‘Real Housewives of New Jersey’ Husband Ordered Deported to Italy

In July, the Norris McLaughlin Immigration Blog reported that Teresa Giudice, best known for starring in The Real Housewives of New Jersey, would soon become a “Real Housewife of Italy.”  Well, Teresa may stay in New Jersey, but her husband, Giuseppe “Joe” Giudice, will be traveling by “ICE Air” on a permanent trip to Italy.  CBS Newsreported that Giudice was ordered to be deported to his native Italy yesterday by Judge John Ellington at the York Immigration Court in York, Pennsylvania.

Giudice immigrated to the United States from Italy when he was a child as a lawful permanent resident, or “green card” holder.  Running on the incorrect assumption that “permanent resident” really meant “permanent,” Giudice never went through the process of becoming a naturalized citizen of the United States.  Therefore, his conviction triggered civil deportation proceedings with ICE alleging, now successfully, that Giudice was convicted of a crime that immigration law refers to as an “aggravated felony”—a deportation death trap.  Giudice’s conviction gave him little hope of avoiding deportation from the United States, absent a showing that Giudice fears returning to beautiful Italy because of persecution or torture at the hands of the Italian government.

Giudice has 30 days to appeal the decision to the Board of Immigration Appeals in Arlington, Virginia.  Should Giudice appeal, his deportation to Italy will be temporarily stayed pending the appeal’s outcome.  Giudice will, however, be subject to mandatory immigration detention for the duration of any immigration appeals, without the possibility of bail, even if he completes his criminal sentence.

If you are not a citizen of the United States and have been charged with a crime in New Jersey, a criminal conviction will have serious immigration consequences, including possible permanent banishment from the United States.  Before taking a plea, it is crucial that all non-citizen criminal defendants and their New Jersey criminal defense attorneys seek the assistance of immigration counsel who understand the immigration consequences of the plea and can assist in crafting a disposition that will minimize or eliminate those consequences.

Finally, do not assume “permanent resident” means permanent.  If you are eligible to become a naturalized United States Citizen, now is the time to apply.

If you have any questions about this post or any other immigration matter, feel free to contact me, Raymond G. Lahoud, at [email protected].

Medical Innovation Can Help First Responders Save Lives

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IN THIS ISSUE, we feature our Annual Healthcare CEO Roundtable, which focuses on advances in medical technology, next-generation research and development of biotech and pharmaceuticals, and life-saving innova­tions at hospitals and medical centers.

Patient care and new “miracle” drugs are giving so many people second chances after diagnoses that used to be considered a death sen­tence—instead people we know are surviving, thriving and living to see the birth of grandchildren.

Innovative New Jersey companies, well-trained doctors and top-rated hos­pitals are a source of pride for the Garden State.

Medical innovation is also saving lives at the first responder level, well before a patient gets to a doctor or a hospital. For example, a new study shows that “a change in the type of breathing tube paramedics use to resuscitate patients with sudden cardiac arrest can signifi­cantly improve the odds of survival and save thousands of lives.”

Sudden cardiac arrest caused by a heart attack—according to the American Heart Association—usually occurs when the heart suddenly or unexpectedly stops beating, cutting off blood flow to the brain and other vital organs. The vast majority of out-of-hospital cardiac arrests occur at home, and only about 10 percent of people survive. According to the National Institutes of Health (NIH), more than 90 percent of Americans who experience sudden cardiac arrest die before, or soon after, reaching a hospital.

“During resuscitation, opening the airway and having proper access to it is a key factor for the survival of someone who goes into cardiac arrest outside of a hospital,” explains George Sopko, M.D., M.P.H., program director in the National Heart, Lung, and Blood Institute’s Division of Cardiovascular Sciences and coauthor of the study. “But one of the burning questions in prehospital emer­gency care has been, ‘Which is the best airway device?’”

This study—funded by the NIH’s National Heart, Lung, and Blood Institute—is the largest of its kind to test oxygen delivery methods used by firefighters, emergency medical service (EMS) providers and paramedics. It is the first to show that a particular airway intervention can positively affect patient survival rates. The findings were pub­lished online in the Journal of the American Medical Association.

“This study demonstrated that just by managing the airway well in the early stage of resuscitation, we could save more than 10,000 lives every year,” says Dr. Sopko.

According to the NIH, EMS providers treat the majority of the 400,000 out-of-hospital cardiac arrests each year. For more than three decades, their standard-of-care technique for resuscitation has been endotracheal intubation—the inser­tion of a plastic tube into the trachea to maintain an open airway. They use this technique in hopes that mirroring the care given by in-hospital physicians will produce better patient outcomes.

“While identical to techniques used by doctors in the hospital, intubation in these severe and stressful prehospital settings is very difficult and fraught with errors,” says Henry E. Wang, M.D., professor and vice chair for research in the Department of Emergency Medicine at McGovern Medical School at The University of Texas Health Science Center at Houston. Wang was the study’s lead author.

Today, however, the NIH says new devices such as laryngeal tubes, offer simpler alternatives to opening and accessing an airway. These tubes are easier to use, and the trial showed that cardiac arrest patients treated with this alternative had a higher survival rate.

In recognition of the wide array of contributors to medical innovation, we expanded this year’s Healthcare CEO Roundtable—which used to be only for hospital CEOs—to include biotechnology, pharmaceutical and medical insurance company CEOs. This accurately reflects the healthcare supply chain, which benefits from new ideas from the moment of a 911 call to robot­ic surgery to long-term, life-saving medi­cines and treatments.

Annual Healthcare CEO Roundtable: Technology is Changing Patient Care

AS TECH GIANTS INCLUDING APPLE, Amazon, and Google make healthcare market entrances, traditional healthcare systems and hospitals face increasing pressure to remain competitive. Traditional healthcare systems continue to merge to compete; the fear is that providers will become vulnerable to competition from digital health companies who can more efficiently deliver care and treatment directly to patients

Many drugstore players are working to expand digitally, while pharmaceutical companies are also competing with Amazon’s first official move into healthcare, following the e-commerce giant’s upcoming acquisition of online pharmacy PillPack.

Given these market trends, COMMERCE asked New Jersey’s top healthcare CEOs to address the follow­ing questions. How is technology chang­ing healthcare, patient care and the future of medicine? What impact is it having on the healthcare system and the medical, pharmaceutical and biotech industries?

The following industry leaders participated in our Annual Healthcare CEO Roundtable:

  • Atlantic Health System President and CEO Brian Gragnolati, FACHE;
  • BioNJ President and CEO Debbie Hart;
  • CarePoint Health Chief Executive Officer Natasha Deckmann, M.D.;
  • Celgene Corporation Chairman and CEO Mark Alles:
  • Delta Dental of New Jersey President and CEO Dennis Wilson;
  • Englewood Health President and CEO Warren Geller:
  • Hackensack Meridian Health Co-CEO Robert C. Garrett, FACHE;
  • Hackensack Meridian Health Co-CEO John K. Lloyd, FACHE;
  • HealthCare Institute of New Jersey President and CEO Dean J. Paranicas;
  • Holy Name Medical Center President and CEO Michael Maron;
  • Jefferson Health, New Jersey Division President Joseph W. Devine, FACHE;
  • Kessler Institute for Rehabilitation President Sue Kida;
  • New Bridge Medical Center President and CEO Deborah Visconi;
  • RWJBarnabas Health President and CEO Barry H. Ostrowsky;
  • Saint Peter’s Healthcare System Interim CEO and President Leslie Hirsch, FACHE;
  • St. Joseph’s Health President and CEO Kevin J. Slavin, FACHE;
  • Trinitas Regional Medical Center President and CEO Gary S. Horan, FACHE;
  • UnitedHealthcare of New Jersey CEO Paul Marden;
  • Valley Health System President and CEO Audrey Meyers.

Atlantic Health System

By Brian Gragnolati, FACHE, President and CEO

The care patients receive has benefitted from technological advancements for decades. Countless examples of drugs, devices, surgical techniques and equipment have furthered our ability to prevent, diagnose and treat disease. In addition to these medical breakthroughs, Atlantic Health System is harnessing technology to improve access to care while making it more affordable. Through mobile apps and online scheduling, patients may seek care at their convenience. With tele-health technology in our ambulances, physicians use the precious minutes during transport to assess patients in real time. Soon, we will launch tele-medicine services to support electronic physician consultations, saving patients time and money by preventing unnecessary office and hospital visits. Behind the scenes, we have implemented amazing technologies to deliver better coordinated care. One foundational component is Epic, which has created a single electronic health record for each of the 780,000 patients seen annually at our 450 sites of care. Epic provides patients with easy access to their physicians, medical

and prescription history and test results—right from their smartphones. At Atlantic Health System, we envision a future where technology and compassion meet to encourage a lifetime of health and wellness for the patients, families and communities who entrust us with their care.

BioNJ,

By Debbie Hart, President and CEO

The healthcare landscape is changing rapidly with the introduction of new digital technologies and the infusion of “non-traditional” stakeholders in the life sciences

space. The convergence of big data into the clinical environment has created powerful point-of-service tools allowing providers and patients to tailor treatment plans to meet personal needs—yielding better, more cost-effective clinical results. We are especially seeing this in the field of oncology which is undergoing rapid change due to the integration of genomics, precision medicine techniques and easier access to large

EHR data sets. New Jersey’s Hackensack Meridian Health is making great strides in this area. With the implementation of new digital advancements, healthcare delivery is in transformation, creating new collaborations and opportunities for the biopharmaceutical industry, patients, regulators, payers and policymakers to look differently at the drug development process, the regulatory environment and the healthcare system as a whole. This is an exciting time with the advent of cutting-edge technologies and Big Data helping to expedite the creation of life-saving drugs and treatments and getting them to market and, ultimately, to patients, with less overall cost burden to the healthcare system.

CarePoint Health

By Natasha Deckmann, M.D., Chief Executive Officer

The healthcare industry, like nearly all industries, is benefitting significantly from advances in technology. Innovations are transforming the consumer experience and increasing the ways in which patients can take ownership of their healthcare—an asset to the patient and industry overall. Engaged consumers drive better outcomes and help lower costs. That’s why we made it a priority to include, in our newly redesigned website platforms for patients, the ability to search for physicians, book appointments online and digitally research healthcare information. Just this year, we also introduced CarePoint Connect, a unique technology-driven platform that utilizes telemedicine to facilitate continued patient care after emergency room visits. Now, when a patient is discharged from the ER, they are provided the opportunity for a “video-visit” with a clinician several days later. This helps ensure the patient is improving and allows the doctor to discuss test results, answer questions, and schedule follow-up appointments in real time without a repeat visit.

CarePoint Health is currently the only hospital system in the New York metropolitan area using this technology in its emergency departments. Innovation is at the core of our mission and is integral to how we extend the continuum of care beyond the traditional hospital walls.

Celgene Corporation

By Mark Alles, Chairman and CEO

The treatment of cancer is at a remarkable technological inflection point, where cutting-edge innovation is increasingly harnessing the power of the human body’s immune system to attack blood and solid tumor malignancies. At Celgene, our purpose is to change the course of human health through bold pursuits in science and a promise to always put patients first. One of these bold pursuits is the use of chimeric antigen receptor T cells (CAR T) in the treatment of blood cancers. By applying Celgene’s experience with treatment of hematologic malignancies and a history of developing cellular-based treatments and pioneering technology through research partnerships, we are building a clinical development program that has the potential to deliver several novel therapies for patients battling these deadly cancers. We are expanding our capability to produce these potentially transformational investigational therapies, including at a newly opened facility in Summit, New Jersey, where a CAR T therapy for multiple myeloma is being developed for the U.S. market. For patients, the stakes are too high and the potential for discovering life-changing therapies too great for Celgene not to embrace this technological evolution and work to deliver transformational improvements in cancer care.

Delta Dental of New Jersey

By Dennis Wilson, President and CEO

The dental benefits industry and oral healthcare have changed for the better because of technology. We’re using technology to better inform our providers on dental treatment trends, clients on benefits utilization, as well as build an industry-leading Data Science Team to better interpret and drive actionable insights from our data. One key project we’re currently executing is a partnership with Google to apply artificial intelligence, sometimes called machine learning, and learn from those insights to better understand our customer’s journey with us, enable efficient operations and improve interactions with our clients. As the industry continues to move toward helping people improve their oral health and overall wellness, technology will be one of our greatest assets. We look to the future through a “tech-forward with a human touch” approach.

Englewood Health

By Warren Geller, President and CEO

Englewood Health recently joined the ranks of major hospitals and health systems around the country with the installation of Epic, a single-platform electronic health record system. Rather than patients having separate records tied to each point of care, such as the emergency room, an internist’s office, a lab or imaging center, or an inpatient unit, all data and information about a patient are consolidated into a single Epic record. This longitudinal record gives every member of the care team real-time access to the patient’s entire history of treatment provided in Epic facilities. The resulting benefits related to quality, safety, coordination and collaboration, efficiency, and patient experience are profound. Epic also allows healthcare providers to access information from hospitals outside their network. If, for example, one of our patients seeks emergency care in another state while on vacation or traveling for business, the receiving emergency department can pull the record of the patient’s care at Englewood Health, and vice versa. Robust reporting and analytics, a user-friendly and powerful patient portal, additional patient safety tools, and customizable templates and tools for providers are just some of the additional benefits of improving care and making workflows more efficient.

Hackensack Meridian Health

By Robert C. Garrett, FACHE and John K. Lloyd, FACHE, Co-CEOs

Technology is helping us take quantum leaps to improve patient care, the patient experience and to achieve another major goal—making healthcare more affordable to our patients. Electronic medical records are providing more coordinated care and helping us reduce costs by eliminating duplicative testing and other unnecessary treatment. With electronic medical records, everyone is literally on the same page. Additionally, enhanced technology leads to better data collection and analysis, which is essential for improving population health strategies. It gives us a better read on disease. It makes us smarter when we can observe pat- terns in illness by looking at groups of patients in addition to treating individual patients. We created a $25 million innovation fund to launch the next breakthrough in healthcare delivery and recently funded a company that developed a health hub for the home. A robot reminds people to take medication, automatically refills prescriptions and arranges telemedicine visits between patient and physician. We are also using technology to improve patient satisfaction. We launched Wambi, a digital system powered by real-time feedback. This allows us to immediately remedy patient issues and reward team members for outstanding care. Our pilot was so successful that we are rolling this out network-wide.

HealthCare Institute of New Jersey

By Dean J. Paranicas, President and Chief Executive Officer

Technological advances are dramatically altering the landscape for our member companies, which include most of the world’s leading research-based biopharmaceutical and medical technology firms.

Artificial intelligence (AI), for instance, can provide highly sophisticated tools for drug discovery and development. AI offers the prospect of accelerating the shape and pace of research and improving results, enabling scientists to succeed—or fail—faster and cheaper. AI also can discern patterns across patient population data that yield critical insights, allowing the creation of new, more effective medicines.

New analytical tools will enable expanded data review of the benefits, use and risks of medicines. Information gleaned from the practice of medicine (real-world evidence) may contribute toward more efficient drug development programs and lead to more timely access to innovative, safe and effective medicines.

Precision medicine, personalized healthcare, remote monitoring and wellness and prevention programs are dramatically reshaping the way patients are diagnosed and treated. They require increasingly sophisticated analytical and diagnostic tools from medical technology companies, which is a major reason for the 80 percent increase in patents for breakthrough medical technologies in the last decade.

Holy Name Medical Center

By Michael Maron, President and CEO

Technology has revolutionized how we care for patients in numerous ways, from how they are treated—with robotic surgical systems and surgical navigational systems—to how mobile carts are allowing physcians to access patients’ clinical data at the bedside. Within 10 years, we’ve moved from a paper-based recordkeeping system to electronic health records (EHRs) that assist the healthcare team in providing personalized, culturally competent care. Within the next decade, we’ll see more of the use of artificial-intelligence technology in surgery and data-sharing beyond our borders. At Holy Name Medical Center, we have remained competitive while providing exceptional patient care by developing our own innovative, easy-to-use secure information technology environment. Ours is the only such software in New Jersey and one of only a few in the United States to be developed and owned by the facility that uses it. This allows us to deliver value-based, efficient patient care that stands out among others within a complex healthcare environment.

Jefferson Health, New Jersey Division

By Joseph W. Devine, FACHE, President

At Jefferson Health, we pride ourselves on staying up-to-date with the latest healthcare technologies that help our team provide patients with the best possible care. One way we plan to “stay ahead of the curve” is by transitioning our New Jersey facilities to the EPIC electronic medical records system, which has been rated several times as the #1 electronic health records system by healthcare research and insights firm KLAS. Using electronic medical records has revolutionized and added another layer of security to medical recordkeeping—making it a top priority for us. Jefferson Health’s Philadelphia locations have been using EPIC for a few years, and by introducing it to our New Jersey locations, the EPIC system will provide seamless medical records throughout our enterprise. That means whether a patient is in a physician’s office, ER, operating room, or procedural area, all of their medical data will be accessible to their entire care team at Jefferson—not just at one location. Using EPIC will help our physicians, nurses and support staff deliver convenient, accurate and efficient care, while minimizing errors. We look forward to this exciting addition that will improve patient care and enhance workflow.

Kessler Institute for Rehabilitation

By Sue Kida, President

Medical rehabilitation is being enhanced by an increasing variety of technologies designed to help individuals who have had catastrophic illnesses or injuries return to productive lives. For example, robotics, including exoskeletons, are being used to help restore strength, function and mobility. Innovative wheelchair and assistive technologies, along with computers, smartphones and a growing library of apps are offering greater support and independence for those living with disabilities. Further-more, electronic medical records and telecommunications are providing new platforms through which we can connect with patients and providers at points all along the care continuum and enable individuals to better monitor and manage their health. And as autonomous cars become available, greater personal, social and employment opportunities are likely to follow. In our field, however, the balance of high-tech and high touch makes all the difference. Technological advances can help to transform the delivery of care, communications and the ability to perform daily activities. But it can’t replace the human factors of caring, compassion and empathy that make medical rehabilitation so valuable and impactful in the lives of our patients and their families.

New Bridge Medical Center

By Deborah Visconi, President and CEO

New Bridge Medical Center utilizes technology by maximizing interoperability, the ultimate goal of healthcare reform, which allows disparate technology systems to interact so patient information can be exchanged. NBMC is the first Trusted Data Sharing Organization to route healthcare data to the New Jersey Health Information Network, a shared services platform, created by the NJDOH and powered by NJII that provides the infrastructure for electronic exchange of patient health information among healthcare providers, HIE organizations, and state health data sources. As part of the Jersey Health Connect HIE, New Bridge can leverage the utilization of the health information exchange, while giving consumers more convenient access to their records. Connecting partners through the exchange of data in a secure fashion helps the continuity and coordination of consumer care upon discharge. Technology allows us to continually improve care by helping us deliver the right care at the right time in the right place. An example of technology helping New Bridge improve care is our new partnership with the NJ Veterans as a Veterans Choice Provider. This relationship allows veterans to seek care in their communities. Technology will help us share critical clinical information with a veteran’s care provider assuring seamless care continuity.

RWJBarnabas Health

By Barry H. Ostrowsky, President and CEO

Technological developments in healthcare are saving lives and improving healthcare delivery and patient care. Innovation in technology has already led to the digitalization of health records, ease of workflow, lower healthcare costs, mobile app technology in the field and telemedicine. Dynamics created by technology are fascinating. Take, for example, the changing dynamic between patients and their physicians. Today, patients can have a meaningful digital consultation with a physician through an app from the comfort of their home. Technology will create more efficient and effective patient care that is the norm rather than the exception. In addition, RWJBarnabas is piloting telemedicine programs. Employees have a new benefit that offers them, their spouses and their dependents a convenient, low-cost option for urgent care medical services, delivered online. Visits occur through a smartphone, tablet or computer, where users can view profiles of the doctors who are “on call” and connect to the doctor of their choice via video. Our goal is to expand our telemedicine services to positively impact more of the communities we serve. Technological creativity is changing all kinds of industries and, based on what we are doing already, the health and patient care industries are clearly no exception.

St. Joseph’s Health

By Kevin J. Slavin, FACHE, President and CEO

Digital technology— at times considered a “disruptor”—has become mainstream, with our patients and consumers using technology to enhance their access to care and improve their overall health. This summer, St. Joseph’s Health embarked on a transformation to improve patient experience, quality and outcomes by implementing the Cerner Millennium electronic health record (HER) across all of our facilities.

The EHR represents a new milestone as we use digital technology to transform the delivery of care across the continuum. Our Cerner system enables and expedites contact among health team members who work in and across multiple coordinating facilities and services. With a philosophy of “one patient, one chart,” the healthcare team will be able to have a more complete, real-time digital view of each patient’s health history, medications and illness management.

Patients also benefit from MyStJosephsRecord—a new portal— that provides easy access to view appointments, immunizations and medications, test results, and wellness information. All of this progress and innovation means greater connectivity between patients and providers to enhance our community’s overall health.

Saint Peter’s Healthcare System

By Leslie D. Hirsch, FACHE, Interim CEO and President

The Medical Genetics and Genomic Medicine department, led by Geneticist Debra Day-Salvatore, M.D., Ph.D., is the first to provide patient consultations and counseling using telemedicine technology at Saint Peter’s Univer-sity Hospital. Since 1992, our state-designated regional center has seen more than 34,000 patients of all ages with more than 2,000 different genetically-influenced conditions. Diagnosis is commonly delayed in rare-disease patients, if ever made at all, resulting in missed opportunities to avoid or decrease sometimes life-threatening medical complications. Patients or other providers can now connect online, in real time, with a geneticist, genetic-metabolic dietitian and a licensed genetic counselor. This two-way virtual consultation helps eliminate the need for patients requiring repeated follow-up to travel regularly to the hospital. It improves access to care when barriers such as geography, transportation, limited patient ambulation, home ventilator support, immunodeficiency or other chronic medical problems are present. Telemedicine also facilitates interactions among different specialty providers to improve patient care coordination and allows us to expand the reach of our renowned genetics service to other regions, states and countries where genetic services may be limited or non-existent. This technology is simple to use, and we plan to expand telemedicine services in the future.

Trinitas Regional Medical Center

By Gary S. Horan, FACHE, President and CEO

We are seeing an expanding range of robotic surgical procedures that are shortening operations and lessening trauma to the patient. In our emergency department, we are using technology to raise the quality of care and lessen the time of diagnosis through our 128-slice CT scanner. High quality CT scans can be done in seconds. Technology is also having a significant impact on Information Technology. Electronic medical records are now a reality, and so is the ability to share (with the patient’s permission) information among hospitals and physicians so that emergency treatment can be more effective and repeated testing can be eliminated. Trinitas is a leader in Jersey Health Connect—the largest and most comprehensive Health Information Exchange in the state, which allows thousands of healthcare providers and millions of patients to be electronically connected. Telemedicine is now a reality for our patients thanks to a partnership with Horizon BCBS and American Well, which is offering easier, more convenient access to quality healthcare for those who may not have the time or ability to get to a doctor’s appointment. Telemedicine physicians and select mental health practitioners provide face-to-face, real-time “examinations” online for a diagnosis, prescription and referrals for subsequent testing.

UnitedHealthcare of New Jersey

By Paul Marden, CEO

For many Americans, the health system is a challenge to access and navigate. But the industry is evolving with innovative programs and technologies that are helping deliver connected health solutions to people nationwide. Technology is making quality healthcare more accessible and affordable, while empowering consumers to take charge of their care like never before. By providing people with more personalized, convenient and easier-to-use resources, we can simplify the healthcare experience, achieve better outcomes and translate data into action. UnitedHealthcare is doing its part through wearable device wellness programs that enable people to earn financial incentives, value-based contracting that helps make healthcare more affordable and online resources that enable people to better manage their health. We are even simplifying the pharmacy process with PreCheck MyScript, which allows doctors to run a trial claim before prescribing medication. Technology is enabling predictive medicine that will use direct-to-consumer genetic tests to anticipate health problems, and remote patient monitoring programs that will use connected devices to evaluate the health of patients in real time. These emerging trends will become more widespread during the next five years, and they will enable individuals to make better decisions based on quality and cost of care.

Valley Health System

By Audrey Meyers, President and CEO

Advances in technology are reshaping the delivery of healthcare in many different ways. For example, patients are seeking healthcare providers that have the highest outcomes with the lowest associated costs. As such, providers must focus on improving technologies and developing innovative treatments to ensure that patients are receiving the highest level of care in the most cost-effective manner. One way that providers are achieving this is through telemedicine, which enables them to communicate with, diagnose and/or prescribe treatments to patients remotely. In addition, it allows for a patient-centered approach to chronic disease management (i.e., a patient’s heart rate or blood sugar levels can be monitored accurately without needing to come into the office). As another example, Valley is using online appointment scheduling to facilitate patient access to providers. By using advanced analytics, we are able to make informed, evidence-based clinical decisions for our patients, reduce unnecessary costs and improve the efficiency of care as patients move across the healthcare continuum.

Black Hawk Test Pilot Kristina Sofchak Didn’t Hit the Glass Ceiling—She Busted Right Through It

NEW JERSEY ARMY NATIONAL Guard Chief Warrant Officer 3 Kristina Sofchak, a Black Hawk helicopter maintenance test pilot with Detachment 2, C Company, 1-171st Aviation Regiment, loves to talk to her mother about career paths.

“I would say, ‘I want to be a waitress,’ and my mom would say, ‘Why not own the restaurant?’ I would say, ‘I want to be a nurse,’ and my mom would say, ‘Why not be a doctor?'” recalls Sofchak. “She was constantly challenging me to think about the things I could accom­plish as a woman.”

Sofchak noted that her mother even named her in a way that could aid her with job applications.

“My mom purposefully named my sister and I with gender neutral names, so I could put Kris on a resume, and my sister could put Casey,” explains Sofchak. “She wanted us to be judged on our merits, not because we are women.”

Sofchak was inspired in the 1980s by women such as Lynn Rippelmeyer, who became the first woman to fly the Boeing 747 and in 1984 became the first woman to serve as captain.

“I heard about women making history in aviation while I was in school, and I told my guidance counselor that I wanted to be a pilot,” says Sofchak. “He said that girls couldn’t be pilots.”

A chance encounter put Sofchak on a path toward a career in aviation.

“My mother took us to Great Adventure, and there was an AH-1 Cobra static display there—I knew I wanted to work with Cobras,” says Sofchak.

She went to her high school guidance counselor and told him she was going to join the New Jersey Army National Guard. Sofchak enlisted as a helicopter mechanic, and soon was running main­tenance teams on the hangar floor.

“I was working on a helicopter one day, when a supervisor of mine, a male, told me I hit the glass ceiling. I was confused about what he meant,” says Sofchak. “He said that I was going to climb as high as I could go on that lad­der—that I could see the rest of the path, but I could never get there.”

But, after 12 years as an enlisted maintenance soldier, Sofchak’s dream of flying was realized when she became a helicopter pilot. As a young pilot, she found herself going from the lush Pine Barrens of New Jersey to the dangerous skies over Iraq.

“I was scared at first, but the more missions we did, the better it got,” she says. “We were doing the air assault mission—taking soldiers right to com­pounds to pick up high-value targets.”

Sofchak is the New Jersey Army National Guard’s first female mainte­nance test pilot.

“I love what I do, and I just want little girls out there to know that this is some­thing they can do, too,” says Sofchak.

And that supervisor that told Sofchak she had hit the glass ceiling?

“I saw my old supervisor after I came back from flight training, and he was really happy for me. He said instead of hitting the glass ceiling, I busted right through it.”

For Most Family Businesses, Success or Failure is All or Mostly “Relative(s)”

IN THE FOLLOWING SPECIAL REPORT, accountants and attorneys offer financial, legal and management best practices for New Jersey-based family businesses—keys to success for this gen­eration and the next. The nuances and dynamics of steering a family business in the right direction can be best imple­mented early in the life cycle of the company, where short-term and long-term planning can map out the future—including a succession plan. Here is a roadmap of insights and advice for these unique enterprises for which success or failure is all or mostly “relative(s).”

ACCOUNTING

BDO USA, LLP

By Charles A. Barragato, CPA, CFE, Office Managing Partner, Melville Tax Practice; NE Regional Leader, Private Client Services

To be successful, family businesses in New Jersey should establish a succession plan. On Jan. 1, 2018, the state’s estate tax was effectively phased out, which, coupled with recent changes to the fed­eral tax code, has enhanced the ability to transfer wealth from generation to gen­eration—reducing tax consequence and providing an opportunity for family busi­nesses to preserve value and ensure a smooth transition. Additionally, privately held companies must act now to address new regulations and changes, including updated revenue recognition guidelines (ASC 606) effective Jan. 1, 2019; the SD v. Wayfair decision’s impact on taxation of products and services; and new pass-through guidance just released by the Treasury and IRS. It’s an ideal time for family businesses to ensure they under­stand their total tax liability and oppor­tunities amid new regulations.

EisnerAmper LLP

By Lisë Stewart, Director, EisnerAmper Center for Family Business Excellence

To ensure the long-term success of a family business, as well as build a healthy ROI for the owners, the most important ingredients are planning and the time to implement the plan. Many business owners wait until they experience a significant health event or some other precipitating crisis before undertaking some of the most impor­tant planning of their life. An effective and implantable succession or transition plan can take more than five years to fully implement, so starting early and sticking to the process can go a long way toward ensuring that business own­ers will reach both their personal and financial goals.

Ernst & Young LLP

By James Wood, Executive Director, Family Enterprise Business Services

Become highly focused on generating value from your enter­prise. For most family owned businesses, the business represents the owners’ most significant source of wealth. Thus, do everything possible to protect and enhance that wealth—think of yourself as an investor, not an operator. It is easy for business-owning families to over-identify with their business because of the family legacy, status in the commu­nity or personal involvement with the business. However, an investor wants to make sure their investment is growing, and the value is increasing year after year. Know the top three financial value drivers of your business (such as Return on Equity, Return on Invested Capital, EBITDA growth) and build a process to monitor, align management and contin­uously improve those metrics.

Goldstein Lieberman & Company LLC

By Phillip E. Goldstein, CPA, Managing Partner

The advice I’d give any family business: “Assume nothing.” Don’t assume a family business will function like a family. It doesn’t, and it shouldn’t. Put everything in writing and make the rules clear. Go into detail about compensation, ownership shares, duties (yes, even specific job descrip­tions). Once it’s on paper, respect what it says. Don’t micromanage. Sweating every detail as a group will lead to bad feelings and bog down forward momen­tum. Seek outside advice for a reality check and to keep ideas fresh. Nothing helps avoid internal strife better than having external sources. Have a financial­ly sound succession plan. Sort out details for how and when the younger genera­tion takes over. Planning for tomorrow makes things more efficient today.

Klatzkin & Company LLP

By Frank G. Sweeney, CPA, Partner, Tax Dept.

Family businesses should consult with an attorney and a CPA to make sure the business structure is the best fit for their needs. They should make sure that they have signed, written agreements clearly out­lining what each partner will be doing for the partnership, the ownership per­centage and the amount being invested by each to start the business, as well as provisions for additional capital calls. A succession plan is vital—early planning provides more flexibility and will allow family members to continue working in whatever capacity they choose before and after a transition. Family business owners shouldn’t be afraid to ask their professional advisors questions. A phone call could save tax money down the road or keep an issue out of court.

Levine Jacobs & Co. LLC

By Michael H. Karu, CPA, CFF, CGMA, Member

A significant portion of our practice is with closely held, family businesses, most of which are New Jersey-based. The family dynamic can be extremely difficult, espe­cially between generations. We remind everyone to keep their eyes on the prize; to look forward and to remain focused on the core business. We also insist on proper communication between the family members. Small issues quickly can grow out of proportion. While many family businesses may be small, they need to be run as if they are larger. Hold meetings, not just between the owners, but with key employees; look for indus­try trends; understand your competition and try to stay ahead of them; and, as the older generation nears retire­ment, recognize that proper succession planning is necessary.

Mazars USA LLP

By Paula Ferreira, CPA, Partner

First and foremost, the company should define key management positions and responsibili­ties so that roles are properly estab­lished, and personnel are held account­able. Secondly, the company will need to determine how the business will be financed considering cash flow needs and if subsequent lending will be neces­sary, as well as identifying the most advantageous source of financing. Finally, a successful family business should be proactive with their finances. This means having the right accounting system. Real-time access to financial information will allow regular reviews and comparisons between management expectations and actual results. It is also important to discuss these results with trusted advisors. Having a strategic and knowledgeable partner to assist and support management will be key to the company’s success.

Sobel & Co., LLC

By Michael LaForge, CPA, CGMA, Director, Family Business Practice

Good to Great was pub­lished almost 17 years ago and was hailed as the best management book ever. It’s overriding message was simple: Get the right people on the bus. The bus is your family business. The right people may or may not be members of your family. As much as you may want to have your daughter or son driving the bus, it is possible that the continued suc­cess of your family business depends on looking outside of the family for talent, innovation and ideas. Conversely, bring­ing family members into the business who may have other passions or profes­sional goals may stunt the success of the family business. The success formula is this: Putting the right people, in the right seats, on family bus equals contin­ued success.

Wilkin & Guttenplan P.C.

By William J. McDevitt, CPA, CVA, Shareholder

Clarity of expectations and roles is critical among family members who are running a busi­ness together. An agreed-upon vision is also vital to keep the business running in the right direction. Transparency and communication are also key to pro­mote harmony and (hopefully) resolve conflict before it manifests itself as resentment. Conflicts, as long as they serve as a platform to improve the busi­ness, can be educational. Hiring or pro­moting family members because they are family rather than on their ability, will eventually cause conflict. Hire the best people that you can for the job, which may not always be a family mem­ber. Running any business is challenging. Running a family business is more diffi­cult but, if done well, can be unifying and rewarding.

LAW

Archer

By Gianfranco A. Pietrafesa, Esq., Partner

Every family business should have a written agreement to resolve disputes. One dis­pute resolution procedure is to engage a third-party neutral, such as a mediator. A second is to create a board of advisors comprised of trusted people, such as an accountant, attorney, banker and other business owners. A third is to form a family council comprised of owners and non-owners, such as members of the next generation. Each of these mecha­nisms is intended to assist family mem­bers in resolving their dispute. However, if family members cannot resolve their dispute on their own, then other means are necessary. One mechanism is to sub­mit the dispute to binding arbitration. Another, more drastic, mechanism is a buy-sell where one side buys and the other side sells their equity interest in the family business.

Cole Schotz, P.C.

By Jennifer L. Horowitz, Esq., Co-Chair, Corporate Department

Family businesses are often nurtured like a family member from creation and launch of the busi­ness, through developmental stages, to ultimately maturity or sale. Typically, there is the utmost care for products and services, culture, employees and community. Family businesses should also establish a legal entity for optimal tax treatment and protection from liability; a governance agreement to avoid disputes regarding management, compensation and succession; written agreed terms with key suppliers and customers to protect business arrange­ments and anticipate adverse events; policies or agreements with employees for effective operations; and protection of trademarks and proprietary informa­tion. Family businesses may not address these legal matters, but it is prudent to do so to avoid disputes, protect the business and prepare for possible sale, financing, expansion and other business life cycle events.

Fox Rothschild LLP

By Douglas J. Zeltt, Esq., Partner, Co-Chair, Corporate Department

The enduring maxim for real estate is location, location, location. For a family business, the adage should be plan, plan, plan. Plan for and docu­ment the proper governance of the business today. Plan for and document the orderly succession of management and ownership of the business tomor­row. Plan (in writing) for an unforeseen event. A family business is like an heir­loom—it needs constant stewardship, upkeep and an appreciation for value. It is the role of today’s owners to bal­ance the roles of family and non-family employees in the operation of the busi­ness, to instill in the next generation the values which enable the family and the business to succeed, and to plan for the eventual transition of own­ership to allow the business to endure.

Harwood Lloyd, LLC

By Thomas Loikith, Esq., Partner, Corporate Department

The challenges of run­ning a small business are magnified when the principals are family members. It’s important not to cut corners because “it’s just family.” Before starting the business, the principals should prepare a written business plan outlining their shared goals and expectations. They should consult with an attorney and an accountant to determine the appropri­ate type of business entity to form. They should then enter into a written agree­ment addressing issues such as capital contributions, management, and the transfer and buy-out of a member’s interest in case of retirement, disability or death. Without expectations and responsibilities being clearly spelled out, not only is the success of the busi­ness itself placed at risk, but unnecessary strains will be placed on the relationship of the family members involved.

McCarter & English, LLP

By Jeffrey Muller, Esq., Leader, Tax Group

Family business owners should formulate succession plans relative to ownership and management. It’s impossible to predict when illness, death or another emer­gency will require changes, and even routine retirement requires planning. Family members may lack the skills or desire to take over, in which case employees should be incentivized to continue the businesses’ success. Without planning, the value created by one generation can be quickly lost by the next. Maintaining and passing the wealth generated from the family business should be an integral part of owners’ estate plans. At times, the best way to protect wealth generated by the first or second generation of owners is to sell the business to employ­ees, other owners, strategic buyers or financial buyers.

Norris McLaughlin, P.A., Attorneys at Law

By David C. Roberts, Esq., Co-Chair, Litigation Practice Group

Most disputes in family owned busi­nesses result from miscommunication. Whether the owners are first or second generation, making sure everyone’s duties and responsibilities are clearly spelled out at the outset is critical. For example, a Shareholders Agreement can give a minority owner majority say in a specific designated area, such as sales. When one generation takes over from the last, it is difficult to imagine that documents created at the outset can cover the issues facing the new regime. Redrafting Shareholders Agreements can focus owners to make sure that everyone has the same goals and objectives. If one part of the family wants to maximize short-term money, while another faction wants to reinvest, deciding to part ways amicably now is significantly more palatable than a future, messy business divorce.

NPZ Law Group, P.C.

By David H. Nachman, Esq., U.S. Managing Attorney

An immigration and nationality law firm, we can help guide a family owned business through sensitive and complex issues related to corporate immigration mat­ters. When two spouses jointly own a closely held corporation, certain fac­tors affect either spouse’s immigration status. One spouse may have Intracompany Transferee, Specialty Occupation, or Investment visa status in the United States, while the other business owner spouse is permitted in the United States as the derivative beneficiary. If the cou­ple were to divorce, the derivative beneficiary could lose his or her immi­gration status. NPZ can work to protect the derivative beneficiary to change his or her status to become a Temporary Business/Visitor, allowing the spouse to remain in the United States to litigate and/or to get status under his or her own qualifying work visa.

Sills Cummis & Gross P.C.

By Jason L. Sobel, Esq., Chair, Family Owned Real Estate Practice

Dealing with the real estate underneath the family business facility is key. Whether the business owns or long-term leases its real estate, there may be an opportunity to unlock its hidden value. This can be achieved in a number of ways: a sale/leaseback arrangement whereby the family sells the land on a tax-efficient basis (perhaps a 1031 tax-free exchange) and leases it back for as long as it expects to contin­ue to operate its business; relocate the business to a less costly or more convenient location and either entitle and sell the land as a redevelopment site or retain ownership and contribute it into a joint venture with an experienced redeveloper; or engage a redevelop­er for hire to redevelop the site and retain full ownership.

Wilentz, Goldman & Spitzer, P.A.

By Brett R. Harris, Esq., Shareholder

Good governance is critical. According to SCORE, a non- profit association that partners with the U.S. Small Business Administration to provide educational and mentoring resources for small businesses, 94 per­cent of family owned firms are con­trolled by supervisory or advisory boards. Those charged with manage­ment of family businesses need to realis­tically identify strengths and weaknesses of their family members and bring in outside advice and perspectives. The non-family members provide certain objectivity in decision-making which may otherwise be biased by family dynamics. Governance should be clearly documented in the company’s organiza­tional documents. A formal succession plan should be adopted with guidance from business and estate planning coun­sel, seeking financial legacy for the fam­ily alongside continued viability of the business, whether still owned by the family or transitioned to professional, non-family management.