Karen regularly represents health care systems, hospitals, clinics, and other institutions in matters of quality management, medical staff credentialing, and peer review, hospital and medical staff structures, bylaws and confidentiality, as well as National Practitioner Data Bank, state professional board, and other government reporting. She counsels health care institutions and practitioners about Medicare certification, state licensure, EMTALA compliance, and many other regulatory matters touching clinical operations. Karen advises health care clients in antitrust, contracting and other disputes related to hospital and medical staff relationships. She has substantial experience handling contested matters before administrative bodies including hospital, surgery center and managed care peer review panels, Medicare QIOs, Joint Commission, and many state professional boards. She works actively on patient-related legal issues including refusal of treatment, restraints and advance directives. In all these areas, Karen has worked with urban, academic, community, and rural institutions and providers.