Thursday, June 2, 2011

CMPs Reduced for Self-Reporting and Correction of Violations

 

The Centers for Medicare and Medicaid Services (CMS) released the final rule “Civil Money Penalties for Nursing Homes,” which allows proactive nursing homes to reduce civil money penalties (CMP) by 50% by self-reporting and promptly addressing compliance violations.  The rule, created through a section of the Patient Protection and Affordable Care Act, will become effective on January 1, 2012.

 

                To take advantage of the 50% reduction, a nursing home must meet the following conditions:

·         The nursing home must self-report the compliance violation before it is identified by CMS or the State.

·         The nursing home must correct noncompliance within 15 calendar days of the incident causing the noncompliance or 10 calendar days from the date the CMP was imposed, whichever is earlier.

·         The violation must not involve immediate jeopardy or patient harm.

·         The nursing home must waive its right to administrative hearings.

 

Under the new rule, an independent informal dispute resolution process will be available when a CMP is imposed.  Following an independent informal dispute resolution, CMP funds will be held in an escrow account pending completion of any appeal.  If the appeal succeeds, the CMP funds will be returned to the nursing home with interest.  According to CMS, CMPs currently range from $50 to $10,000 per day of noncompliance.

 

 

 

Tammy Schroeder

Knudsenlogomay.jpg

Paralegal
  Office: 402-475-7011

Fax: 402-475-8912

tschroeder@knudsenlaw.com

 Knudsen, Berkheimer, Richardson & Endacott LLP
 3800 VerMaas Place, Suite 200, Lincoln, NE 68502

 http://www.knudsenlaw.com

 

 

Friday, May 27, 2011

SPRING FREEZE

The Centers for Medicare & Medicaid Services (CMS) is making changes to its Nursing Home Compare website (http://www.medicare.gov/NHCompare/). In the interim, CMS is freezing the quality measure data and the five-star quality ratings that are currently on the site for a period of six months.

In an age where technology makes everything easier, the federal website Nursing Home compare function makes choosing a nursing home as easy as choosing the latest movie release based on a five-ranking system. The public can compare rankings of nursing homes before they make that all important decision.

Starting April 23, providers that had a bad previous quarter will have six months to mull over their sub-par ranking while the public absorbs this frozen data. By the time the data are unfrozen, new quality measure data from MDS 3.0 will have been collected.

By then, the site also will be giving consumers better opportunities to file complaints against providers with state survey agencies by including links to state complaint websites, and making state fax and phone numbers more prominent. Additionally, CMS will add instances of “enforceable actions” such as civil monetary penalties and denials of payment or new admissions.

 

 

 

Tammy Schroeder

Knudsenlogomay.jpg

Paralegal
  Office: 402-475-7011

Fax: 402-475-8912

tschroeder@knudsenlaw.com

 Knudsen, Berkheimer, Richardson & Endacott LLP
 3800 VerMaas Place, Suite 200, Lincoln, NE 68502

 http://www.knudsenlaw.com

 

Circular 230 Disclosure: Pursuant to recently-enacted U.S. Treasury Dept. Regulations, we are now required to advise you that, unless otherwise expressly indicated, any federal tax advice contained in this communication, including attachments and enclosures, is not intended or written to be used, and many not be used, for the purpose of (i) avoiding tax-related penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any tax-related matters addressed herein.

 

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This electronic message transmission contains information from the law firm of Knudsen, Berkheimer, Richardson & Endacott, LLP which may be confidential and privileged.  DO NOT FORWARD THIS E-MAIL WITHOUT ASSURING PROTECTION OF PRIVILEGED MATERIAL.  If you have questions about forwarding this message, contact us first.  All clients are advised that communication by e-mail may not be secure and may be subject to interception.  The information in this e-mail is intended solely for the use of the individual or entity named above.  If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited.  If you have received this electronic transmission in error, please notify us by telephone (402-475-7011) or by electronic mail (postmaster@knudsenlaw.com) immediately

 

Monday, February 28, 2011

Nebraskas Supreme Court to review Republican River status

http://www.businessweek.com/ap/financialnews/D9LLA0D81.htm

 

 

 

Jeanelle R. Lust

 

kbre

"We Help You  Deal With It."

Knudsen, Berkheimer, Richardson & Endacott, LLP

3800 VerMaas Place, Suite 200

Lincoln, NE 68502

402/475-7017  ext 1128 

402/475-8912 (fax)

402/440-3731 (cell)

 

 

Friday, February 25, 2011

Walking May Stall Decline of Cognitive Function

 

According to a recent study, walking five miles per week may stall the decline of cognitive function among those who are experiencing mild forms of dementia. 

 

To assess the impact that physical exercise might have on Alzheimer’s progression, Cyrus Raji, M.D., Ph.D., and colleagues analyzed the relationship between walking and brain structure in 426 adults.  Among the participants, 299 were cognitively healthy and 127 were diagnosed as cognitively impaired. 

 

For the study, participants were asked how many city blocks they walked in an average week.  Follow-up questionnaires confirmed that the number of blocks remained steady over time.  Participants also underwent MRI exams so researchers could measure changes in brain volume, and took the Mini-Mental State Exam, a test of cognitive skills, at various times throughout the study.

 

The study indicated that walking protects the brain structure in people with Alzheimer’s and mild cognitive impairment (MCI), specifically in areas of the brain’s key memory and learning centers.  Raji stated that those who walked five miles per week also had a slower decline in memory loss over five years.  In those diagnosed with MCI, the exercise reduced brain atrophy and cognitive decline by more than 50%.

 

The study also revealed that walking six miles per week is associated with a 50% reduction in Alzheimer’s risk in cognitively normal adults.

 

 

Jeanelle R. Lust

 

kbre

"We Help You  Deal With It."

Knudsen, Berkheimer, Richardson & Endacott, LLP

3800 VerMaas Place, Suite 200

Lincoln, NE 68502

402/475-7017  ext 1128 

402/475-8912 (fax)

402/440-3731 (cell)

 

 

Friday, February 18, 2011

A Class Act

 

The Community Living Assistance Services and Support (CLASS) Program, was created to provide assistance for individuals who need long-term care (LTC) services and have difficulty with activities of daily living. CLASS is the first federal and consumer financed LTC program in the United States. 

 

CLASS is a voluntary, government-run LTC insurance program that offers participants a single benefit plan with a daily cash benefit of $50, indexed to inflation. Beneficiaries can use the money to purchase nonmedical services to use either at home or at their chosen residence. There is no limit on how long a person can receive benefits through CLASS.

 

Currently, nursing home costs can average approximately $75000 per year while home care costs $20 an hour, these prices will increase in the succeeding years. Long term care services are utilized by elderly individuals and widely needed by people with disabilities. The CLASS Act also aims to revamp the untenable provisions in Medicaid by introducing consumer funded scheme that won't affect the overall public budget and mitigating the asset limit requirement. Most of the provisions in the CLASS Act aim to lessen the impact of outrageous long term care effects on people.

 

However, there are many concerns about the long-term fiscal soundness of the CLASS plan. The consensus of the American Academy of Actuaries is that CLASS poses “a significant and likely risk that, in a relatively short time period, the program will either need increased premiums and/or significant reductions. CLASS reduces the deficit in the short run because the government collects premiums for five years (2012–2016) but pays no benefits. The Congressional Budget Office estimates that premium payments into CLASS will exceed benefit payments out of CLASS only until 2030; the Centers for Medicaid and Medicare Services approximates that this will happen in 2025. Subsequently, CLASS adds to yearly federal budget deficits

 

Michael W. Khalili | Associate Attorney*

Knudsen Berkheimer, Richardson & Endacott, LLP
3800 VerMaas Place, Suite 200, Lincoln, NE 68502

( 402.475.7017 ext. 1156 | Fax 402.475.8912

* mkhalili@knudsenlaw.com | www.knudsenlaw.com

*Also admitted in Iowa & Washington

Wednesday, February 2, 2011

Weather

Readers of this blog will note two postings this year closing the office.  You may wonder – why is this being posted?  It is being posted as the most efficient method of notifying all employees of a weather related closure – which brings to mind the issue of employment policies for employers facing severe weather closing decisions.  Employers should consider the following in crafting their policies:

 

        What standards will cause the business to be closed for the day?

·       Who will be the decision maker and how will that be told to the employees?

·       Will you allow early departures on days when bad weather looms?

·       Will employees be expected to take work home if they depart early?

·       Is working from home even a possibility for the employee?

·       Will you waive tardiness rules on severe weather days?

·       Are there essential employees that must report to work no matter the weather?

 

The Fair Labor Standards Act allows employers to exclude from pay time that employees are off for severe

weather. In other words, if an employee cannot attend work due to weather conditions, an employer does not have to pay the employee for that day unless:

        an hourly employee telecommutes (or works from home) on the day of the absence; or

        the employee is exempt.  I.e., Management employees receiving salary should generally be compensated on days the office is closed pursuant to the terms of their salary agreement. If, however, an exempt employee decides to take a day off due to severe weather when the employer is open, the employer can deduct that absence from the exempt employee’s pay.

 

Jeanelle R. Lust

 

kbre

"We Help You  Deal With It."

Knudsen, Berkheimer, Richardson & Endacott, LLP

3800 VerMaas Place, Suite 200

Lincoln, NE 68502

402/475-7017  ext 1128 

402/475-8912 (fax)

402/440-3731 (cell)

 

This email is not meant to relay any tax advice. This email may be privileged. DO NOT FORWARD THIS EMAIL WITHOUT ASSURING PROTECTION OF PRIVILEGED MATERIAL. Email may not be secure.  If you have received this email in error, please delete it.

 

Tuesday, February 1, 2011

Severe Weather Closing

The Knudsen Law Firm will be closed today, February 1, 2011, because of severe weather conditions.

Wednesday, January 19, 2011

Credit Reports and Employment Applications -- Don't use them

Employers should  only perform credit and consumer report checks on applicants for employment for financially sensitive positions that

require bonding. The EEOC recently sued the Kaplan Corporation for using credit checks in hiring decisions.  Kaplan argues that the job openings for which they used credit reports involved financial advice to students and that, thus, the credit information was important information about the applicants fitness for the job.  The EEOC disagrees, claiming that such credit checks have a disparate impact on minority applicants. While the EEOC’s position does not yet have the force of law, since the EEOC is the agency charged with discrimination enforcement,  until resolution of this lawsuit, a prudent employer should refrain from using credit checks in making employment decisions, whenever possible.

 

Avoiding credit checks should not be much of a hardship.  Studies have shown that poor credit ratings, in general, have no relationship to job performance.

 

If an employer feels it must run a credit check, the employer should ensure compliance with the Fair Credit Reporting Act. Generally speaking, employers need an employment purpose for obtaining a consumer credit check on applicants and employees, and must provide the employee a clear written notice of its intent to obtain such a report. The applicant or employee must then give written permission to obtain the report. This should be a stand-alone document and not part of the job application. The employer must then certify to the credit reporting agency that it has complied with the FCRA. If the applicant is turned down for the position, and information in the consumer report is a factor in the decision (even if only a minor factor, with other sufficient reasons, or even if the information wasn’t negative, but was a factor) then the employer must comply with the FCRA procedures. Generally, that requires the employer to provide adverse action notice telling the applicant why the decision was made, providing the employee or applicant with a written description of rights, providing a copy of the report, and the name and address of the reporting agency or service that provided the information. The employee or applicant can also request information about the sources used for the report and the other recipients of the report. More details can be obtained from the Federal Trade Commission’s web-site at

 

www.ftc.gov/bcp/edu/pubs/business/credit/bus08.shtm

.

 

Jeanelle R. Lust

 

kbre

"We Help You  Deal With It."

Knudsen, Berkheimer, Richardson & Endacott, LLP

3800 VerMaas Place, Suite 200

Lincoln, NE 68502

402/475-7017  ext 1128 

402/475-8912 (fax)

402/440-3731 (cell)

 

 

Monday, January 10, 2011

Office Closing

The Knudsen Law Firm will be closed today, Monday, January 10, 2011, due to severe weather conditions.  Staff and attorneys may report if necessary, but attendance is not required.

Friday, January 7, 2011

EEOC issues regulations on GINA

The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits
employers and other entities covered by GINA Title II from requesting,
requiring or purchasing genetic information of employees or their family
members. Although it has been in effect for over a year the Federal
Government just issued regulations about its application. The biggest
clarification under the rules is what constitutes acquisition of genetic
information.

According to new EEOC regulations, a request for genetic information
even includes "conducting an Internet search in a way that is likely to
result in obtaining genetic information, as well as 'actively listening'
to third-party conversations or making requests for information about an
individual's current health status in a way that is likely to result
genetic information."

There are circumstances when an employer may legitimately come into
possession of genetic information without violating GINA's prohibition
on requesting, requiring or purchasing genetic information. However,
confidentiality and prohibitions on use remain. These circumstances
include:

* Where information is acquired inadvertently. For example, a
casual reference overheard at a water cooler that an employee's mother
has breast cancer and that the employee herself has been tested for a
gene related to that, will not be a violation. Similarly, employers who
employ multiple family members will have a little more flexibility
obtaining information from one family member without that being an
offense against another family member (remember that one employee's
manifestation of disease or disorder could be the family medical history
of the brother or sister or father, mother, uncle and so on who also
works for the employer).
* Where information is acquired as part of health or genetic
services, including wellness programs. Employers are free to offer
financial and other incentives to encourage employees to participate in
wellness programs, though they cannot offer those incentives to provide
genetic information. Employees may still be provided the questionnaires
seeking the information, but must be told that they need not provide
genetic information in order to receive the incentive, and in fact, a
particular notice provided below is recommended.
* Where information is acquired in the form of family medical
history in order to comply with Family Medical Leave Act, or Nebraska or
other local leave laws, or even certain employer leave policies
requiring, for example, return to work certification.
* When information comes from sources that are commercially or
publically available, such as newspapers, books, magazines, and even
electronic sources. This exception does not apply to court records,
medical or research databases, or other sources with limited access such
as social networking sites that require a creator's permission to
access. Similarly commercially available sites an employer
intentionally accesses with intent to gather, or from which an employer
is likely to gather such genetic information are prohibited.
* Where information is gathered as part of a legitimate genetic
monitoring program required by law or provided on a voluntary basis.
For example, employers may be required to perform such tests to see if
employees are being harmed by substances or energies in the workplace.
If doing monitoring that is not required by law, proper notification and
fully informed authorization of the employee must be obtained.
Similarly, if required by OSHA or otherwise by law, certain
notifications may be required. In either case, consultation with an
attorney is likely critical before conducting such monitoring.
* Where information is conducted by employers who do DNA testing
for law enforcement purposes as a forensic lab, or for human remains
identification. Any such employee genetic information can only be used
for analysis of DNA markers for quality control, to detect sample
contamination.

Whenever lawfully requesting information from an employee that may
reveal genetic information, for example through a wellness program, to
support an ADA accommodation request, request for sick leave, FMLA or
similar certification, or otherwise, employers should include the
following notification:

"The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits
employers and other entities covered by GINA Title II from requesting or
requiring genetic information of employees or their family members. In
order to comply with this law, we are asking that you not provide any
genetic information when responding to this request for medical
information. 'Genetic information,' as defined by GINA, includes an
individual's family medical history, the results of an individual's or
family member's genetic tests, the fact that an individual or an
individual's family member sought or received genetic services, and
genetic information of a fetus carried by an individual or an
individual's family member or an embryo lawfully held by an individual
or family member receiving assistive reproductive services."

Whenever the notice is properly given it will provide a safe-harbor for
employers, and any such acquisition will be considered inadvertent, and
therefore not a GINA violation.

www.knudsenlaw.com
Jeanelle R. Lust
jlust@knudsenlaw.com

Thursday, August 5, 2010

Our Pledge

At the Knudsen Law Firm, we know this is what clients want, and we
promise to deliver:

* Value. Whatever the fee arrangement is - alternate, fixed or
hourly - you will get your money's worth.
* Solutions to (and prevention of) problems, i.e., getting you out
of trouble.
* Money. Ways to save it, keep it or make it.
* Expertise in the particular area(s) of law where you need
counsel.
* Attention. You will feel that you are our most important client.

* Communication. Only bats and mushrooms like to be kept in the
dark. You won't be
* To be involved. You will be asked your opinion and have a say
in every decision.
* Timeliness. We will meet every deadline.
* Courtesy and respect. You will be treated as a person, not just
a file.
* No surprises. We will tell you what will happen and prepare you
for what might happen.

* Prompt and understandable billing.

* Prompt answers. To questions - and to any complaints.

* Guidance and counsel. On what you must or should do.
* Responsiveness.
* Advocacy.
* Follow through.

If you do not find that have met or exceeded your expectations in all of
these areas, I want to hear about it. I personally will do what it
takes to make you satisfied.

"We help you deal with it"

Change in Nursing Home Survey Process

Nebraska Implementing QIS Process.

Nebraska is moving toward implementing the QIS (Quality Indicator
Survey) process. Nebraska is part of the second group of states in
which CMS is doing this, along with Colorado and New York. Nebraska
will begin implementing the QIS process beginning August 2010.

Compared to the current, traditional, surveying system which has
information documented on paper throughout the process, each CMS team
member will use a tablet PC to document findings. These findings will
then be electronically synthesized, organized and loaded to the CMS.
When doing onsite preparation, QIS team members will analyze
alphabetical resident censuses with room numbers and units in addition
to a list of new admissions over the last thirty days. There will also
be substantial changes to offsite preparation, the initial tour process,
sample selection, and to various other aspects of the survey process.

QIS surveys will involve two stages. Each stage will involve three
steps. Step one will be "computer generated sampling". Step two will be
"investigation". Step three will be "synthesis". The first stage will
involve a preliminary investigation of regulatory areas. The second
stage will involve an in-depth investigation into deficiencies
identified in stage one.

This system will be implemented in phases across the state, using
"teams" to do one area of the state at a time. This will take two to
two and a half years to implement fully. Because it will be more
objective, driven by MDS data, and feature large sample sizes it will
likely result in a higher rate of deficiencies in place of many "FYI"
comments surveyors presently give.

<http://www.knudsenlaw.com/Att_Bio_JRL.htm>
<http://www.knudsenlaw.com/>

Jeanelle R. Lust

Knudsen, Berkheimer, Richardson & Endacott, LLP

3800 VerMaas Pl

Suite 200

Lincoln NE 68502

402 475 7011

402 440 3731 (M)

402 475 8912 (F)

www.knudsenlaw.com

jlust@knudsenlaw.com

Managing Partner

"We help you deal with it"

Tuesday, May 25, 2010

Lexington Public Schools receives summary judgment

Yesterday Judge Doyle in the District Court of Dawson County issued
summary judgment to the Lexington Public Schools finding the school not
liable for injuries to one of its students. The Lexington Public
Schools was represented by Jeanelle Lust of the Knudsen Law Firm.

The student alleged that she fell into a manhole on Lexington Public
School's property while participating in an out-door gym class. The
school maintained throughout the litigation that it did not know of any
defects or problems with the manhole (or in fact that a manhole was even
on its property). Judge Doyle agreed and dismissed the plaintiff's
case.

<http://www.knudsenlaw.com/Att_Bio_JRL.htm>
<http://www.knudsenlaw.com/>

Jeanelle R. Lust

Knudsen, Berkheimer, Richardson & Endacott, LLP

3800 VerMaas Pl

Suite 200

Lincoln NE 68502

402 475 7011

402 440 3731 (M)

402 475 8912 (F)

www.knudsenlaw.com

jlust@knudsenlaw.com

Managing Partner

"We help you deal with it"

CONFIDENTIALITY NOTICE: This email contains information which may be
confidential or privileged. DO NOT FORWARD THIS E-MAIL WITHOUT ASSURING
PROTECTION OF PRIVILEGED MATERIAL. Communication by email may not be
secure. If you have received this email in error, delete it.

Wednesday, March 17, 2010

Supreme Court Refuses to Hear Nursing Home Civil Rights Case

By: Laura E. Troshynski

www.knudsenlaw.com <http://www.knudsenlaw.com>

Can alleged inadequate nursing home care lead to a civil
rights lawsuit? According to the United States Court of Appeals for the
Third Circuit, the answer is "yes." In July of 2009, in the case of
John J. Kane Regional Centers-Glen Hazel v. Grammer, the Third Circuit
held that the Federal Nursing Home Reform Amendments (FNHRA) guarantee a
nursing home resident's civil rights. Consequently, according to the
Third Circuit, private civil rights lawsuits may be brought against
nursing homes in the event of alleged wrongful death or inadequate
patient care. Recently, the United States Supreme Court declined to
review the case, allowing the Third Circuit decision to stand.

The Third Circuit's ruling was the result of a claim brought
by Sarah Grammer against a Pittsburgh-area nursing home in which Grammer
alleged that her mother, Melvinteen Daniels, was neglected by the John
J. Kane Regional Center. According to Ms. Grammer, the facility
provided inadequate care which eventually resulted in her mother's
death. Instead of filing a typical negligence claim against the nursing
home, Ms. Grammer chose to sue under the Federal Nursing Home Reform
Amendments. According to Ms. Grammer, the FNHRA guarantee various
patient rights, including the right to quality care. Therefore, Ms.
Grammer contended that the alleged inadequate care received by her
mother constituted a civil rights violation for which she could bring a
civil rights lawsuit under the FNHRA. The nursing home, however,
contended that the FNHRA were simply meant to outline requirements for
Medicaid and Medicare certification.

Initially, the District Court ruled in favor of the nursing
home facility. However, the Third Circuit overturned the District
Court's ruling, holding that the FNHRA creates the right to a private
civil rights lawsuit in the event of inadequate care. Various groups,
including the AHCA, the American Association of Homes and Services for
the Aging, and various individual states petitioned the Supreme Court to
review the holding of the Third District. However, despite this
petition, the Supreme Court refused to hear the case. Therefore, it
appears as if nursing homes throughout the country may be exposed to
potential civil rights lawsuits in the event of alleged inadequate
patient care.

Monday, March 8, 2010

What to do when a Loved One Passes

Although first taken aback by shock and grief, you may be called upon to handle the necessary details surrounding the loss of your loved one and it is important to know what to do.

First, you have to get help and depending on the scenario, local law enforcement may have to be contacted first (i.e. if the death was not attended or due to unknown circumstances.) In most other circumstances various parties must be immediately notified, including:

  • The attending physician, a coroner or medical examiner to officially pronounce the death. If the deceased was in a hospital or other care facility, this is typically arranged by the staff.
  • Family members or a legal representative of the deceased. They will need to locate the deceased's pre-arranged funeral plan, if one exists, for direction in how to proceed with funeral arrangements.
  • A Funeral Director to transfer the body from the place of death to a funeral home or comparable care facility. Funeral directors are available through funeral homes and other funeral service organizations.

In the absence of instructions from the loved one, or a pre-arranged funeral plan, you'll need to make a series of decisions relatively quickly. If there are several family members and friends assembled, make a list of the necessary tasks and delegate responsibility. Organizing a funeral usually entails planning the funeral ceremony and the disposition of the deceased's body, accommodating guests and, usually, arranging for a subsequent gathering.

If it is too difficult or you want it handled by a Funeral Director and one hasn't been pre-selected, you should call a recommended funeral home, cremation service or other service provider that will handle all the funeral arrangements. Funeral directors help you plan the funeral ceremonies and then direct the ceremonies in accordance with your wishes, including coordinating with the cemetery. A typical cemetery offers various types of grave spaces for earth burial and mausoleum crypts for entombment. Similar options are available for burial or entombment of cremated remains. The cemetery also provides services to open and close the grave or crypt and to install grave markers. Some cemeteries charge recurring fees for the perpetual maintenance of the grounds. Since you are likely to visit the cemetery periodically to remember your loved one, location is an important consideration in selecting a cemetery. Many people purchase cemetery property in advance to relieve their survivors of this responsibility. There are several cemeteries available in Lincoln and you should decide where you may want the "final resting place" for your loved one. A few local cemeteries are listed below:

www.wyuka.com - (402) 474-3600

(402) 474-4500

(402) 476-8787

(402) 441-0585

www.lincolnfh.com - (402) 423-3826

Some choices will influence others. If the deceased is to be directly cremated before a funeral, then you may opt for a simple casket to transport the body to the crematorium, but choose an attractive urn if the cremated remains are to be present at the subsequent service. If there is to be an open casket for viewings, then embalming becomes a consideration, as does the type of casket. A cemetery interment means choosing between ground burial and entombment in a mausoleum, whereas a scattering of ashes raises the question of location and accompanying ceremony. If you want a funeral or memorial service held at a church or other place of worship, you'll need to make such arrangements with the appropriate officials, and you'll need to discuss the nature of the service. Some of the choices that must be made when arranging a funeral are set forth below:

Method of interment

· Will the deceased be buried or entombed?

· Will the deceased be cremated? If so, will the cremated remains be buried, entombed, scattered or kept by the family?

· Will the body be donated to science? Will organs be donated?

Ceremonies

· Will there be a traditional funeral with the casket present or a memorial service without the presence of the casket? Will both types of services be held or no ceremonies at all?

· Where will the ceremonies be held? At a funeral home? At a place of worship? At the graveside?

· Will there be one or more visitations? If so, will the casket be open or closed?

· Will the deceased be embalmed?

· Should a DNA sample be taken?

· Who will participate in the funeral ceremonies? Clergy? Pallbearers? Speakers? Musicians or vocalists?

· Will the ceremonies feature certain music, readings, or tributes?

· Will there be a procession to the cemetery? Will the deceased be transported in a hearse? Will family travel in a limousine?

Following the funeral a variety of financial, legal and administrative matters must be addressed. The tasks you may need to do include:

  1. Sending acknowledgement notes expressing gratitude for flowers, donations and special assistance.
  2. Commencing estate proceedings. Whether an extensive Probate proceeding is necessary is determined by the size of the estate and the existence of a will and living trusts. An Executor, named in the will or appointed by the Probate Court will shepherd the estate through this process. Also, it may be necessary to hire an estate planning attorney to provide legal guidance.
  3. Accounting for all assets and debts of the deceased. Make arrangements to pay outstanding bills. It may be necessary to have the Probate Court release short-term funds to cover these bills.
  4. Filing death benefit claims with insurance companies, Social Security, the Veterans Administration, pension/retirement funds, unions, etc. Certified copies of the death certificate are usually required in making these claims. See http://www.socialsecurity.gov/pubs/10084.html.
  5. Changing all jointly held accounts including, bank accounts, credit cards, mortgages, loans, brokerage accounts, stocks, bonds and other investments.
  6. Sending notifications of death to:
    • Employers.
    • Fraternal, social, and religious organizations.
    • State and local agencies, such as the Department of Motor Vehicles, to transfer all licenses and titles.
    • Telephone, utility, newspaper and any other services that are registered in the deceased's name.

Try not to take on the entire responsibility for organizing a loved one's funeral and post-funeral yourself. Others will want to help, to share the experience as a way to feel connected to the one who has died and to make a contribution to the memorial, and you need to allow yourself time to grieve.

NEBRASKA FUNERAL & BURIAL REQUIREMENTS

DO YOU KNOW WHAT YOUR STATE REQUIRES?

  1. Does the law of your state require a licensed professional (such as a funeral director) to prepare a body for burial?

In Connecticut, Indiana, Louisiana, Michigan, Nebraska and New York, laws require that a funeral director handle human remains at some point in the process. In the 44 other states and the District of Columbia, loved ones can be responsible for the body themselves. The state of Nebraska requires a licensed Funeral Director to care for human remains. See below, Neb Rev. St. § 71-605.

  1. Does the law of your state require embalming for an open casket funeral service?

In Nebraska, funeral homes have their own rules and factors (such as time) regarding whether or not to embalm. Required embalming depends on such factors as whether the family selected a service with a public or private viewing of the body with an open casket; if the body is going to be transported by air or rail; or because of the length of time prior to the burial or cremation. If a funeral home charges for embalming, they must explain why in writing. EXAMPLES: (i) Selected a service with a viewing or (ii) Arranged for shipment by common carrier or (iii) Selected arrangements that require the funeral home to hold the remains for more than 24 hours provided that no refrigeration is available or a hermetically sealed container is not used and provided that embalming does not conflict with religious beliefs or medical examination.

According to the Federal Trade Commission Funeral Rule, all funeral homes are required to get permission to embalm. If you select a funeral service which requires embalming, such as a funeral with a viewing, you may have to pay for embalming. You are not required to have embalming if you selected arrangements such as direct cremation or immediate burial. If a funeral home charges for embalming, they must explain why in writing. EXAMPLES: (i) Selected a service with a viewing or (ii) Arranged for shipment by common carrier or (iii) Selected arrangements that require the funeral home to hold the remains for more than 24 hours provided that no refrigeration is available or a hermetically sealed container is not used and provided that embalming does not conflict with religious beliefs or medical examination.

Truth about Embalming

Preparing the body for public viewing nearly always involved embalming and cosmetic restoration, processes that can add $600 or more to a funeral bill. Is embalming otherwise necessary or required? Not really.

  • Embalming generally is not necessary if the body is buried or cremated within a reasonable time after death.
  • Embalming is not required by law except in certain cases when a body is transported across state lines.
  • Embalming does not preserve the deceased’s body indefinitely; it merely masks the appearance of death and temporarily postpones decomposition.
  • Embalming chemicals are highly toxic. Embalmers must wear a respirator and full-body covering while performing the procedure.
  • Refrigeration is an alternative to embalming for maintaining a body intact while awaiting a funeral service. Although not all funeral homes have refrigeration facilities, most hospitals do.
  • Embalming is common only in the United States and Canada. Orthodox Jews and Muslims consider the procedure a desecration of the body. — From the Funeral Consumers Alliance.

  1. Does the law of your state require the use of a vault or grave liner?

No state law requires a grave-liner or vault, but many cemeteries require them, to keep the grave from caving in. It's a maintenance convenience for the cemetery.

  1. Does the law of your state license or restrict the disposition of cremated human remains?

There are no “cremains police” in any state to ensure proper etiquette, permits, or permission are obtained and used. There are no health, safety or environmental issues to be concerned about. However, if your scattering ceremony is to be held within a city or town limits, city/town ordinances and bylaws should be consulted. See Neb Rev. St. § 71-1381, § 71-1382.

  1. Does the law of your state prohibit the kind of "home funeral" commonly experienced 100 years ago (i.e. a calling in the home of the deceased and burial by the family)?

Home funerals are legal in all states except five. Connecticut, Delaware, Indiana, Nebraska, and New York have restrictions. See Neb Rev. St. § 71-605.

SOURCES:

Nebraska Department of Health and Human Services- Statutes relating to Funeral Directing and Embalming Practice Act Cremation of Human Remains Act..

http://www.dhhs.ne.gov/crl/statutes/Funeral%20Directing%20and%20Embalming.pdf

NEBRASKA REVISED STATUTES

Neb Rev. St. § 71-605 Death certificate; cause of death; sudden infant death syndrome; how treated; cremation, disinterment, or transit permits; how executed; filing; requirements.

Neb Rev. St. § 71-1381 Cremated remains; how treated.

Neb Rev. St. § 71-1382 Cremated remains; final disposition.


Michael W. Khalili
Associate Attorney
*Licensed in Washington State & the U.S. District Court of Nebraska

http://www.knudsenlaw.com/Att_Bio_MWK.htm

Tuesday, March 2, 2010

New Nurses Don't Feel Comfortable Implementing Quality Improvement Measures

An analysis of survey responses by researchers at New York University's
College of Nursing has found that a large number of new nurses feel
ill-prepared to implement quality improvement measures and more than 12%
have never heard of "quality improvement".

The survey was sent to 436 newly graduated nurses with bachelor and
associate's degrees from around the country. The study found that 38.6%
of those surveyed felt that their degree courses either "poorly" or
"very poorly" prepared them to implement quality improvement measures
and 41.7% didn't feel prepared at all to use national patient safety
resources including the National Quality Forum.

The researchers defined quality improvement as the "use of data to
monitor the outcomes of care processes and use of improvement methods to
design and test changes to continuously improve the quality and safety
of health care systems." There is debate over just exactly who should
be responsible for teaching quality improvement with some believing it
should be the school and others believe it should fall to the employer.
However, the study's authors note that only 23.3% of those surveyed said
that their employer provided quality improvement training was "very
helpful."

<http://www.knudsenlaw.com/Att_Bio_JRL.htm>
<http://www.knudsenlaw.com/>

Jeanelle R. Lust

Knudsen, Berkheimer, Richardson & Endacott, LLP

3800 VerMaas Pl

Suite 200

Lincoln NE 68502

402 475 7011

402 423 4768 (H)

402 440 3731 (M)

402 475 8912 (F)

www.knudsenlaw.com

jlust@knudsenlaw.com

Wednesday, February 24, 2010

Wrongful Termination

We are often contacted by people who have been fired from their job and who want to know if they have a potential lawsuit against their employer for wrongful termination. It is important to remember that Nebraska is an at-will employment state. That means that if your private employer fires you, and you are not part of a union and do not otherwise have a written contract, your employer may generally fire you for any reason, as long as that reason is not illegal or in violation of certain public policies. In other words, your employer can be the world’s biggest jerk, have had no reason for firing you, and your firing can be completely “unfair,” but in most cases there is no legal remedy for your firing. The most common exception for this general rule is when your employer has violated your civil rights. Therefore, when you’ve been let go by your employer, you may want to ask yourself these questions before contacting the lawyer:

1) Is a union involved, or did you have an employment contract with your employer?

2) Was your firing on account of your race, color, religion, national origin, sex, age, physical or mental disability (or perceived disability), marital status, genetics, service in the uniformed services, or any other classification protected by law?

3) Was your firing in relation to having recently been injured at work or making a workers compensation claim?

4) Have you complained about not being paid overtime, minimum wage, or similar concerns?

5) Have you reported your employer to any authorities because of illegal conduct or unsafe working conditions?

Jeanelle R. Lust

Knudsen, Berkheimer, Richardson & Endacott, LLP

3800 VerMaas Pl

Suite 200

Lincoln NE 68502

402 475 7011

402 423 4768 (H)

402 440 3731 (M)

402 475 8912 (F)

www.knudsenlaw.com

jlust@knudsenlaw.com

Managing Partner