Jones Health Law Podcast

Florida allows for conversion of a business from another state. The terms ‘conversion’ and ‘domestication’ can be used interchangeably depending on the state you are in but there are a few differences that should be noted. The most notable difference is that conversion allows for a change in entity type.  Florida allows for LLCs to change the applicable governing law and convert into a Florida corporation (an S Corp). The company is then treated as though it was originally formed in Florida. This might provide tax benefits for the business owner. Domestication of a company merely allows for the company to relocate. In Florida, the term ‘domestication’ refers to the move of a company formed internationally into the state and is a more complex procedure.

Alternatively, business owners can register as foreign LLC’s, dissolve the company and form a new company, or go through a merger in their new state if conversion is not allowed. However, these methods can be more costly and don’t have the added benefits previously mentioned.

It is recommended that an attorney assist with the process to ensure the forms are submitted accurately. At Jones Health law, we have experienced attorneys that can provide legal support during the conversion process.

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A group home by definition is a residence that offers full time care for those who are unable to care for themselves. Group homes offer assistance for those who are unable to care for themselves due to age or medical disability and can’t be cared for by family members.

Group homes are usually smaller than other care facilities with more centralized care and fewer residents (usually 6 beds or under). Typically, 24-hour care and supervision is provided by at least one caregiver around the clock. Group Homes are not typically responsible for the personal care of residents such as bathing or using facilities. While health insurance does not typically cover the cost of a group home, long term care insurance might.

Applicants will need to provide their licensing department with a business plan and operations manual along with the prospective location and community plan, geographical plan, zoning requirements, etc. Applicants may be eligible to receive Community Development Grant Block Funding to set up their home. Local community offices provide information on funding and assistance for group homes.

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Developments of new drugs and medical technology have enabled physicians to perform treatments and procedures in the comfort of medical offices that were once only able to be performed in hospital settings. To confirm whether obtaining an Office Surgery License is required for your office to perform these surgeries you must carefully examine the rules on office surgeries because they have changed recently.

The registering Surgeon should submit an Office Surgery Registration form with an original signature. The office must also provide proof of completion of necessary training (i.e. certificates/diplomas) by all physicians. If any physicians that will also be performing Level 2 or Level 3 surgeries are hired to the office after the approval, the Department must be notified immediately to update records.

For each level, there are specific outlines for medication, equipment, and registration requirements which can be found by visiting: http://www.doh.state.fl.us/mqa/medical/osr_home.html.

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Whether an aromatherapy product is a cosmetic or a drug under the law is determined by the product’s intended use. The Federal Food, Drug and Cosmetic Act defines “cosmetics” by their intended use, as “articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance.” Florida Statute §499.003(12) adopted the FDA’s definition of “cosmetic” verbatim, but further stated that the definition does not include soap. The law doesn’t require cosmetics to have FDA approval before they go on the market. But FDA can take action against a cosmetic on the market if they have reliable information showing that it is unsafe when consumers use it according to directions on the label, or in the customary or expected way, or if it is not labeled properly.

The FDA Act defines “drugs”, in part, by their intended use, as “articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” and “articles (other than food) intended to affect the structure or any function of the body of man or other animals. For example, claims that a product will relieve colic, ease pain, relax muscles, treat depression or anxiety, or help you sleep are drug claims.

Intended use may be established by claims stated on the product labeling, what consumers expect it to do, in advertising on the internet, or in other promotional materials. Ultimately, the FDA makes decisions on a case-by-case basis. Certain claims may cause a product to be considered a drug, even if the product is marketed as if it were a cosmetic. It may also be established that a product is a drug based upon the ingredients that have a well-known therapeutic use.

Essential oil fragrances marketed for promoting attractiveness is a cosmetic. However, a fragrance marketed with certain “aromatherapy” claims, such as assertions that the scent will help the consumer sleep or quit smoking, meets the definition of a drug because of its intended use. Under Florida Statute §499.005(5) it is a crime to disseminate false or misleading advertisement of a drug, device or cosmetic, which is punishable as a misdemeanor of the second degree. It is also a violation of the Florida Drug and Cosmetic Act to disseminate any false advertisement of any drug, device or cosmetic, which includes misleading advertisements according to Florida Statute §499.0054(1)(a). These advertisements include those on a website or social media account. Keep in mind that a cosmetic product must be labeled according to cosmetic labeling regulations.

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In this episode we are discussing the ear, nose, and throat with Otorhinolaryngologist, Daniel Branovan, M.D.! As the Director and Chair of the New York Ear, Nose & Throat Institute, Dr. Branovan is an Ear, Nose and Throat doctor who has served Brooklyn for 14 years, and who utilizes the most modern technology and equipment to get patients on the road to better health more quickly. He is widely known as a top provider of minimally-invasive sinus surgery. Recently, Dr. Branovan has opened a second medical office in Hallandale Beach, Florida. 

Dr. Branovan studied medicine at Stanford University and completed his residency at The New York Eye and Ear Infirmary in Otolaryngology. Dr. Branovan also earned a Master’s degree at Harvard University. His awards and recognitions include “Best Physicians in America,” New York Magazine’s “Best Minimally Invasive Surgeons,” and Castle Connolly’s “Best Physicians in the New York Metro Area.”

He is certified by the American board of Otolaryngology, and belongs to professional associations like the American College of Surgeons. He is fluent in English and Russian.

During our discussion, Dr. Branovan discussed a range of topics including: (1) His training and the pros & cons of being an ENT doctor; (2) a description of a typical day in the office; (2) why we feel pressure in our ears when travelling via airplane; (3) whether certain demographics are predisposed to certain health conditions that an ENT doctor treats; (4) why we shouldn't put Q-tips in our ears and alternatives to cleaning out ear wax; (5) minimally invasive surgery due to advancements in tools and technology ; (5) myths and misconceptions about ENT procedures; (6) how weather, environment, and lifestyle have an impact on your ENT health; and more.

We touch on a wide range of topics in this podcast that I know you don't want to miss. Don't forget to listen and share with anyone that you think would be interested in listening as well.

Dr. Daniel Branovan can be reached at:

Instagram: @doctorbranovan

Address: 1000 E. Hallandale Beach Blvd., #1-102, Hallandale Beach, Florida 33009

Phone: 754-400-5959

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Under Florida law, no person other than a Florida licensed dentist, nor any entity other than a professional corporation or limited liability company composed of dentists may:

1. Employ a dentist or dental hygienist in the operation of a dental office.
2. Control the use of any dental equipment or material while such equipment or material is being used for the provision of dental services, whether those services are provided by a dentist, a dental hygienist, or a dental assistant.
3. Direct, control, or interfere with a dentist’s clinical judgment.

As per statute, a non-dentist must not directly employ a dentist (i.e. W-2 employee) but they may work with the dentist as a 1099 independent contractor. The non-dentist cannot pay a dentist a salary or commission. The dentist may create their own wholly owned professional corporation while the non-dentist may provide their services through an LLC or other taxable organization. No employment contract may exist between the dentist and the operator but an independent contractor agreement may be necessary. Any dentist who is employed by a non-dentist may face disciplinary action.

The non-dentist who is providing the office space and equipment cannot control the use of dental equipment while such equipment or material is being used for the provision of dental services (emphasis added). This means that while the dentist is operating dental equipment the non-dentist cannot barge in and place restrictions on how the equipment or material is being used once a patient is being treated. For example, if a dentist is treating a patient and that treatment was expected to last 30 minutes but is now at the 45-minute mark the non-dentist cannot physically manipulate any dental equipment or tell the dentist that she has to finish within the next 5 minutes because another dentist needs to use it. However, a lease agreement can place general restrictions on the operation and use of the equipment that is being leased to the dentist.

Most importantly, a non-dentist cannot interfere with a dentist’s clinical judgment by instructing them on a course of treatment to provide to a patient. All clinical decisions must be left to the discretion of the dentist. The purpose of this law is to prevent non-dentists from influencing or interfering with the exercise of a dentist’s independent professional judgment.

The relationship between the non-dentist and dentist will be a network of lease, rental, marketing, practice management and administrative agreements. Any dental equipment lease agreement between a non-dentist and dentist must contain a provision stating that the dentist expressly maintains complete care, custody, and control of the equipment or practice.

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Phone: (305)877-5054

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The administration of intravenous (“IV”) therapy is defined as the therapeutic infusion and/or injection of substances (i.e. supplements, vitamins and minerals) through the venous peripheral system, consisting of activity which includes observing, initiating, monitoring, discontinuing, maintaining, regulating, adjusting, documenting, planning, interviewing and evaluating. It involves the administration of medication through a needle or catheter. It is believed by some that delivering medication directly into the bloodstream can help to quickly manage a patient’s pain or symptoms. In addition to treating illnesses, IV therapy proponents claim that it may also increase athletic performance, reduce jet lag, build immunity or help with dehydration by using vitamins and minerals. According to several practitioners, IV therapy should be customized for each patient’s needs to maximize results.

Most Florida licensed medical doctors, osteopathic doctors, dentists, registered nurses, medical assistants, and licensed practical nurses may provide iv therapy to patients if they possess the appropriate certifications and training. Several of these practitioners must complete a required 30-hour IV certification course. Regardless of who you hire to provide IV therapy they should have several years of experience with administering IVs.

The overwhelming majority of mobile IV therapy patients will be self-pay. Medicare, Medicaid and commercial payors typically won’t cover the costs for these treatments. However, I have seen reports where commercial payors may utilize specific per diem codes to pay certain infusion providers for services, supplies and equipment. Medicare has limited coverage for home infused drugs under the Part B and Part D benefit when it is medically justified.

Web: www.JonesHealthLaw.com

Phone: (305)877-5054

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Recently, the Board of Nursing voted to approve the following revised language for adoption by rule as the definition of “primary care practice”: “Includes physical and mental health promotion, assessment, evaluation, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses, inclusive of behavioral and mental health conditions”. This definition would be read in conjunction with Section 464.0123(3), Florida Statutes. The Board also voted to accept the recommendation, also for adoption by rule, from the Council on APRN Autonomous Practice for “standards of practice” as: “Advanced practice registered nurses who are registered pursuant to Section 464.0123, F.S., shall engage in autonomous practice only in a manner that meets the General Standard of Practice. The General Standard of Practice shall be that standard of practice, care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similarly situated health care providers.” Web: www.JonesHealthLaw.com Phone: (305)877-5054 Instagram: @JonesHealthLaw Facebook: @JonesHealthLaw Youtube: #JonesHealthLaw --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Whether you are still in nursing school, just graduated from nursing school or seeking new employment as a nurse you will likely need take a drug test as part of the pre-employment process. Also, it is not uncommon for nurses and other healthcare providers to submit to random drug testing even after they are employed. Some nurses are taking illicit drugs and it should come as no surprise if they fail their drug test. However, there are individuals who are shocked to find out that they have failed a drug test because they are not knowingly taking any illicit drugs. Some nurses may have false positives on drug tests for various reasons not related to drug abuse. One common way that nurses fail drug tests is when they take prescription drugs that may contain prohibited drugs as part of the formula. For example, some drugs may contain a very small percentage of methamphetamine. Nurses who take prescription drugs without a prescription or any legitimate medical reason for using the drug can also subject your license to discipline.

If you have a legitimate problem with drugs or alcohol the Board of Nursing might require you to attend rehabilitation center or treatment facility. If you fail your drug test many hospitals require the nurse to self-report to the Intervention Project for Nurses (“IPN”). If you choose not to self-report they will likely report you. You should speak with a health law attorney to determine whether self-reporting to the IPN is the right decision for you. You should review your hospital’s policies and procedures manual to determine how the hospital handles these types of matters internally. The manual should also inform you of whether IPN reporting is mandatory or voluntary.

Web: www.JonesHealthLaw.com

Phone: (305)877-5054

Instagram: @JonesHealthLaw

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Keiana Chisholm is a 12-year software architecture consultant for her firm, “Chisholm Perennial Solutions.” Her firm consults on software architecture and engineering with a focus on healthcare systems. She received a bachelor’s degree in health services administration from Florida International University in Miami, FL and a Master of Science in Health Informatics from Northeastern University in Boston, MA. Keiana also owns and operates “The STEM Kidz” a STEM toy focused e-commerce site. She founded the charitable initiative the “Chisholm Perennial International Foundation” in 2018, which promotes STEM advocacy in early education.

Keiana  is an established New York based software architect and founder of IT software firm Chisholm Perennial Solutions. Her passion for developing meaningful technology is only eclipsed by her drive to instill that same passion in future generations. She believes social, education, and economic empowerment all grow from a strong scientific education. This philosophy is reflected in her personal motto to “innovate, inspire and be of service to others.” Keiana puts this motto into action though her e-commerce venture “The STEM Kidz” which provides the educational toys and tools for today’s youth to develop into tomorrow’s world leaders. A business leader herself, Keiana has partnered with Amazon to act as a mentor for Amazon’s Black Business Accelerator program. Through her guidance and mentorship, she helps build sustainable equity and growth for Black entrepreneurs in their own online business ventures.

Keiana plans to continue building her career as a leader in technology whose focus on empowerment and education will lift those around her and their communities. The charity she founded in 2018, the “Chisholm Perennial International Foundation,” was developed with STEM advocacy at the heart of its mission. The foundation serves to advance STEM curriculum in a hands-on capacity by helping foster innovation in underserved communities. The foundation’s reach stretches from Brooklyn to Africa, where she travels every year to speak to both students and educators about the importance of STEM focus in every school’s curriculum.

Contact:

Chisholm Perennial Solutions

Email: [email protected]

Instagram: @cpsgroup1

Web: www.cpsolutionsgroup.org

The Stem Kidz

Instagram: @tehstemkidz

Web: www.thestemkidz.com

Chisholm Perennial Solutions International Foundation

Instagram: cpsinternationalfoundation

Web: www.cpsolutionsfoundation.org

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