Author: Courtney Patterson

April 22, 2021

Posted on by Courtney Patterson

QUESTION:    “I hear that they changed the rules that apply to the Paycheck Protection Program so that nonprofits can qualify for PPP loan forgiveness if they employ no more than 500 employees at any given physical location, even if they employ more than 500 employees overall. Is that so?”

ANSWER:      Yes. Section 5001 of the so-called American Rescue Plan Act provides:  “a nonprofit organization shall be eligible to receive a covered loan if the nonprofit organization employs not more than 500 employees per physical location of the organization.”  An interim final rule implementing this change was promulgated by the U.S. Small Business Association on March 22, 2021.  86 Fed. Reg. 15083. This is so even if the organization employs more than 500 employees overall.

April 15, 2021

Posted on by Courtney Patterson

QUESTION:      Our hospital is considering adopting a standard, universal consent form for patients, or their representatives, to review and sign upon admission to our intensive care unit. This form will include a list of several commonly performed invasive procedures on the unit. What are the benefits and potential problems with universal consent?

ANSWER:       This is an interesting question. Universal, or “bundled,” consent can be efficient means to obtain permission to perform common procedures in the intensive care unit ahead of their indicated need. By obtaining informed consent for common procedures upon admission, the hospital’s intensive care unit may see an increase in documented informed consent, as well as a swifter response time to emergent events that require one or several procedures listed on the signed form.

In addition, obtaining universal consent at the outset can afford patients and their family members greater opportunity to dialogue with the physician regarding each of the procedures listed on the consent form and can better align these anticipated procedures with the patient’s goals of care. Overall, this practice may serve as an efficient alternative to obtaining per-procedure consent in haste or performing a procedure without the patient’s express consent.

However, there is a difference between merely asking the patient to sign-off on a laundry list of procedures and engaging in an informed discussion with the patient regarding each procedure and its risks, benefits, and alternatives. If it is the hospital’s practice to do the former, then there may be cause for concern that the patient, or their representative, is not providing actual informed consent.  In addition, expecting universal consent immediately upon admission for procedures that may occur could prove overwhelming, upsetting, or stressful to the patient or their representative. Therefore, when considering whether to adopt universal consent forms, it is important to ensure that patient understanding, patient goals, and good bedside manner are not compromised as a result of the appeal of efficient documentation and expeditious care.

April 8, 2021

Posted on by Courtney Patterson

QUESTION:       I’ve heard that the Centers for Medicare & Medicaid Services (“CMS”) have concluded their series of COVID-19 Office Hours Calls.  Are there any other channels we can use to pose questions to the agency?

ANSWER:          It’s true that the CMS Office Hours series has concluded.  The last call was Tuesday, April 6.  At the conclusion of that Office Hours session, CMS encouraged listeners to direct future COVID-19 questions to the Provider-Specific “Open Door Forums.”  A list of those regularly scheduled calls can be found here.  That page also includes the option to sign up for a mailing list that will notify you of upcoming sessions.

Depending on the nature of your question, you may also be able to find the answer in a transcript from an earlier call.  CMS has provided transcripts for each of its COVID-19 Office Hours Calls at this web page.

Of course, you can always skip that process and instead contact us.  We’ll be happy to assist you.