Long-Term & Post-Acute Care Providers


The “aging of America” puts new pressures on long-term care facilities and other post-acute providers to furnish ever more innovative care. New care delivery models emphasize aging-in-place wherever possible. Backed by the resources of a full-service law firm, Dykema lawyers provide comprehensive guidance on myriad regulatory, transactional, litigation, and ethical issues facing this intensely scrutinized sector of the health care industry.

Dykema long-term care attorneys have a “soup to nuts” understanding of this rapidly expanding industry. Importantly, we know the impact that our evolving society has on the industry—such as the effect of advanced age, chronic illness, technological innovations, federal and state financial belt-tightening, and changes in the supply of health care workers. To help our clients manage and respond to these and other challenges, our services combine thorough assessment of options and strategies, strong work ethic, thought leadership and client advocacy. Our long-term care attorneys’ leadership-level involvement in industry-related trade associations and professional groups keeps us on the cutting edge of industry developments—knowledge that we pass on directly to our clients. Our strong relationships with state and federal regulators often help us negotiate creative and strategic solutions to our clients’ issues and problems.

Dykema is recognized for its track record of success serving the full spectrum of long-term care and post-acute provider clients. This includes nursing homes, homes for the aged, adult foster care facilities, unlicensed assisted living facilities, continuing care retirement communities (CCRCs), senior housing, post-acute rehabilitation services, PACE providers, home health agencies and hospices. Among the types of services we provide these clients:

  • Certificate of Need (CON) and strategic planning for business ventures

  • Change of Ownership (CHOW) matters, including drafting/reviewing sale, merger and acquisition documents, performing due diligence, negotiating transactions, closing deals and advising on regulatory compliance

  • Obtaining and retaining State licensure, including options to operate legally as an unlicensed facility

  • Medicare/Medicaid certification and compliance, including development of compliance plans and proactive advice regarding Stark, anti-kickback, false claims, and OBRA ’87 operational obligations

  • Medicare/Medicaid survey, certification and enforcement matters, including IDRs and DAB appeals

  • Defending against Attorney General, OIG and DOJ fraud and abuse and vulnerable adult abuse investigations and formal charges

  • Defending administrative and civil litigation

  • Counsel regarding third-party payment and overpayment matters

  • Structuring joint ventures between hospices and home health agencies

  • Legal issues raised by establishing and operating hospice residences

  • Living Care Disclosure Act registrations for CCRCs

  • Proactive advice regarding Fair Housing and ADA nondiscrimination obligations and reasonable accommodations, and defense of HUD and DOJ noncompliance investigations and formal charges

  • Tax exempt bond financings, private equity financings, and HUD financings

  • Obtaining and retaining tax exempt status, including community benefit plans and documentation, real property tax appeals, governance and excess benefit issues

  • Drafting and reviewing operational contracts, including physician relationships, managed care, SNF-hospice, SNF-ESRD, resident agreements, general management agreements, and vendor relationships

  • Resident/patient rights, including end-of-life decision-making and clinical ethics, behavioral health, information privacy and security, guardianship/conservatorships, visitation, refusal of care and services, management of psychotropic medications, proper use of restraints, and resident/patient autonomy and involvement in care planning

  • HIPAA/HITECH policies, procedures, business associate agreements, audit readiness advice, breach notification compliance, and defense of noncompliance complaints and investigations by OCR

  • Employment and unionization matters, including NLRA compliance