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Biomedical subjects

M W Peregrine

Publications and source records attributed to M W Peregrine.

At least 19 recordsLinked to original sources
PubMed2001

Closing ... closing ... closed.

What can a board do when all signs point to the need to close a hospital, but its community and the state's attorney general, is not buying it? Here's some legal guidance if you're in that position.

Community-Institutional Relations↗
PubMed2000

The business judgment rule and other protections for the conduct of not-for-profit directors.

The authors review the Business Judgment Rule as applied to a not-for-profit director's duty of care, with particular emphasis on the different forms of state statutory liability shields that serve to enhance the protections of the Rule. They also examine current trends in enforcement of breach of fiduciary duty of care standards, and provide a series of specific recommendations for not-for-profit boards to consider implementing as a means of increasing the likelihood of affording such protections to individuals serving as directors.

Administrative Personnel↗
PubMed1997

Creative alliances offer alternatives to corporate mergers.

Healthcare organizations form strategic alliances for several reasons: To achieve economies of scale, to provide specialized clinical or other expensive services, and to pursue common charitable missions. To accomplish these objectives, however, not all organizations need to enter into the binding legal agreements that characterize statutory mergers or acquisitions. For those healthcare organizations, variations of traditional arrangements-such as joint ventures, management, and service agreements- and less traditional arrangements-such as rights of first refusal, limited sponsorship arrangements, joint resolutions, overlapping committee arrangements and similar structures-may provide a solution.

Financial Management↗
PubMed1997

Intermediate tax sanctions: an overview.

New federal tax law applies intermediate tax sanctions when tax-exempt organizations enter into so-called excess benefit transactions with corporate insiders. The sanctions take the form of a two-tiered penalty excise tax, which is assessed not on the tax-exempt organization itself but on the insider who receives the excess benefit and the organizational managers and board members who knowingly participate in an improper transaction. The intermediate tax sanctions, therefore, present tax-planning challenges for tax-exempt hospitals and integrated delivery systems as well as for 501(c)(4) HMOs. Forthcoming treasury regulations are expected to add clarity to the new law.

Conflict of Interest↗
PubMed1995

Hermann agreement updates IRS guidelines for incentives.

The October 1994 agreement between the Internal Revenue Service (IRS) and Hermann Hospital of Houston, Texas, elucidates current IRS policy on physician recruitment incentives. The IRS distinguishes between the recruiting and the retention of physicians and perimts incentives beyond reasonable compensation in the former but not the latter circumstance. This new agreement, while not legally precedential, nevertheless provides guidance for healthcare organizations seeking safe harbor protection.

Guidelines as Topic↗
PubMed1995

Choosing medical practice acquisition models.

Various models have been used to carry out medical practice acquisitions. Each model results in a different degree of integration between physicians and purchasing organizations, and all involve potentially detrimental legal and business issues to be resolved. This article describes six models of medical practice acquisition and the most common legal and business problems associated with valuing medical practices.

Employment↗
PubMed1995

Legal issues in medical practice acquisitions.

As the changing healthcare delivery environment places increased emphasis on primary care, many healthcare organizations are striving to broaden their base of primary care physicians. One method that organizations are using to accomplish this goal is acquisition of medical practices. Practice acquisitions require careful planning to address the complex legal issues involved, including possible violations of antikickback, self-referral, and antitrust laws. This article offers an overview of the acquisition process and a checklist of relevant legal issues.

Antitrust Laws↗
PubMed1994

The IRS looks closely at homes for the aging. Organizations must be prepared to face increased scrutiny on tax-exempt status and financing.

Tax-exempt status has long been perceived as appropriate for the traditional retirement home (i.e., congregate housing and life-care facility), which serves the elderly and typically experiences low profit margins. An organization that is both organized and operated exclusively for religious, charitable, scientific, literary, or educational purposes or for testing for public safety may qualify for tax-exempt status under Internal Revenue Code section 501(c)(3). The Internal Revenue Service uses the generic term "homes for the aging" to include all forms of retirement housing facilities (except nursing homes that solely provide the highest level of nursing care). A home for the aging that qualifies under section 501(c)(3) (through satisfaction of the organizational and operational tests) will qualify for charitable status for federal tax purposes if it operates to satisfy the following basic needs of aged persons: suitable housing, healthcare, and financial security. In general, not-for-profit organizations recognized as exempt under code section 501(c)(3) may be eligible for tax-exempt financing to develop a home for the aging through the issuance of tax-exempt bonds. Effective tax-exemption planning is a necessary part of the business planning process by sophisticated not-for-profit organizations that own and operate (or desire to own and operate) charitable homes for the aging and similar housing facilities serving the elderly. The benefits of exempt status remain attractive for many such organizations. The challenge of obtaining and maintaining that status is becoming far more burdensome.

Aged↗