Industries & Practices

Long-Term Care

Long-Term Care

    We are a leading provider of legal services to long-term care providers, including skilled nursing facilities, nursing facilities and assisted living facilities. 

    Our team has significant experience in the vast legal and regulatory issues affecting long-term care providers. We advise them on regulatory matters (including Certificate of Need (CON), licensure, certification, sales and acquisitions, bed right values, franchise permit fees and space requirements), reimbursement (including the evaluation of potential overpayments and reporting and refunding overpayments in compliance with the 60-Day Rule), contracts, resident agreements, corporate structuring, transactions, fraud and abuse, arrangements with other providers (including referral sources), HIPAA and HITECH privacy and security, surveys, audits and compliance programs (including policies and procedures, training and investigation of possible noncompliance).

    Bricker's health care team regularly counsels long-term care providers on topics that include the following:

    • Nursing home licensure
    • Medicare and Medicaid certification
    • Accreditation surveys and corrective action plans
    • Medicare, Medicaid and third-party payer reimbursement; receivables consulting
    • Medicaid hearings and appeals
    • Compliance with the Medicare Conditions of Participation and other state and federal requirements that affect the operation of skilled nursing facilities and nursing facilities
    • Operational policies and procedures
    • Compliance program elements (policies and procedures, training, investigations and audits); self-disclosures to the appropriate governmental, oversight or accreditation agency regarding an issue of potential noncompliance
    • Billing and payment regulations; assistance with overpayment refunds to comply with the 60-Day Overpayment Refund Rule
    • Federal and State Anti-Kickback Statutes and Stark (physician self-referral) Laws
    • Drafting and/or review of medical director and employed physician contracts as well as vendor agreements
    • Structuring arrangements, reviewing and negotiating contracts with other providers including hospices and therapy providers
    • HIPAA investigations, audits and training
    • Resident agreements
    • Labor and employment issues
    • Strategic planning
    • Corporate formation, restructuring and governance issues
    • Membership substitutions, mergers, acquisitions and joint ventures
    • Capital financing, including taxable and tax-exempt revenue bond and HUD loans
    • Tax-exempt status and compliance issues
    • Real estate transactions and leasing

    In addition, through our affiliated consulting company, INCompliance Consulting, we assist with:

    • Space requirements and conversion of space for nursing home and assisted living use
    • Meeting assisted living licensure requirements and waiver regulations
    • Preparation and submission of CON applications and support throughout the CON process, including administrative hearings, if needed
    • Bringing providers together to relocate long-term care beds
    • Assisting with the negotiation of terms for bed transfer agreements
      • Advising on values for bed rights
      • Meeting licensure and certification requirements throughout the planning and implementation of long-term care bed sales and acquisitions
      • Negotiating the allocation of franchise permit fees associated with bed sales and acquisitions
      • Advising on the timing for de-licensure/licensure of relocated beds to minimize franchise permit fee liability