Are You Prepared to Address Ethical Dilemmas? Introducing the PALTmed Ethics Toolkit
Session Summary: A PALTmed Ethics Committee work-group developed a practical online PALTmed Ethics Toolkit for providers and staff in PALTC settings. Members of the workgroup will provide a brief overview of the Toolkit development and domains. The domains of the toolkit include: Legal and Regulatory Background, Basic Ethical Principles, Clinical Ethics Terms and Concepts, Defining the Ethical Question, Creating the Ethics Deliberating Process, and Initiating an Institutional Ethics Committee. This 90-minute presentation will include case-based discussion and audience participation questions. A brief (15-minute) discussion of plans for future development of the online tool, including an audience poll to identify anticipated needs will follow. The session will conclude with a question-and-answer session.
Learning Objectives:
- Describe PALTmed resources to inform ethical decision-making and apply contents of the PALTmed Ethics toolkit to address common ethical dilemmas in post-acute and long-term care
- Understand both the CMS regulatory requirements for an a??ethics programa?? and the legal implications of ethical decision-making while recognizing that not all legal actions may be ethical and conversely, not all ethical considerations are necessarily legal.
- Debate potential innovative solutions for addressing ethical issues in PALTC and ways in which PALTmed members can inform future PALTmed ethics resources.
Katja Elbert-Avila, MD, CMD
Associate Professor
Duke University/Durham VA
Timothy Holahan, DO, CMD
Associate Professor of Medicine
University of Rochester
Dr. Holahan is an Associate Professor of Medicine at the University of Rochester and board certified in Internal Medicine, Geriatric Medicine and Palliative Care. He is an attending physician at Highland Hospital and Highlands at Brighton SNF, Medical Director of Aaron Manor Skilled Nursing Facility and Medical Director of the Monroe Community Hospital Ventilator Unit. He is a past chair of the PALTmed Ethics Committee and the current Chair of the PALTmed Public Policy Committee.
Alan Horowitz, Esq., RN
Of Counsel
Arnall Golden Gregory LLP
Alan Horowitz, Esq., RN, is of counsel in the Healthcare practice and a member of the Post-Acute & Long-Term Care team at Arnall Golden Gregory LLP.. He is an innovative healthcare lawyer handling complex regulatory issues concerning Medicare providers such as skilled nursing facilities. Alan serves as vice chair of education for AHLA's Post-Acute and Long-Term Care practice group. Alan also held clinical, faculty and management positions at major medical centers where he utilized his background as a registered respiratory therapist and registered nurse. Alan served as Assistant Regional Counsel at the United States Department of Health and Human Services’ Office of the General Counsel. He worked closely with and litigated cases for the Centers for Medicare and Medicaid Services (CMS) before the HHS Departmental Appeal Board and the federal courts involving enforcement actions taken by CMS. Currently, as counsel to providers, Alan has successfully negotiated and litigated significant cases against CMS. Alan was the Acting Director of ECRI Institute’s National Center for Independent Medical Review and also served as the Director of Clinical and Legal Affairs for the Institute for Safe Medication Practices. Alan also served as in-house counsel and program director for the pilot SNF-based ventilator-dependent program in New Jersey. Alan has co-authored and co-edited the AHLA publication, Post-Acute Care Handbook: Regulatory, Risk and Compliance Issues as well as having written dozens of articles regarding various aspects of health law. Additionally, Alan has been a frequent presenter at national and state forums on topics regarding health law.
Howard Finger, DO
Attending Physician/Clinical Ethics Consultant
Coler Rehabilitation and Nursing Care Center
Howard J. Finger, D.O., is attending physician/clinical ethics consultant at Coler Rehabilitation and Nursing Care Center and at Henry J. Carter Specialty Hospital and Nursing Facility, where he serves as president of the medical staff. He was co-chairperson of the NYC Health + Hospitals Bioethics Council from 2019 to 2022. He currently is a member of the PALTmed Ethics Subcommittee and the Empire State Bioethics Consortium (ESBC), where he served on its board of directors from2021 to 2024. He was lead author of three articles on end-of-life decision-making for the unbefriended. In 2020, he received the Foundation for Post-Acute & Long-Term Care Medicine’s Quality Improvement & Health Outcome Award for his work in this field.
