Armed with extensive regulatory experience and business knowledge, we guide post-acute and long-term care companies through compliance and certification requirements, help them maximize reimbursement for their services, enter into optimal relationships and expand their businesses through mergers, acquisitions, networking and organic growth.

Armed with extensive regulatory experience and business knowledge, we guide post-acute and long-term care companies through compliance and certification requirements, help them maximize reimbursement for their services, enter into optimal relationships and expand their businesses through mergers, acquisitions, networking and organic growth.

Key Benefits Of Working With Us

  • We counsel post-acute and long-term care providers on every aspect of their business, from real estate and tax to health information technology (HIT) and litigation, and everything in between.

    Efficient collaborators, we proactively spot and help resolve potential issues across your company, and strive to identify opportunities that could generate new sources of revenue. We understand the national and regional markets and key strategies for accomplishing your business goals.

  • Our team represents post-acute and long-term care providers before national and state regulatory agencies on a daily basis. As a result, we know the agencies’ perspectives and use that knowledge to advance your company’s goals while conforming with regulatory requirements. Our lawyers are also skilled in investigating and solving potential compliance problems.

    We are particularly adept in counseling national, regional and local clients on Certificate of Public Need (COPN)/Certificate of Need (CON), survey and certification, licensure and HIPAA matters.

  • Navigating payor rules requires deep knowledge and practical experience. Our team, which includes a former Virginia Deputy Secretary of Health and Human Resources who oversaw Virginia’s Medicaid program, routinely helps clients seek reimbursement for their Medicaid-eligible services.

    We provide counsel on relationships with managed care companies, which are increasingly becoming responsible for Medicaid payments in Virginia, and we represent post-acute and long term care interests in complex bundled payment arrangements.

    Several of our lawyers serve on the Virginia Health Care Association’s (VHCA’s) Regulatory, Payment for Services, Health Planning, Education and Virginia Center for Assisted Living (VCAL) Committees, and regularly speak at the Association’s events and write for its publications. Their involvement in the VHCA enables them to maintain industry relationships and enhances their awareness of emerging trends.

  • Attorneys in our Post-Acute and Long-Term Care Practice call upon decades of combined experience to negotiate and draft provider and vendor agreements that expand your business. We have become so efficient and cost-effective in this area that we are called upon to handle significant contract overflow situations.

  • Members of our Senior Housing Transactions Team develop transactional structures that reduce risk, improve profitability and facilitate the availability of institutional capital. Our attorneys are particularly skilled in the sale of portfolio companies and have a well-established track record in developing Opco/Propco structures that help clients to realize maximum value in a capital markets exit strategy. Regardless of the location of the assets in your transaction, we can assist you. Our experience is national in scope.

Clients

  • Skilled Nursing Facilities (SNFs)
  • Assisted Living Facilities (ALFs)
  • Continuing Care Retirement Communities (CCRCs)
  • Independent Living Facilities (ILFs)
  • Home Health Agencies (HHAs)
  • Personal Care Providers

Experience

  • Bundled payments
  • Certificate of Public Need (COPN)/Certificate of Need (CON)
  • Corporate and facility contracting
  • Data protection and cybersecurity
  • Electronic Medical Records (EMRs)
  • False Claims Act (FCA) advice and defense
  • Fraud and Abuse (Anti-Kickback Statute and Civil Money Penalties) and Stark Law
  • Government agency insured financing programs (Fannie Mae, Freddie Mac and FHA HUD)
  • Health Insurance Portability and Accountability Act of 1996 (HIPAA) advice and audits
  • Internal investigations
  • Labor and employment
  • Litigation
  • Medicare and Medicaid appeals
  • Mergers and acquisitions
  • Partnerships
  • Real estate
  • Reimbursement (Medicare, Medicaid and private payor contracts)
  • Software IT contracts
  • Surveys and certification
  • Tax
  • Telemedicine

The following is a sampling of our lawyers’ experience.

  • Reopened three-year-old adverse Medicaid reimbursement decisions to obtain reclassification of providers into a higher peer group. 
  • Negotiated changes to Medicaid nursing home payment system regulations and policies on behalf of affected providers and provider associations.
  • Handled multiple provider reimbursement appeals through the administrative process and negotiated settlements of reimbursement disputes. 
  • Represented a home care agency through an appeal of Medicaid audit findings and retractions. 
  • Sought legislative relief on Medicaid reimbursement issues for nursing facilities. 
  • Represented hospice and home health companies and other home and community-based services providers in appealing alleged Medicaid overpayments, seeking the correction of auditing errors by government contractors and significant reductions in the alleged overpayments.
  • Advised a post-acute care hospital and nursing facility in Virginia on an investigation of potential overpayment and compliance matters.
  • Navigated steps to address the discovery by a provider of management services to the long-term care industry of an ongoing billing issue at an assisted living facility in North Carolina.
  • Regularly perform internal investigations at senior living facilities for facility quality assurance purposes and for potential survey or certification issues. Work closely with management and staff to manage urgent situations.
  • Represented many nursing facilities in preparing for and responding to survey and certification issues, including handling informal dispute resolution appeals. 
  • Represented a nursing home challenging survey findings through the Independent Informal Dispute Resolution (IIDR) process and appeal to the Departmental Appeals Board. 
  • Represented long-term care facilities in the appeal of adverse findings arising out of state and federal licensure and certification surveys, seeking the removal of citations, a reduction in the severity or scope, or a reduction in civil penalties.
  • Conducted internal investigations arising out of significant regulatory and billing compliance issues, employee misconduct, and allegations of fraud or abuse, enabling clients to take appropriate corrective action and avoid or minimize civil or criminal liability. 
  • Represented buyers or sellers of senior living facilities in numerous sales and acquisition transactions, negotiating business terms and handling reimbursement and regulatory requirements. 
  • Represented an owner/operator of 10 long-term care facilities located in two Southeast states in a $72 million sale-leaseback to a national REIT. 
  • Represented an operator in a $16 million acquisition of multiple nursing facilities and the simultaneous closing of a $20 million term loan facility and a $4.5 million working capital facility.
  • Represented an owner/operator in a $7 million sale of a CCRC.
  • Represented a seller in a $10 million sale of leasehold interests and operations of 12 long-term care facilities located in two Southeast states.
  • Represented an operator in a $13 million acquisition of three SNFs in the Northeast and the sale-leaseback of such facilities to a REIT.
  • Handled numerous COPN matters for Virginia nursing facilities, including applications to replace and relocate outdated nursing homes. Typical representation includes advising clients on pre-application strategies, preparing and handling COPN applications throughout the process and responding to competitor or regulator challenges. 
  • Assisted a nursing home with obtaining a COPN to establish a new nursing home through the relocation of beds from two existing nursing homes.
  • Argued for the Commissioner’s case decision awarding a COPN to establish a new nursing home to be affirmed in the Court of Appeals.
  • Sought a CON approval for a new, 100-bed skilled nursing facility in North Carolina and coordinated the submission of State-required Progress Reports on the facility’s development.
  • Advised nursing home and ALF clients on how to pursue facility renovation and upgrade projects to enhance their operations and improve resident quality of care in North Carolina while avoiding the need for a CON review.
  • Served as outside contracts counsel for national nursing facility, hospice and ancillary provider companies, drafting and negotiating enterprise-wide and facility-level agreements. Worked directly with general counsel and senior business leaders to provide contracting advice on arrangements that require knowledge of core business, reimbursement and regulatory issues. 
  • Developed new forms of resident agreements for a provider of management services to the long-term care industry for its ALFs to ensure compliance with applicable requirements, increase flexibility and efficiency in resident admissions and discharges and provide the client with mechanisms to resolve issues.
  • Assisted long-term care facilities and hospice companies in the negotiation of health plan provider agreements seeking more favorable business terms and strengthened legal protections.
  • Advised a Virginia hospital and hospice provider regarding regulatory and contracting issues.
  • Advised long-term care facilities, ALFs and HHAs on licensure and regulatory issues.
  • Assisted a post-acute care hospital and nursing facility in Virginia with medical staff by-laws, entity by-laws, a compliance plan and governance documents.
  • Assisted a provider of assisted living, skilled nursing and long-term care and hospice and home health care in Virginia with developing HIPAA compliant forms and policies.
  • Counseled a home health care company on legally-appropriate responses to various forms of HIPPA breaches involving facilities throughout North Carolina.
  • Represented minority stockholders in a suit seeking the liquidation and sale of a nursing home chain provider.
  • Advised skilled nursing facilities on the regulatory requirements relating to a Change of Ownership (CHOW). 
  • Advised long-term care facility operators on the corporate practice doctrine relating to therapy services across the United States. 
  • Assisted a post-acute care hospital and nursing facility in Virginia in developing a supplemental executive retirement plan (SERP) and executive compensation matters. 
  • Assisted a post-acute care hospital and nursing facility in Virginia with the establishment of a tax-exempt foundation for fundraising and charity grants. 
  • Served as bond counsel and restructuring counsel for a CCRC tax-exempt and taxable refunding bond financing issued through the Virginia Small Business Financing Authority for a provider of assisted living, rehabilitation therapy and home care services, in accordance with the Borrower’s Plan of Reorganization and exit from its Chapter 11 bankruptcy proceeding.
  • Provided government affairs services, including assistance with legislation and budget issues for long-term care clients.
  • Represented an ALF in North Carolina in appealing a penalty imposed upon the facility for resident misconduct.
  • Assisted a hospice facility that was operated by a hospital system with planning and executing a reasoned response to a resident with a tendency to leave the facility through the use of a motorized wheelchair.