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Overview

We are in the midst of the greatest senior “population boom” in history—and it is not only the numbers that are unprecedented. The way that this generation is aging is also unique.  Demands for active lifestyles, intellectual stimulation, and broader community connection are paired with real innovation in the creation of housing and communities designed for this vital cohort. Hinckley Allen is highly attuned to the needs of those serving this market—particularly in the senior living sector, where so many of the disciplines our firm is known for intersect, such as real estate, corporate & governance, health care, financing, taxation, and construction.

Solid representation in a dynamic environment.

Our Senior Living team is proud to represent senior living facilities from traditional continuing care retirement communities to more innovative small home models as well as stand-alone nursing homes and assisted living facilities across the Northeast and beyond. We make sure our clients are well represented in all aspects of their businesses, from complex corporate structures to financing, development, and construction—right through to regulatory and administrative matters.  We advise on resident issues and agreements, employee/labor law, payer matters (including fraud and abuse), healthcare regulation, and many other matters—so our clients can focus on managing their core businesses with confidence.

Services

The broad array of services we offer to our senior living clients at all phases of their lifecycle includes:

Corporate Structures and Transactions

Establishing and managing an enterprise in the senior living industry often involves sophisticated transactions and agreements surrounding the establishment of an enterprise serving seniors.  We ensure these transactions are executed efficiently and comprehensively.  We advise on all legal matters, including:

  • Nonprofit, for-profit, and hybrid nonprofit/for-profit joint ventures
  • Branding and intellectual property rights
  • Mergers and acquisitions
  • Affiliations and partnerships (including among providers and payers)
  • Tax-exempt bond and other financing arrangements
  • Professional service agreements

Real Estate Matters

We represent senior living organizations in connection with real estate matters both regionally and nationally, including:

  • Real estate expansion programs
  • Land acquisitions
  • Leasing
  • Environmental matters
  • Land-use permitting

Financing, Construction, and Development

Our lawyers represent lenders and borrowers in the full range of construction and real estate financing transactions, and asset-based lending throughout the United States, including:

  • Complex multistate financings
  • Large portfolios of properties regionally and nationally

Senior Living Operations

The daily operation of a senior living facility involves a myriad of legal matters—any of which can have a significant impact.  We work diligently to protect our clients’ businesses in critical matters, including:

  • Residency agreements
  • Admissions policies and agreements
  • Tax-exempt and charitable organization matters
  • Corporate governance
  • Labor and employment law
  • Healthcare reform initiatives
  • Healthcare delivery issues, including telemedicine, genomics, and clinical research matters
  • Payer contracts
  • Reimbursement issues
  • Payment in lieu of property tax (PILOT) negotiations 

Regulatory Compliance

Every day, senior living operations face new regulations and oversight.  Whether you’re working to influence new laws, or facing court action around current regulations, our team is at your side. As the rules change and evolve, we work to make sure your interests are preserved and protected.  We can help with:

  • HIPAA/HITECH, Stark law, fraud, and abuse
  • Affordable Care Act compliance and state law issues
  • Regulatory investigations, repayment determinations, self-reporting, and settlement
  • Legislatively mandated insurance programs
  • Clinically integrated networks (e.g. FQHCs and other community health providers)
  • Licensing and certificate-of-need matters
  • Professional licensing board disciplinary matters
  • Reimbursement program participation and payment issues
  • Policy review and revision for federal and state law compliance
  • Cy pres and mission-deviation petitions

Experience

Assisted Living Facility in East Greenwich, RI

We represented an assisted living facility for seniors in East Greenwich, Rhode Island in its formation and establishment. The facility is owned and operated by a nonprofit entity governed by a board comprised of representatives of two long-term care facilities (skilled nursing homes). We remain counsel to the organization and provide advice on a regular basis.

Formation of Parent and Subsidiary Corporations (Non-profit)

We helped a nonprofit corporation create a new parent company and potential new subsidiaries.  The company operates a continuing-care retirement community.

Negotiation for Member-Substitution Agreement

We advised a continuing care retirement community and its parent company in negotiating a member substitution agreement with another continuing care retirement community and obtaining required regulatory approvals. The affiliation was completed in July, 2016 and we continue to advise the parent company regarding integration, tax-exempt bond financing, and governance matters.

Acquisition of Two Continuing Care Retirement Communities in Illinois

We represented a national senior living developer, investor, and operator in connection with its acquisition of two CCRCs located in Illinois.  The facilities are owned and operated by for-profit entities and managed by a national senior living provider.  We remain counsel to both communities and provide advice on a regular basis, including in connection with day-to-day operational matters and strategic planning.

Financing of Skilled Nursing Component of a Continuing Care Retirement Community

We represented a continuing care retirement community in connection with a multi-million dollar construction financing to fund the construction of its skilled nursing facility.

Restructure of Financings for a Continuing Care Retirement Community

Starting in 2001, we represented a national senior living developer, investor, and operator in connection with its development of a CCRC.  The project was constructed in phases and we represented the CCRC in each phase of its financings and restructuring of its debt, including most recently in 2016 with a mortgage modification and mezzanine loan.  We remain general outside counsel to the community and regularly assist with regulatory filings, disclosure statements, residency agreements, litigation assistance, employee and resident issues, and many other matters.

Merger of Assisted Living Facilities While Preserving Their Missions

Our team provided representation of a nonprofit assisted living facility during its merger with another assisted living facility—guiding the parties in structuring the affiliation as a merger whereby the surviving corporation reflected the combined missions and operations of the parties. We also assisted the parties with issues related to the integration of the operations of the two organizations and consolidation into a single facility. We continue to advise the parties regarding the development of a new continuing care retirement community project.

Complex Merger of Complimentary Health Care Providers

We represented a health and home care services agency and a visiting nurse and hospice care agency in their joint undertaking of a merger. In this role, we guided all parties in identifying their mutual objectives, and prepared all requisite merger agreements and documents. We successfully obtained regulatory approvals and completed the merger within 21 months of the commencement of negotiations.

Disaffiliation of a Home and Hospice Client

We helped a home and hospice care provider disaffiliate from a large healthcare system and provided representation during their conversion to a freestanding entity. We provided counsel during the negotiation of deal terms, representation before the Attorney General’s office on the proposed use of nonprofit foundation assets, and representation before the Department of Health for regulatory approval and transfer of ownership licenses.

Merger of Two State Affiliates of a National Health Organization

Hinckley Allen assisted two state affiliates of a national health organization in structuring their merger and obtaining necessary regulatory and judicial approvals. We helped our clients obtain regulatory approval in a contentious public hearing process before the state Department of Health for change of control and licensing of a healthcare facility. We secured approval from the state Attorney General for the transfer of charitable assets and modification of a charitable trust. We conducted successful negotiations with trust beneficiaries and prevailed in judicial proceedings to obtain court approval of a cy pres petition regarding the charitable assets and trust.

Healthcare Real Estate Experience

Hinckley Allen provides ongoing representation of a national senior living developer, investor, and operator consisting of four CCRCs with various real estate transactions, ranging from leasing, financing, acquisition, and disposition of real property, development, and other related matters.

Real Estate Financing Experience

We represented a Boston-based opportunity fund in negotiating a joint venture agreement for the development of a high-end residential community in South Carolina.

Case Studies

Represented The Prospect-Woodward Home in Its Sale of a Nonprofit Continuing Care Retirement Community

Hinckley Allen represented The Prospect-Woodward Home ("Prospect-Woodward"), a nonprofit organization that commenced operations of a senior living facility in 1874. When the Prospect-Woodward Board of Trustees recognized that its facility no longer met the…

Newsroom

Publication

CMS Announces New Proposed Rules for Disclosure of Nursing Facility Ownership

February 17, 2023

On February 13, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule affecting Medicare skilled nursing facilities (SNF) and Medicaid nursing facilities (“Nursing Facilities”).  The proposed rule aims to implement cer…

Publication

Staying Curious: A Conversation with Jared Shwartz, Partner

February 6, 2023

Jared L. Shwartz brings a collaborative, inquisitive approach to his practice. As a corporate and business attorney, Jared’s ability to work with clients large and small has given him a broad background in a myriad of industries. Recently elevated to par…

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