Healthcare services

Long-term care and senior living


In recent years, the long-term care and senior living industries have seen increased regulatory pressure, market-driven consolidation and a shift in consumer demands and the types of services expected. As the environment for long-term care and senior living has grown more complex, so have the legal issues associated.

We bring national experience developed over several decades representing numerous healthcare providers, including independent senior living, assisted living and skilled nursing facilities, and continuing care retirement communities. Our experience and expertise ranges from day-to-day operations to out-of-the-ordinary transactions, such as a sale or reorganization.

Our services to long-term care and senior living clients include:

  • Accreditation and licensure
  • Benefits and qualified retirement plans 
  • Corporate governance and planning
    • Planning for expansions, restructuring and other changes – and the tax consequences of each option
  • Counsel to providers in payment controversies with private and commercial payors before:
    • Fiscal intermediaries
    • Provider Reimbursement Review Board
    • Recovery audit contractors
    • Administrative law judges
    • Medicaid integrity contractor
  • Compliance and minimizing fraud and abuse risk in relation to:
    • Medicare and Medicaid anti-kick-back laws
    • Stark I and II laws
    • Similar state laws
  • Criminal and civil defense actions involving alleged violations of fraud and abuse laws.
  • Data privacy and cybersecurity
    • Complying with state and federal notification laws, including:
      • Health Insurance Portability and Accountability Act
      • Health Information Technology for Economic and Clinical Health Act
  • Financing matters, including:
    • Tax-exempt bond financing
    • Bank credit facility borrowing
    • Day-to-day working capital facilities
  • Labor and employment
  • Litigation
  • Mergers and acquisitions
  • Nonprofit and 501(c)(3) status tax issues
  • Payor disputes and reimbursements
    • Advise on reimbursement matters, including Medicare, Medicaid, TriCare and commercial reimbursement matters
    • Representation in negotiations with payors
    • Assistance  in the review and negotiation of hardware/software and billing contracts.
  • Real estate transactions
  • Regulatory matters, including disclosure requirements and change in ownership for assisted living and skilled nursing care facilities
  • Restructurings, including out-of-court workouts and reorganizational action plans
  • Risk assessment and management
  • Tax-exempt matters
    • Structuring of business relationships with private individuals or taxable entities
    • Limitations imposed on contracts 
    • Establishment of tax exempt foundations
    • Serving as hospital counsel for several tax-exempt bond issuances
    • Representation before the IRS
    • Assistance with 501(c)(3) health systems obtaining  IRS Office approval of evolving healthcare structures



Richard S. Cooper profile image

Richard S. Cooper

Shawn M. Riley profile image

Shawn M. Riley

Todd C. Baumgartner profile image

Todd C. Baumgartner

Christopher B. Hopkins profile image

Christopher B. Hopkins

Representative Matters
  • Representation of a large CCRC in negotiating its separation from a large hospital system and commencing operations as an independent entity. In this representation, the firm also negotiated the terms of various financing agreements, which included $14.28 million of hospital facility bonds and approximately $36 million of bank financing.
  • Development of HIPAA and fraud and abuse compliance plan for hospitals, long-term care facilities, physicians, laboratories and other healthcare facilities and providers.
  • Restructuring a CCRC, resulting in the successful confirmation of a chapter 11 plan of reorganization.
  • Representation of a creditors’ committee for a CCRC that filed for chapter 11 relief, which included negotiating with parties in interest to secure a distribution to the unsecured creditors and the continued operation of the CCRC.
  • Representation of long-term care facilities, hospitals and physicians in employment litigation, including claims of race, age, sex and handicap discrimination.
  • Representation of long-term care facilities, hospitals, physicians and other healthcare facilities and providers in the defense of professional liability and tort claims.
  • Sales of assisted living facilities to various purchasers.
  • Representation of two Ohio-based distressed nursing facilities in the successful sale and transition of operations.
  • Preparation of residential contracts of long-term care facilities.