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John Golembesky

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John Golembesky is a partner in the Corporate Practice Group in the firm's Downtown San Diego office.

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At last week’s America’s Physician Groups Spring conference in San Diego, California, we listened as physicians and health system leaders described the ways in which they are responding to short and long term challenges to the sustainability of America’s healthcare system in its current form. It now stands at a critical juncture, facing challenges such as provider shortages and burnout, increasing concerns around access and cost for pharmaceutical products and other supplies, the increasing burden of managing chronic diseases, rising demand for services across the spectrum from an aging population, and balancing the transition to value-based care models in a predominantly fee-for-service environment.Continue Reading Acting Now to Sustain and Improve America’s Healthcare System: Advice from Innovative Physicians and Health System Leaders

At last week’s America’s Physician Group Spring conference in San Diego, California, our team heard firsthand how physicians are leading efforts to integrate Artificial Intelligence (AI) applications in ambulatory and inpatient settings in major healthcare systems across the nation. Physician and IT leaders described in detail their organizations’ efforts to identify safe, cost-effective, desirable ways to leverage AI to enhance the efficiency and quality of patient care and reduce physicians’ administrative workload. Here, we highlight key approaches that have generated early success for various health systems and physician groups, as well as key pitfalls that participants looking to adopt these technologies need to account for in their planning.Continue Reading How Physicians are Pioneering Use of AI Applications in Ambulatory and Inpatient Care

Our clients report that addressing and preventing burnout for their physicians and other caregivers continues to be a critical priority in the aftermath of the pandemic. Healthcare organizations need high functioning, engaged clinicians to provide outstanding care and meet goals for quality patient outcomes. However, many grapple with how to create and maintain a robust organizational culture where physicians feel psychologically safe and well resourced, and in which they report lower rates of burnout. In light of ongoing physician shortages, particularly in primary care and high-demand specialties like radiology, effectively recruiting and retaining physicians is critical to delivering care, maintaining contractual staffing commitments, providing for more consistent revenue, and reducing associated costs. We hear often that physicians feel they are being asked to do more with less and adapt to a rapidly changing environment in terms of clinical care, medical record documentation, patient communication, mid-level supervision, and technological advancements. In response, many of our clients are actively exploring how to support providers, create and sustain a cohesive organizational culture, and reduce burnout rates. In this article, we discuss one piece of that larger puzzle – the importance of promoting psychological safety for physicians through both internal programming and participation in external opportunities.Continue Reading Solving for Physician Burnout: Creating a Culture of Psychological Safety

Congress passed the Corporate Transparency Act (the “CTA”) in 2021 with the aim of enhancing transparency in entity structures and ownership as well as combating terrorism, money laundering, and other forms of corporate misconduct. This sweeping new rule is designed to cast a wide net over entities that, except in the case of taxes, do not regularly report to federal agencies (i.e., non-publicly traded entities), regardless of the degree to which they are already regulated at the state level. This post specifically speaks to medical groups and management services organizations (“MSOs”) that now need to navigate the new CTA requirements and account for their complex contractual relationships (e.g., management services agreements, equity restriction or succession agreements). For additional information on a particular topic, links to helpful resources have been provided in the footnotes.Continue Reading The Corporate Transparency Act: A Reporting Guide for Medical Groups and MSOs

The intersection of patient satisfaction and quality of care is central to healthcare today, and a provider’s level of cultural competence can significantly impact his/her performance in both areas. Recent focus on diversity, equity, and inclusion initiatives in healthcare has impacted how policymakers are approaching related issues, such as cultural competence in patient care.[1] Some state governments have determined that a provider’s ability to deliver culturally competent care is an essential component to promoting effective and efficient healthcare delivery.[2] For example, Nevada, Oregon, Connecticut, New Jersey, California, Washington, New Mexico, and the District of Columbia each require some form of cultural competency training in their continuing education requirements for certain healthcare providers. In 2023, Illinois legislators introduced two major bills that mandate cultural competency training: H.B. 2450 and S.B. 2427. While these bills take different approaches, both seek to reduce challenges that patients can face in navigating the healthcare system in the absence of culturally competent care and well-resourced providers, including discrimination, reduced quality of services and insurance inadequacies.Continue Reading Get Prepared – Newly Mandated Cultural Competency Training for Illinois Healthcare Providers

All types of healthcare providers depend on medical directors to oversee clinical operations and consult with administrative leadership on facility, unit, or clinical service line plans and performance. Medical directors function at the intersection of administration and clinical care, weighing in on matters as varied and important as accreditation, capital expenditures for equipment, staffing, standard operating procedures, and peer review. In addition to clinical skills, they ideally need excellent people skills to balance competing priorities and communicate effectively with different stakeholders. They are a valuable resource and partner for compliance professionals. With proper support, medical directors can support an organization’s compliance efforts and help mitigate risk for both employee issues and healthcare regulatory matters. This article outlines five key best practices in contracting for medical director services:Continue Reading Do Your Medical Director Arrangements Meet the Top Five Best Practices?

A. Health Care Providers Benefit from Internet and Social Media Presence.

Electronic medical record software and social media offer wide-ranging ways for health care providers to connect with their patients and the public. Having robust technology offerings support healthcare employers’ efforts to improve clinical integration and value-based care delivery efforts. It also provides greater patient access to healthcare information and engagement with their care team. Internet-based publishing and other social media channels allow healthcare providers opportunities for marketing and for patient education, and may expand access to health information for patients who may not seek regular medical care. There are huge benefits available from these resources for healthcare institutions and providers at every scale and in every specialty, which are likely to continue to expand in the future.Continue Reading Tick-Tock – Time for Healthcare Employers to Review Their Internet and Social Media Use Policies!

A well-crafted letter of intent (“LOI”) adds value for the negotiating principals by helping to ensure the parties are in agreement on key deal terms before they spend significant time and money on diligence and definitive documents. It can also help the parties’ advisors understand the deal and prepare initial drafts of transaction documents that minimize the number of open issues to be resolved, thereby significantly reducing the time it might otherwise take to finalize the documents. Putting in the additional effort to flesh out details at the LOI-stage can thereby help reduce “deal fatigue” and frustration later on. Below are some often overlooked terms that can bolster your LOI to avoid time-consuming post-LOI disputes and increase the chances of a successful transaction.Continue Reading 7 Key Value-Adding LOI Terms

The New Year energizes us to plan for success in the coming months. To increase the odds of meeting your business goals, we suggest taking a quick inventory of legal risks and brainstorming corrective actions for 2023. While important, legal risks may not seem urgent until a related problem impacts your business (i.e., you are subject to litigation, a business dispute erupts over unclear contract terms, an insurer or Medicare Administrative Contractor notifies you of billing/coding problems, or an employee makes a claim). Once present, legal risks can take a significant amount of time, expense, and energy to resolve that could be spent elsewhere in your business. We recommend taking a few minutes today to ask yourself the following questions:Continue Reading Are You Ready for 2023? Here’s a Quick Checklist to Reduce Legal Risks in the New Year

In a recent blog post, we described general registration and application considerations for employers seeking to enroll in California’s new Hospital and Skilled Nursing Facility COVID-19 Retention Payment Program (the “WRP”) on behalf of their employees, including details on eligibility, qualifying periods, and defined legal terms. Readers have asked how to analyze whether physicians and other employees who perform at least some “management” or “supervisory” duties qualify for the WRP, which we address here.Continue Reading Who is a Manager or Supervisor Excluded from California’s Healthcare Worker Retention Payment Program?

On June 30, 2022, Governor Gavin Newsom signed legislation to stabilize and promote the retention of California’s healthcare workforce in response to the COVID-19 pandemic. This response included the allocation of $1.3 billion for retention payments to physicians and other clinical and non-clinical healthcare workers. California’s Department of Health Care Services (“DHCS”) will administer the distribution of those funds through its Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payment program (the “WRP”). The program is designed so that WRP payments will first be made to eligible employers, who then will pass through the WRP funds to individual physicians and other healthcare workers. In order to receive WRP funds, California employers must register with and provide certain information to DHCS on an expedited timeline.Continue Reading Important Deadline Approaches for California Healthcare Employers to Apply for Worker Retention Payments