Nominations will be accepted from November 1st until December 2nd.  Selected nominees will appear on the list of charities that can win up to $2500 during our 10 days of giving, beginning December 9th.