Editor's note: This is the second article in a two-part series on managing poor performers. Last month, we discussed finding the cause of the problem and talking to the employee. This month, we will look at conducting performance appraisals and carrying out discipline. Performance appraisals and progressive discipline are tools that you can use to help your employees and protect both yourself and your practice. These final two steps for dealing with and confronting a poor performer will help you to evaluate the problem honestly and take action.

To encourage private practices to adopt electronic health records (EHR), CMS will now allow "certain entities" to make "nonmonetary donations" to physicians to be used only for the acquisition and maintenance of EHRs in their facilities, according to an announcement in an August Federal Register (42 CFR Part 411). "These exceptions are consistent with President Bush's goal of achieving widespread adoption of interoperable electronic health records to improve the quality and efficiency of healthcare while maintaining the levels of security and privacy that consumers expect," according to the Federal Register.

Can you stop staff from talking salaries? How do you change an existing vacation policy? Editor's note: As an office manager, HR matters may not be your main area of expertise, yet they do require constant attention. Each month, TDO receives HR questions from readers seeking advice on everything from polices and procedures to personnel matters. We asked Thomas L. Ealey, CPA, consultant with the Ealey Group, Inc., in Findlay, OH, who has 20 years of healthcare and risk-management experience, to address some of your HR concerns.

A risk assessment allows your practice to take inventory of risk areas and identify current risks, potential risks, and control weaknesses. It measures your practice's compliance level with laws, regulations, and internal policies/procedures, and should be performed once every two years. A risk assessment is important because it allows you to address risks proactively detect weaknesses that could affect operational risk identify internal and external factors that you must address determine a method to manage the risk

Congress passed legislation in August containing important tax changes that might affect your financial planning for 2007. The most sweeping pension overhaul in 30 years, the Pension Protection Act of 2006 covers everything from charitable donations to individual retirement account (IRA) contributions. To spare you from sifting through the 900-plus-page document, we spoke with Barry Fruchter,1 CPA, of Moore Stephens Tiller, LLC, a certified public accounting firm in Atlanta, about the most important aspects of the Pension Protection Act.