TOP 10 LEGAL ISSUES IN A DENTAL OFFICE – PART 1
We have heard from members across the state that one of the benefits of being a member of the Ohio Dental Association is being able to reach out to gain information regarding legal issues in their offices. While the ODA cannot give direct legal advice that a member can act upon, we can give you important information to help you make determinations on your legal liability or direct you to your personal legal counsel with matters that require direct legal advice. Being a member of organized dentistry provides dentists with a wide range of benefits from savings on products and services used in dental offices to continuing education opportunities to legislative advocacy. Along with these benefits, your membership also offers you access to necessary information in the dental community. This information covers almost every aspect of the dental practice and ensures that you are receiving crucial information in regard to regulatory bodies and legal issues that may arise.
In the last year the ODA legal and dental services departments have fielded hundreds of phone calls with questions from dental offices across the state on a variety of legal and regulatory issues. My goal in these legal briefs articles in the next three months is to outline the most common questions we are hearing and give important information regarding these topics. Members of the ODA should also understand that our departments appreciate the opportunity to speak with individual dentists on these issues and respond to questions in a timely manner. If you are not a member of the ODA now is a great time to make that commitment and begin to utilize the staff in helping with issues in your office.
10) Animals in the Office
I wanted to start this list of commonly asked legal questions with something that I do not think most dentists would assume is a commonly asked question. The idea of animals in the dental office has become more and more common over the past few years and I receive more phone calls than I anticipate on this issue. It has become more common to see an animal in a dental office or in public places and the next logical question is what rights do animal owners have in a dental office? Even further development in this area has led to dental offices asking if they are allowed to have an office animal? The answers to these questions depend on the liability an office is willing to take on and the type of animal in the office. From office dogs to emotional support animals, to service animals, every situation presents different challenges to a dental office and differing legal standards.
The answers to these questions generally depend on the office’s willingness to take on liability. However, the one scenario with clear rules that an office must follow is in the case of a service animal and their rights under the Americans with Disabilities Act (ADA). A service animal is a dog or miniature horse that is individually trained to perform basic tasks for people with disabilities. A service animal is to be treated as an extension of the patient and is allowed to be in all areas that the patient can go. When a person with a service animal enters the office you may ask the patient two questions. Those questions are 1. Is this a service animal? 2. What is the animal trained to do? Asking these questions can help the office understand what the dog or miniature horse will be doing for the patient and clarify that they are actually a service animal. You may not ask the patient any other questions including questions like: What disability is the animal helping you with? Do you have medical documentation for the animal? Can the animal demonstrate what it is trained to do? The only situations where the animal can be removed from the office are if the animal cannot be controlled by their handler (posing a threat to the health and safety of others) or if the animal is not housebroken.
Aside from service animals that are covered under the ADA, any other animal that could present in the office is not covered by that law and the questions regarding whether they should be there or not depend on office policies. It is important for each office to make their own policy regarding animals in the office. This policy should include what to do with emotional support animals (ESAs). When writing the policy it is important to take into consideration all factors. You must not only consider the positive impact that an ESA could have on a patient’s treatment but the side effects of that ESA being in the office. The flip side of that is the other patients in the office that may be afraid of animals or allergic to the animal. Along with your other patients it is important to take into account your staff and their interaction with the patient and if they have any concerns with having ESAs in the office. Once you address these questions you can write a policy to define how they will be handled.
Lastly, I have seen some offices that have an office animal, usually a dog that helps welcome patients to the office and helps with any anxiety the patient may feel. I have been asked the “legality” of having a dog in the office for emotional support. This question poses the same questions about the policy for patients having ESAs in the dental office. The same allergy concerns, fear of animals and possibly sanitary standards come to mind. However, there are increased concerns when the practice is the one who brings the animal into the office. When the practice is solely responsible for the animal the liability concern also creeps in from what harm the animal could do. What if the patients of the practice are not notified that a dog is going to be in the waiting room for patients and a patient suffers a severe allergic reaction because of the dog being present? Or what if the dog bites one of the patients? These situations increase the liability for the practice because they own the dog.
9) Commercial Activity Tax Changes
The commercial activity tax (CAT) was implemented in 2005 and phased in over a 5-year period to replace the corporate franchise tax and the tangible personal property tax. The idea behind the commercial activity tax was to place a tax on business privilege with a broad base and a low rate on gross receipts. The original annual minimum tax was $150 for all gross receipts up to $1 million and a 0.26% tax on any gross receipts over $1 million. There are many other exceptions for excluding gross receipts but not many that apply to dental offices. The reason for mentioning this tax in an article about the top legal questions for 2024 is due to the changes that took place for the CAT tax starting Jan. 1, 2024.
The good news for most dental offices is that the new changes to the CAT tax may reduce the administrative burden of filing the tax. As of Jan. 1, 2024 the CAT annual minimum tax, which was $150 for most offices, has been eliminated. Further, the annual exemption for gross receipts has been increased from $1 million to $3 million. This means offices with $3 million or less in gross receipts are no longer subject to the CAT tax. If your office does have more than $3 million dollars in gross receipts then you would need to file in 2024, however, in 2025 the annual exclusion for gross receipts increases to $6 million dollars. This increase to $6 million dollars of excludable gross receipts will prevent many dental offices from being subject to the CAT tax. It is important to work with your accountant or attorney in understanding these changes and correctly filing CAT tax returns or closing your account due to not meeting the threshold to be subject to the tax.
If you have questions regarding the CAT tax in your office you may contact the Ohio Department of Taxation at (888) 722-8829 or visit their website at tax.ohio.gov/catlawchanges. If you have any general questions please feel free to reach out to the ODA legal department as well at 614-486-2700.
Please continue to read along in the coming months for the remainder of the top legal issues in dental offices. In the next two months we will dive deeper into terminating a dentist patient relationship, the terminal distributor of dangerous drugs exemption, other tax issues and more. With questions about this article or general legal or regulatory compliance questions please contact the ODA legal department at 614-486-2700.
