National Healthcare Law

Long-Term Care Facilities

• Residential Care Facilities
• Intermediate Care Facilities
• Skilled Nursing Facilities
• Continuing Care Retirement Communities
• Hospices
• Assisted Living Facilities
• Independent Living Facilities

Faced with ever-increasing demand for its services and the aging of the baby-boomer generation, the long-term healthcare industry stands poised to grow dramatically in coming years. At the same time, providers confront a complex, shifting regulatory environment and often challenging relationships with payors and staff. Nelson Mullins's experienced healthcare attorneys understand the unique needs of our long-term healthcare clients and provide a full array of services. We guide our clients through complicated matters such as:

• Facility development and expansion, including assistance with construction contracting and financing, as well as coordination of the construction timetable with obtaining facility licenses and certificates of need (when required);
• Outsourcing to a third party management company, including a working knowledge of market terms and conditions relating to duties and compensation;
• Financing arrangements and tax planning, drawing upon experience on the lender side and borrower side in structuring secured mortgage- and cash flow-based financing; tailoring financial and other covenants to the reimbursement cycle and overhead needs of a long-term care facility;
• At the planning stage, compliance with state and federal regulatory requirements such as certificate of need review and licensure and certification—working closely, for example, with North Carolina's Division of Health Service Regulation, Georgia's Department of Community Health and the South Carolina Department of Health and Environmental Control to secure approval for long-term care facility clients;
• Advising on ongoing compliance with state licensing laws and federal conditions of participation and accreditation standards —including assistance with re-surveys, plans of correction and removal of tags in a re-survey;
• Providing advice on the requirements of state and federal laws such as HIPAA, Stark, fraud and abuse and anti-kickback statutes;
• Billing arrangements with governmental and third-party payors, counseling on issues such as prospective vs. cost-based payment, consolidated billing, provider enrollment and managed care contracting agreements; and
• Staff management, including negotiation of employment contracts, assistance with benefits structuring and provision, and resolution of workplace-based claims.