Long Term Care / Senior Living
Facing profound generational changes, the industry has reinvented itself. And is now one of the most regulated. We were prepared.
Overview
Arent Fox represents operators, owners, managers, developers, lenders, and other capital providers across the gamut of the senior living industry, including skilled nursing, assisted living, continuing care, retirement and independent living facilities. Our clients range in size from regional operators to large publicly traded businesses. Our transactional and regulatory lawyers work as an integrated team to assist our clients in every aspect of their businesses ranging from acquisitions, dispositions and financings of both senior living companies and individual senior living facilities to advising our clients on operational and regulatory matters that impact the senior living sector.
To learn more about our Senior Living Practice Group, click below:
Real Estate
Arent Fox’s depth and breadth of knowledge of the senior living industry across several practice groups enables us to provide more than just real estate services to clients – we understand our clients’ business and we understand the regulatory and compliance issues that impact their business. These insights allow us to help our clients navigate the challenging senior living care landscape and to better position our clients for success, no matter where their business intersects the law.
Real estate plays an integral part of the senior living industry and Arent Fox has established itself as a go-to firm for clients that need both strategic real estate services and an in-depth knowledge of the senior living regulatory environment. We have represented purchasers, sellers, investors, managers, borrowers and lenders in some of the largest real estate transactions in the senior living industry. Over the past six years, we have been a part of numerous portfolio transactions, each over $200 million, and, separately, have handled the acquisition, development and sales of over one hundred properties, valued at over $1 billion, for a single client.
We handle all aspects of acquisitions and divestitures by companies transferring ownership or control of independent living, assisted living, skilled nursing and other long-term care facilities and related businesses. This includes extensive expertise in the negotiation of purchase, sale, financing, restructuring, leasing, development and management agreements related to single-asset projects as well as large portfolios in multistate transactions. We also handle complex financing, refinancing, loan modification and restructuring transactions related to distressed projects.
Representative Transactions
Arent Fox has represented its senior living clients in numerous real estate and corporate related transactions. The following projects and transactions provide a glimpse into the depth and breadth of our senior living practice.
- Financing
- Purchase and Sales
- Joint Ventures and Development
- Management and Leasing
- All Representative Transactions
Regulatory
Health care is one of the most highly regulated industries in the United States, and Arent Fox has expertise in navigating this challenging landscape. We advise clients on the regulatory implications of dispositions and acquisitions of senior living facilities and senior living companies. The senior living team’s regulatory lawyers work to ensure that sale/leaseback arrangements, the provision of health care services to senior living facility residents, and vendor/service agreements are structured appropriately under applicable law.
We assist clients in satisfying applicable state licensure requirements, Medicare/Medicaid regulations, federal and state fraud and abuse standards, corporate practice guidelines and fee-splitting laws. To this end, we have developed contacts in regulatory agencies across the country. Among other regulatory services we provide is assisting clients with Medicare/Medicaid enrollment and reimbursement issues to minimize successor liability and cash flow problems. We counsel providers on federal and state survey and certification processes, including analysis of deficiencies, informal dispute resolution, plans of correction, and strategies for dealing with follow-up surveys. In sum, our regulatory lawyers provide on a daily basis effective counseling on the full range of regulatory issues faced by our senior living clients.
Compliance
Arent Fox provides compliance counseling on federal and state health care regulation to meet our clients' needs in assessment, adherence and avoidance. Our services include counseling in fraud and abuse, including the civil and criminal defense of fraud-related allegations, conducting internal investigations, and developing corporate compliance programs. We evaluate provider operations and offer suggestions for correcting deficiencies. We perform legal audits to determine if long term care facilities and affiliated entities comply with the requirements of Medicare and Medicaid programs. We conduct compliance reviews of documents and assessments of compliance program issues. We provide training services to our clients’ employees geared to long term care issues and perform “spot check” audits and due diligence compliance reviews for clients growing through acquisitions. We assist clients with audits of security systems for electronic health information and ensuring compliance with Health Insurance Portability and Accountability Act (HIPAA) security standards. To this end, we offer a model compliance program that allows health care providers to implement the most important aspects of HIPAA privacy standards cost effectively. Our regulatory lawyers work with our clients to ensure their business remains compliant with legal requirements and, when clients are not compliant with such requirements, our regulatory lawyers work with clients to address the non-compliance in an efficient manner.
Operations
Arent Fox acts as primary outside general counsel to several of the nation's largest senior living providers, and we are experts on the day-to-day operation of senior living facilities. Our regulatory lawyers advise clients on billing and reimbursement, risk management, employment disputes, internal corporate governance and structure, managed care contracting, information technology, record management, construction, resource contracting and finances. We negotiate on behalf of our clients management agreements for the management of nursing homes, assisted living facilities and independent living facilities. Finally, our lawyers are expert in transitioning operations of senior living facilities from one operator to another.
Litigation
We represent clients before administrative and judicial forums dealing with survey and certification appeals, informal dispute resolution, coverage and reimbursement appeals, individual and institutional licensure hearings. Arent Fox has more than 70 litigators skilled in the arts of advocacy and dispute resolution and a team of trial lawyers who have won verdicts in state and federal courts throughout the country. We also have an active appellate practice and have successfully argued cases before state and federal appellate courts and the United States Supreme Court.
Bankruptcies, Restructurings and Workouts
Arent Fox has represented parties in virtually every relationship in bankruptcy reorganization and liquidation, as well as in the restructuring of debt through out-of-court workout agreements. We were appointed special counsel in the Integrated Health Services case, one of the largest and most complex reorganizations in the health care industry. We serve as bankruptcy counsel to a large regional nursing home operator and 26 of its subsidiaries and affiliates in bankruptcy cases pending in the United States Bankruptcy Court for the District of Utah.
Our secured creditor representations include Chapter 11 cases of Sun Healthcare Group and Mariner Healthcare Group. We have represented secured creditors of long-term care companies in Chapter 11 proceedings pending in bankruptcy court and have assisted them in restructuring relationships with reorganized debtors who have emerged from bankruptcy. We have also been actively involved in out-of-court workouts and restructurings involving senior living companies.
© 2012 ARENT FOX LLP