SOURCE: Marks Paneth & Shron LLP

Marks Paneth & Shron LLP

September 12, 2011 09:10 ET

Rash of Employment Regulations Creates Headaches and Night Sweats for Medical Practices -- But an HR Compliance Assessment Can Help Prevent Penalties, Fines, Lawsuits and Turnover

Most Practices Are Too Small to Hire Human Resources Departments; They're Busy Caring for Patients and Can Be Blindsided by Regulatory Violations and Personnel Problems, Says Human Resources Authority at Marks Paneth & Shron

NEW YORK, NY--(Marketwire - Sep 12, 2011) - A modern medical practice involves headaches, chills, fevers and night sweats -- and that's just when it comes to running the business side of the office: Scheduling patients, tracking reimbursement and keeping the practice profitable.

Now there's yet another cause for those symptoms -- the risk of fines, penalties, lawsuits, higher insurance premiums, and staff drama and turnover that can result when the medical practice fails to keep track of human resources issues and fails to comply with dozens of new human resources laws and regulations.

Personnel management is always complex. In addition, HR laws are under constant revision, and revenue-starved agencies are tightening enforcement. Regulatory audits are a real risk.

But most medical practices are too small to have human resources departments, or even HR specialists. That means they can be blindsided by the complex and overlapping demands of new federal, state and local employment laws and regulatory requirements, and by staff problems that spiral out of control.

"Medical practices are at risk because they're focused on their mission, which is patient care. They often don't have human resources professionals on hand to help manage the complexity," says Eric A. Marks, MPA, MBA, SPHR, Principal of the Human Resources Consulting and Business Advisory Services at New York accounting and consulting firm Marks Paneth & Shron LLP. "Office personnel are focused, first and foremost, on the quality of care, as they should be. But often, that means that HR issues don't get the attention they need and deserve.

"Depending on their size, the practice might have an office manager who is responsible for functions such as billing, bookkeeping, scheduling and marketing, in addition to HR," Mr. Marks says. "It's difficult if not impossible for that person to keep track of all the HR issues. Medical practices should seriously consider an HR compliance assessment to make sure they're current with the myriad laws and regulations that are already on the books or are coming down the pike."

Among the HR risks and issues for medical practices, and the benefits of HR compliance assessments...

  • The HR problems that medical practices face. "Like other small businesses, medical practices must confront a range of HR issues," Mr. Marks says. "Among them are sexual harassment and retaliation policies; employee v. independent contractor agreements; wage and hour practices; payroll and withholding policies; interviewing, testing, and disciplining employees; leave and time off policies, and practices for handling credentialing, licensing, insurance, and privacy-related issues. That's daunting even for a specialist, and all the more so for someone who has to handle HR among many other functions."

  • The growing web of laws and regulations. "Among the many requirements medical practices must grapple with are the Fair Labor Standards Act, the Equal Employment Opportunity Act, Title VII of the Civil Rights Act, the Occupational Safety and Health Act, the Family Medical Leave Act, the American with Disabilities Act, the Genetic Information Nondiscrimination Act, the Homeland Security Act, and the Health Insurance Portability and Accountability Act, to name a few," Mr. Marks says. "And then there are the rules and regulations -- many of them new -- of the Department of Labor, the Internal Revenue Service, the Department of Justice and the Department of Health and Human Services. All of them impose processes and procedures that the practice must comply with. And there are penalties for noncompliance."

  • Special risks for medical practices. "Large businesses have fully staffed HR departments to keep track of regulations and produce the necessary policies and documentation," Mr. Marks explains. "Medical practices generally do not. There might be, at best, an office manager charged with handling HR among many other matters. It's asking too much to expect this person to stay current with a vast array of regulations that are constantly changing. Even a large practice with one or two full-time HR staff may find itself overwhelmed."

  • The warning signs of HR problems. "HR problems can manifest themselves in many ways -- in absenteeism, turnover, poor morale, workplace conflict, or inefficiencies, such as having trouble getting the billing out. Or they can remain hidden. Policy manuals and forms might be out of date or incomplete -- but if the first you become aware of that is in the context of an employee lawsuit, that's a major problem," he says.

  • Consequences for not complying. "Many medical practices feel that they're protected by employment practices liability insurance, and in the short term they may be right," Mr. Marks says. "But in the longer term, excessive claims by employees will drive premiums up, and government assessments and bad will with employees can damage the practice irreparably. It's much more cost-effective to take action up front by conducting an HR compliance review."

  • The ins and outs, and value, of HR compliance assessments. "An HR compliance review scans internal policies and outside developments, and detects gaps, or key practices that have been omitted," Mr. Marks says. "It flags missing, non-compliant or insufficient documentation, inadequate record-keeping, misclassification of jobs, and problematic policies and practices. Reviews also highlight key metrics such as absenteeism and turnover rates that the practice can use to flag future problems early.

    "A team of outside HR professionals and labor attorneys can conduct a top-to-bottom review, suggest changes and provide assurance that policies and procedures are up to date. The team can also serve as an on-call resource to identify new developments that might require future review."

"The HR environment is complex and is only going to become more so," Mr. Marks says. "Medical practices owe it to themselves, their employees and their patients to get their HR house in order. A compliance review is the most effective and efficient way for the practice to do exactly that, and be confident that it has its HR bases covered."

For more information, or to schedule an interview or arrange a bylined article, contact Itay Engelman of Sommerfield Communications at (212) 255-8386 or

About Eric Marks, MPA, MBA, SPHR

Eric A. Marks, MPA, MBA, SPHR is the Principal-in-Charge of Human Resource Consulting at Marks Paneth & Shron LLP. Mr. Marks provides leadership in strategic human resource and specialized business management issues for the firm and its clients. Mr. Marks is a facilitator and consultant with more than 20 years of executive management experience. He has been responsible for developing processes and systems to improve organizational capability in key business areas such as goal alignment, performance management, accountability, leadership, career development, change management and succession planning.

About Marks Paneth & Shron

Marks Paneth & Shron LLP is an accounting firm with nearly 475 people, of whom approximately 60 are partners and principals. The firm provides businesses with a full range of auditing, accounting, tax, consulting, bankruptcy and restructuring services as well as litigation and corporate financial advisory services to domestic and international clients. The firm also specializes in providing tax advisory and consulting for high-net-worth individuals and their families, as well as a wide range of services for international, real estate, media, entertainment, nonprofit, professional and financial services and energy clients. The firm has a strong track record supporting emerging growth companies, entrepreneurs, business owners and investors as they navigate the business life cycle.

The firm's subsidiary, Tailored Technologies, LLC, provides information technology consulting services. In addition, its membership in JHI, the leading international association for independent business advisers, financial consulting and accounting firms, facilitates service delivery to clients throughout the United States and around the world. Marks Paneth & Shron LLP, whose origins date back to 1907, is the 30th largest firm in the nation and the 13th largest in the New York area. In addition, readers of the New York Law Journal rank MP&S as one of the area's top forensic accounting firms.

Its headquarters are in Manhattan. Additional offices are in Westchester, Long Island and the Cayman Islands. For more information, please visit

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