Health Care
Practice Area Chair:
Aaron J. Besen
503.227.1111 Main
503.972.4253 Direct

Health Care

Long-Term Care and Senior Housing

Our lawyers specialize in providing legal services to long-term care and senior housing providers.  We work with the full spectrum of this industry, including skilled nursing facilities, assisted living and memory care facilities, independent living facilities, home health agencies, hospice, therapy providers, and LTACHs.  We routinely represent landlords (including REITs), tenants, providers, and management companies.   

We have a robust regulatory and transactional practice.

Our lawyers work with clients in the acquisition and divestiture of both the real estate and operations of long-term care facilities and related businesses in Oregon, Washington, California, Idaho, Montana, and Nevada.  We act as borrower's counsel with respect to real estate, account receivable, Fannie Mae, and HUD financing transactions, and often work as local real estate and licensure counsel.  We also work to purchase facilities out of bankruptcies and receiverships.

We complete and submit licensure applications and also counsel providers regarding licensing issues, including revocation, denial, and imposition of conditions on licenses.  We prepare effective resident admission agreements, resident handbooks, and policies and procedures. We also handle complex resident discharge and transfers. Our lawyers are also skilled at helping providers assess risk, develop risk management strategies, and comply with resident rights and duties under state and federal law.

We advise and train on compliance with evolving laws and regulations, including HIPAA, the Anti-Kickback Statute, and local and federal regulations.

We also offer effective collection of accounts receivables and know how to navigate collection issues specific to long-term care.

Health Care Professionals and Other Providers

We represent other healthcare professionals with formation and governance of healthcare entities. 

We regularly defend professionals before regulatory governing boards and state and federal agencies. 

Our lawyers are also skilled in providing advice on employment issues specific to healthcare businesses, including employment agreements, advice and training concerning hiring, evaluations, compensation, background checks, discipline and discharge, leave laws, and other employment issues. 

Our areas of expertise include:

  • Purchase and Sale of Healthcare Businesses and Real Estate
  • Operations Transfer Agreements
  • Management Agreements
  • Health Care Facility Leases
  • Health Care Finance
  • Non-Compete Agreements
  • Health Care Regulatory Issues (Anti-Kickback, Stark, federal and state regulatory agencies)
  • Resident Discharge and Transfers
  • HIPAA Compliance
  • Collections for Long-Term Care Facilities
  • Arbitration Agreements
  • Residency and Admission Agreements
  • Resident Handbooks
  • Policies and Procedures for Long-Term Care Providers
  • Risk Management and Risk Management Agreements
  • Strategies to Handle Agency Investigations
  • Defense against Agency Actions and Appeal of Civil Monetary Penalties
  • Agency Investigations and Actions against Adult Foster Home Providers
  • Physician Employment Agreements
  • Defense of Health Care Executives and Owners from Resident Care Claims
  • Defense before Professional Boards (Medical, Nursing, Nursing Home Administrator, Dental, and Naturopath)
  • Health Care Contract Drafting and Disputes
  • Bankruptcy and Receivership Issues for Health Care Companies
  • Distressed Sales and Acquisitions
  • Accountable Care Organizations
  • Recoupment Issues  

Representative Work
$65 Million Sale of Four Senior Housing Campuses
We represented the owners of four Oregon assisted and independent living campuses managed by Grayco, LLC in the sale of those campuses to Spring Living, a McMinnville-based senior housing operator.  The facilities are located in Lake Oswego, Sherwood, Wilsonville, and The Dalles. 
Bankruptcy of Hospital
We represented a community group in a Chapter 11 bankruptcy of an acute care hospital and were instrumental in causing a replacement hospital to be constructed.
Collections of Accounts Receivable
We successfully collected over $2 million for health care facilities from individuals, state agencies, probate and protective estates, and health insurance companies.
Employment Claim Defense
We defended a long-term care facility against discrimination claims brought in federal court by a terminated nurse assistant. The court granted the facility's motion to dismiss all of the former employee's claims, with prejudice.
ESOP Transaction
We represented EmpRes Healthcare Group, Inc., and its affiliates, with the sale by the shareholder of 100% of the stock in the company to an Employee Group Stock Ownership Trust. This transaction involved one of the first 100% ESOPs in the long-term care field.
Health Share of Oregon Coordinated Care Organization (CCO)
We represented Multnomah County with respect to the formation of the Tri-County Coordinated Care Organization. 
Hospital Acquisition
We represented doctors in the acquisition of a hospital and related securities issues.
Line of Credit Facility
We represented an affiliated group of borrowers in a $25 million line of credit facility primarily secured by accounts receivable.
Nursing Home and Residential Care Transaction
We represented the seller/lessor in a transfer of operations and the lease of a campus with a skilled nursing facility and residential care facilities.
Nursing Home Purchase Transaction
We represented the buyer in the acquisition of a management company that had management agreements with four skilled nursing facilities in California.
Nursing Home Sale and Leaseback Transaction
We represented the seller/lessee in a sale leaseback transaction of 10 skilled nursing facilities in Washington, Oregon, California, and Nevada.
Nursing Home Sublease Transaction
We represented the sublessor in the sublease and transfer of operations of five skilled nursing facilities and one assisted living facility in Arizona.
Training Health Care Staff
We provided training to administrators, admissions staff, business office managers, and operations managers regarding admission issues and collection strategies.