Texas Nurses

08/16/2025

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08/16/2025

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08/14/2025

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08/14/2025

Joe Flores JD APRN FNP-BC
361-887-8670
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Surviving Medicare Audit or Investigation

Preparing for a CMS audit in the home health sector involves several key steps to ensure compliance and readiness. Here’s a structured approach:

1. Understand Audit Requirements:
Familiarize yourself with CMS regulations, including the Conditions of Participation (CoPs) and any specific guidelines relevant to your agency.

2. Review Documentation: Ensure that all required documentation is up-to-date and accurately reflects the services provided. This includes patient care plans, medical records, and billing information.

3. Conduct Internal Audits: Perform your own audits to identify any areas of non-compliance or documentation issues. Use the same criteria that CMS will use for their audit.

4. Staff Training: Ensure that all staff are trained on documentation standards, patient care protocols, and compliance requirements. This includes nurses, therapists, and administrative staff.

5. Organize Records: Create a system for organizing patient files, ensuring easy access to all necessary documents during the audit. This includes clinical records, therapy notes, and physician orders.

6. Prepare for Interviews: Be ready for interviews with auditors. Designate knowledgeable staff to answer questions about policies, procedures, and patient care practices.

7. Review Quality Measures : Familiarize yourself with the quality measures relevant to your agency. Be prepared to demonstrate how you meet these measures and the outcomes of your services.

8. Maintain Open Communication: Keep lines of communication open with your staff throughout the audit process. Address any concerns or questions they may have.

9. Plan for Follow-Up: After the audit, be prepared to address any findings or recommendations from the auditors. Develop a plan for corrective actions if necessary.

10. Stay Informed: Keep up with changes in regulations or audit processes by participating in industry webinars, conferences, and workshops.

By following these steps, home health agency owners can better prepare for a CMS audit and ensure compliance with federal regulations.

Joe Flores is both a lawyer and Nurse Practitioner
3618878670
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08/10/2025

Misdiagnosed or undertreated by your worker’s compensation doctor or healthcare professional? We want to hear more.
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08/01/2025

Joe Flores Attorney FNP

https://youtu.be/oFcYgdGlAq4?si=WRKga4V6YRWF0J31

08/01/2025

Many nurses, advanced practice nurses, PAs and physicians ask about malpractice insurance.

My reminders:
***Occurrence based can cover you even if you drop the insurance later so long as the occurrence or alleged malpractice occurred while you were covered.

***Claims made, as it suggests has to be in force when you receive a lawsuit or a board complaint. Although cheaper as a rule it must be in force when the occurrence or alleged malpractice happened and when you are served with a lawsuit or complaint.

Furthermore:

Nurses carrying their own malpractice insurance is increasingly important for several reasons:

1. Protection of Personal Assets: Malpractice claims can result in significant financial losses. Having personal malpractice insurance protects nurses' personal assets from being targeted in case of a lawsuit.

2. Peace of Mind: Carrying insurance provides emotional and psychological comfort, allowing nurses to focus on patient care without the constant worry of potential legal claims.

3. Increased Job Mobility: Nurses who carry their own insurance may find it easier to transition between jobs or work as independent contractors, as they are not solely reliant on their employer’s coverage.

4. Coverage for Non-Employment Situations: Nurses may encounter situations outside of their employment, such as volunteering or providing care in community settings. Personal malpractice insurance can provide coverage in these scenarios.

5. Employer Coverage Limitations: Employer-provided malpractice insurance may not cover all situations, particularly if a nurse acts outside the scope of their employment. Personal insurance ensures comprehensive protection.

6. Legal Defense Costs: Malpractice insurance typically covers not only settlements or judgments but also legal defense costs, which can be substantial.

7. Professional Accountability: Carrying malpractice insurance can enhance a nurse's professionalism and accountability, showing a commitment to high standards of care.

Overall, having personal malpractice insurance is a crucial aspect of a nurse's professional toolkit, offering essential protections in an increasingly complex healthcare environment.

Having your own policy can cover you and can be portable for different “side hustles” such as teaching, consulting, moonlighting and other instances of rendering care while not on your regular job.

Joe Flores
Attorney and Nurse Practitioner
National and Global Speaker
3618878670
[email protected]

07/26/2025

https://youtu.be/Wem8__8Q6dc?si=QscAUfI_DQbeUDPn

The Future…

As of September 1, 2025, new legislation in Texas will significantly reform non-compete agreements for healthcare professionals, including nurses. Under Senate Bill 1318, these agreements must adhere to specific criteria to be enforceable. Key changes include:

1) Restrictions on practice can only be within a five-mile radius of the nurse's primary practice location.

2) The duration of non-compete agreements is capped at one year following the termination of employment.

3) Any buyout provision cannot exceed the nurse's total annual salary and wages at the time of contract termination.

Existing contracts signed before this date will still be governed by previous laws unless they are renewed or modified. This legislation is aimed at promoting fair treatment of healthcare professionals and enhancing workforce mobility while maintaining patient access to care.

07/26/2025

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05/25/2025

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Trucking tragedies- The trucking companies have insurance and other contracts: Nurses- involved in a serious accident with cars and trucks-
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Trucking Accidents call 3618878670

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Fight for nurses! We know healthcare and the law!

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Joe Flores, JD, APRN, FNP discusses his book and how it can benefit students and professionals in the field.

05/03/2025

04/01/2025

Fighting for healthcare professionals and their families.