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NEW JERSEY SOON TO EXPERIENCE SHORTAGE OF NURSES

Posted by on Jul 30, 2018 in Law | 0 comments

NEW JERSEY SOON TO EXPERIENCE SHORTAGE OF NURSES

By 2030, New Jersey will have the third largest nurse shortage in the country – a shortage of more than 11,000 nurses.  This according to the US Health Resources and Services Administration.

It appears that statistically, because of the recession, nurses were putting off retirement and stayed in the workforce a little longer.  Now with the uptick in the economy, nurses are beginning to retire.  The problem is not that new nurses are unavailable, but that the nursing schools are understaffed.  The shortage of appropriate skilled teachers across the country means the nursing schools are not able to take in as many students as are applying.

According to Professor Dr. Nadine Aktan, nursing schools are turning away qualified applicants in droves because of the faculty shortage.  The American Association of Colleges of Nurses says that in 2017 more than 56,000 qualified applicants were turned away from undergraduate nursing programs across the country.

How Definitions in your Physician Employment Contract Have a Changing Impact on your Career

Posted by on Mar 5, 2018 in Law | 0 comments

How Definitions in your Physician Employment Contract  Have a Changing Impact on your Career

Physicians should be aware that definitions contained within a physician employment contract may have one meaning today, but will have a very different practical effect years from now.

One of the most importation components of a physician employment agreement is the non-competition provision.  Those provisions typically provide that the physicians may not engage in competing behavior after the termination of the contract for a specified period of time within a defined geographic area.  The definition of prohibited geographic area varies from contract to contract.  In some cases, the definition will be a specified radius from the primary location of the employer’s office (ie: 10 miles from the employer’s office located at 10 Main Street, Anywhere, USA).

Other times however the prohibited geographic area might be defined as a certain specified radius from wherever the employer may conduct business.  This latter type of definition may have a profound effect.  For example, consider that at the time the physician begins employment, the employer only does business at 10 Main Street, Anywhere, USA.  However, five or ten years down the road, because of mergers or aggressive growth, the employer now does business throughout most of North, Central, or Southern New Jersey, New York, Connecticut, etc.  Then, when the employment agreement is terminated, the employer may very well successfully argue that the physician must essentially relocate to another part of the state in order to avoid being in violation of the literal terms of the employment agreement, as the geographic area in which the employer does business – has grown.

Definitions are important.  Contact Romanowsky Law today in order to avoid pitfalls which may impact your career.

Will NJ Join the Multi-State Nursing Licensing Group?

Posted by on Dec 22, 2017 in Law | 0 comments

Will NJ Join the Multi-State Nursing Licensing Group?

Recently, the New Jersey State Assembly voted unanimously to advance the latest version of a Bill that would enable the Garden State to sign on to a growing collaboration that already includes Delaware, Maryland and most of the Southeast. 

The Bill was sponsored by Democrat Herb Conoway, Jr. who presented the Bill in June of 2016.  “The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states; and uniformity of nurse licensure requirements throughout the state promotes public safety and public health benefits,” reads the latest version of the Bill. 

Some nursing groups however have raised concerns that joining the pact could lower the standards of the State of New Jersey.  They point out that potentially less stringent requirements of other states would enable prospective nurses to find employment in New Jersey to the detriment of New Jersey residents. 

As of 2005, the group comprising the consortium who have adopted the legislation had grown to 25 states.  Multi-state licensing legislation is pending in five additional jurisdictions including New Jersey and Massachusetts.   If the State legislature elects to adopt the legislation, it will need to do so shortly as there are only a handful of voting dates available before the legislation ends in mid-January. 

Changes and Delays Plague the NJ Board of Nursing

Posted by on Dec 13, 2017 in Law | 0 comments

Changes and Delays Plague the NJ Board of Nursing

It is no secret that the New Jersey Board of Nursing has been in crisis.  Currently, there are approximately 4,000 applicants of nurses and home health care aides whose applications have been pending for many months.  This at a time when the State is in dire need of such health care talents.

In July of this year, the Board’s Executive Director, Dorothy Smith Carolina abruptly resigned citing a “staffing crisis” and lack of cash to pay for personnel necessary to make the Board work efficiently.

A majority of the Board members signed a July 25 letter directed to the Governor citing the Board’s deficiencies and need for personnel.  In the words of Senate Majority Leader Loretta Weinberg (D-Bergen), “The inability of this vital State Board to carry out its mission is effecting families and the strength of the State’s health care system.  This situation must be remedied immediately.”

In October, Governor Christie responded.  He named approximately a dozen nurses and other observers to serve on the nursing board less than a week before lawmakers were scheduled to discuss the vacancies and their effect on the citizens of New Jersey.  Missing from the appointments was the appointment of the Board’s president, Patricia Murphy who was “relieved of her duties”.

Murphy was removed from her position and testified before the State Senate, that, “The division has not filed any of the positions that are vacated by professionals with professionals.” 

Some senators are calling for a total overhaul of the Department and requesting outsiders provide an objective assessment. 

Critics of the Governor’s appointments point out that only one Board staff member has actual nursing experience.  Many of the staff members assigned to the Board also report to managers elsewhere creating inefficiencies and potential conflicts, observers allege.   

Former president Murphy advised the New Jersey State Senate that the Board needs a full-time executive director, a position that has been filled by an acting employee-whom the speakers praised for her efforts – ever since former executor director Dorothy Smith Carolina left in frustration earlier this year. 

Non-Competition (Restrive Covenant) Agreements: How Likely Are They to be Enforced?

Posted by on Oct 24, 2017 in Law | 0 comments

Non-Competition (Restrive Covenant) Agreements: How Likely Are They to be Enforced?

Elsewhere on my websites, I have discussed the legal factors which determine whether or not a non-competition agreement is enforceable.  Physicians  are served well to consider the practical question of whether or not such agreements are likely to be enforced, assuming they may be from a purely legal perspective.  A number of factors weigh in to this analysis. 

1.  The Economics.    

Consider whether it is worthwhile for the former employer to incur legal fees, time, and resources to enforce the non-competition clause.  Let us assume that you seek employment at a location which is in violation of your contract during the time when such employment is prohibited by the contract.  Does your new employment cause a financial  detriment to your previous employer?  In the absence of an economic detriment,  the chances that the former employer will seek to prevent your new employment are smaller.  On the other hand, the departure of a physician from a practice to another one in the same geographic area may mean that a substantial client base will have reason to follow the departing physician.  This type of financial harm may lead your employer to enforce the contract, for the financial benefit of the practice.

2.  The Terms.

Does your non-completion agreement provide that if you are in violation of the non-competition clause that the prior employer would be entitled to attorneys’ fees and costs of suit?  If the answer is yes, then the former employer has more incentive to bring an action knowing that they are likely to prevail in their attempt to recover attorneys’ fees and costs of suit.  Without the language, a practical attorney will advise a prior employer that the fees and costs incurred will not be recoverable.  Similarly, some non-competition agreements have a liquidated damages clause which provides that the departing doctor agrees to pay liquidated damages (a fixed sum) equal to a specified amount for each day that the doctor is found in violation of the non-competition clause. The  terms of your contract may tip the scales in favor of, or against, litigation.

3.  Other Factors.

Other, more personal factors may weigh in the employer’s decision.  For example, is the departing physician leaving on “good terms”?  If so, one way to avoid a potential suit to enforce the non-competition clause is to simply request the current employer waive the clause, and allow the departing physician to accept the offer which has been made to him or her.  The request, and the response of the current employer, should be made in writing in order to protect the departing physician. 

4.  Conclusion

The economics, the terms of your contract, and other factors weigh into a determination of whether or not the existing practice will elect to bring an action against a departing physician to enforce a non-competition clause.  Just because the clause is enforceable, doesn’t always mean that the prior employer is likely to bring suit.  Of course, no attorney can predict whether an existing employer will bring an action, but the physician who is contemplating departure or the enforceability of a restrictive covenant should bear these factors in mind.

Contact Romanowsky Law now to have your restrictive covenant reviewed. 

Will A Prospective Employer Change its Standard Physician Employment Contract for YOU?!

Posted by on Oct 9, 2017 in Law | 0 comments

Will A Prospective Employer Change its Standard Physician Employment Contract for YOU?!

I am often asked by clients whether or not and offer made to them by a prospective employer is likely to make changes to the contract presented.

 

I sometimes respond with a question:  “Are you the Derek Jeter of your practice?!”

 

Put in another way, whether a prospective employer is willing to change its contract depends upon the amount of leverage you have.  Some clients are in a positon to bring an incredible reputation to the practice.  The practice wants to be affiliated with you and your reputation.  Sometimes, a physician may bring a book of business which the practice desperately needs.  Sometimes, there are personal relationships at stake which might compel the prospective purchaser to make the changes sought by my client.  And of course, sometimes a mix of all three variables are at play.

 

To continue the analogy, if you enjoy a stellar reputation and your skills are in demand, then you may very well be the Derek Jeter of your practice.  If that is the case, it is more likely then not that the prospective employer will modify its contract because you have leverage with which to bargain.  The same holds true if you have a substantial book of business to bring.  

 

On the other hand, if you are just finishing your residency, and you have neither a stellar reputation (yet!) or a substantial book of business, the practice may not be willing to make the changes you seek.  

 

Consider too, the challenges of the employer.  If it is a small practice, there might be need to treat all doctors in the same way, including some parity with regard to compensation.  Otherwise, if one or more of the other physicians learn of the accommodations which were made to you, the practice morale may suffer.  Furthermore, benefits which you might request which are unique to you but not to the others can cause the same problems.  Making accommodations for you might mean that the same accommodations must be made for the other employees.  This could cause the practice to incur additional costs.

 

Sometimes there are more fundamental practical considerations at stake as well.  Perhaps the practice is not inclined to incur legal fees for the purpose of negotiating the contract for you.  It is easier for the human resources person who provided you the contract to simply say “no, this is our standard form” than to seek management approval and counsel’s advice.  That same person may wish to avoid being criticized by management for having deviated from the standard form.

 

Contact Romanowsky Law today to discuss how we can assist you in negotiating a contract which may have a profound affect on your career.  

 

RAMP and PAP Can Help

Posted by on Dec 30, 2016 in Law | 0 comments

RAMP and PAP Can Help

Romanowsky Law is often contacted by nurses and doctors whose licenses are in jeopardy because of a debilitating dependency on opioids, alcohol or other substances, or psychological disability.  In those cases, it is of utmost importance that clients acknowledge their dependency/disability and utilize a professional organization condoned by the New Jersey Board of Nursing or the Board of Medicine not only for rehabilitating themselves, but to preserve their ability to work as a nurse or doctor.

 

RAMP

 

The NJ Recovery and Monitoring Program (“RAMP”) was established in 2003 as an alternative to discipline.  The program is managed by the Institute for Nursing for the NJ Board of Nursing.

 

RAMP is a confidential voluntary program designed to encourage healthcare professionals, including nurses, to seek a recovery program before their impairment harms themselves or a patient in their charge.

 

Nurses who might otherwise be disciplined or lose their licenses are often referred to the program by the NJ Board of Nursing as a condition or alternative to discipline.

 

Nurses referred to the program are required to take random drug analysis tests, to seek counseling, and to otherwise be in contact with RAMP who reports to the nurse’s employers regarding the nurse’s status with RAMP.  Ultimately, RAMP will often report that restrictions once put in place are no longer necessary.

 

When a nurse is referred to RAMP, or if his or her employer reports a suspicion of chemical dependency or drug deviation to the Board, it is critical that the nurse work with the Board to create a consent order or private letter agreement governing the terms upon which the nurse may continue to practice while attending RAMP.

 

Romanowsky Law has helped many nurses through this arduous process with successful results.

 

PAP

 

Sometimes the nursing board will allow nurses to participate in programs offered by Professional Assistance Program of New Jersey (“PAP NJ”).  This organization is usually utilized by physicians.

 

The mission of the Professional Assistance Program of New Jersey is “to provide services to protect the public safety and welfare of the citizens of New Jersey through education, identification, evaluation, treatment planning and advocacy for licensed health care and other professionals in recovery from an impairing medical condition and/or illness.”

 

Once referred to the PAP program, physicians and nurses undergo a number of psychological evaluations to determine the extent of chemical dependency and to determine an appropriate course of conduct and counseling.

 

Both RAMP and PAP will require that nurses and physicians pay for appropriate testing and other services and both organizations will report to the Board when they believe any restrictions imposed upon the physician or nurse’s work may be terminated.

 

As with RAMP, Romanowsky Law has helped nurses and doctors utilize the services of PAP not only for their personal well-being, but to maintain their ability to earn an appropriate living, in a vocation which they are uniquely trained to execute.

 

If an employer has a referred a suspicion of dependency or deviation to the Board, it is imperative that you call Romanowsky Law now to help you document the terms and conditions upon which you can extricate yourself from this serious situation.

American Nurses Association Reports As Many as 1 Out of 10 Nurses Has a Drug Addiction Problem

Posted by on Nov 12, 2016 in Law | 0 comments

American Nurses Association Reports As Many as 1 Out of 10 Nurses Has a Drug Addiction Problem

Nurses need help too.  Check out this moving story from a nurse who is hoping to help others.  Romanowsky Law can help too…….

www.wcnc.com/news/health/1-in-10-nurses-addicted-to-drugs/347521562

Can You Negotiate Your Medical Contract?

Posted by on Sep 13, 2016 in Law | 0 comments

Can You Negotiate Your Medical Contract?

I am often asked by healthcare professionals whether or not I think the employer who has presented them with an employment contract will negotiate terms of that contract consistent with the comments I offer.  The answer is, “maybe.” Here’s why:

 

Are you fresh out of the farm league or are you Derek Jeter?

                 

Whether or not the employer will actually negotiate depends in part upon your status in the medical community and how badly the employer wants you.  I often use the analogy of whether you are considered the “Derek Jeter” of the medical profession, or are you a newly minted doctor, fresh out of the farm league?  Obviously, if you are the Derek Jeter, it is likely that the employer will go out of its way to accommodate any requests you may have with respect to their employment contract. In that situation, they would be more than willing to make the changes requested in order to get you “on their team”.  Some doctors already have a large body of clients who will come with the doctor.  Others do not.  For the most part, your value probably falls somewhere in between these two extremes.  Try to assess how valuable you are to the employer.

 

Will a change in the contract upset the apple cart?

 

Consider that the employer may not be inclined to make “separate deals” for each of employees.  An employer must consider whether making special accommodations for its newest employee would cause dissention among the existing employees.

 

Is the employer open to change?

 

Some employers do not have an attorney or full time human resource person on hand.  For that reason, they may insist on strict adherence to the “form contract” they have opted to use.  In this case, it is not so much a question of whether they can or should change the contract as much as a question of whether they should incur additional attorney’s fees for the purpose of considering your proposed changes.

 

Conclusion

 

For this and other reasons, the question of whether or not you will be able to negotiate the terms of the offer given to you, depends upon a number of variables some of which are mentioned here.  Regardless, if the employer is not willing to negotiate the contract, you should understand how the contract may affect you in your everyday experience working for the employer.  Contact Romanowsky Law today for a free estimate of the cost involved to better understand the risks you are being asked to accept.  973 451 1116.

Physician Contracts – Pay Attention to What is NOT in the Contract, as Much as What IS

Posted by on Aug 19, 2016 in Law | 0 comments

Physician Contracts – Pay Attention to What is NOT in the Contract, as Much as What IS

Physicians are well served by referring a proposed contract to an attorney who can identify pitfalls contained within the contract. This small investment in legal services may have a profound effect on the day to day life of physicians who accept a contract. Physicians are well advised to also consider certain factors which are not contained within the four corners of the contract itself. Consider the following:

 

  1. Growth. Get a handle on the history of the practice you intend work with. Has the practice seen growth? If a practice is not growing and has remained a certain size over a certain period of time, it may mean that the practice is not being managed well. Of course that’s not always the case and some practices prefer to stay small as opposed to grow. During your discussions with your potential employer, find out what their ambitions are and compare those ambitions to the previous history of the practice. Consider if the practice is shrinking. If so, why?

 

Another reason to consider growth is to determine whether the employer is growing in such a way that time may present you with different responsibilities within the practice, and a more rewarding long term career provided you remain employed by the practice.

 

  1. Turnover. During the interview process, determine how many physicians have come and gone from the practice over the last several years. If the turnover number seems high, ask for an explanation of why the turnover appears to be high and consider the response provided.

 

  1. Investment. Determine whether there has been a commitment to capital and equipment improvements at the practice. Find out what new equipment has been purchased by the practice and what their short and long term goals are in this regard.   Has the practice made a substantial commitment to computerized record keeping, billing and other administrative responsibilities?

 

  1. Get to know personnel. One of the most important things to consider is the personality of the people you will work with. Not only is it important to consider the reputation of your direct report, or reports, but also the personality and reputation of the administrative staff who can make your every working day a pleasure or a nightmare. Ask the people you are negotiating with if you can have some “one on one” time with other peers who recently began working at the practice to determine what their impressions are in this regard. Perhaps a lunch is in order. The more time you spend with the prospective personnel, the better you will be able to make an educated guess about whether they share the same ambitions and work/life balance you seek.

 

Conclusion

 

The terms of your employment contract likely set forth the hours you will work, the pay you will receive, the benefits to be provided, etc. But there are many more issues to consider which will not be found within the four corners of the contract. Bare these factors in mind before you commit your career to a track you might otherwise regret. Call Romanowsky Law now to help guide you through the employment pr