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Polsinelli Shughart PC is one of the nation’s leading providers of legal services to long-term care and senior housing -- two of the most dynamic areas of health care today. Providers face tremendous challenges, from strained and uncertain government payments for services to increased regulatory pressure and unprecedented realignments in the delivery of care.

Polsinelli Shughart’s Long-Term Care and Senior Housing practice group has the knowledge and experience to help providers navigate through these challenges. We understand the long-term care and senior housing industries, so we are able to offer comprehensive representation and creative solutions for providers. Our attorneys are dedicated to representing skilled nursing facilities, assisted living facilities, continuing care retirement communities and providers of independent senior housing. We represent clients across the country including the largest national providers as well as regional and local providers. We have extensive experience representing nonprofit organizations.

We act as partners with our clients in maintaining compliance with state licensing requirements and federal certification requirements. We assist clients in responding to surveys, contesting allegations, appealing findings of non-compliance, and resolving regulatory issues with government agencies.

We regularly provide our clients with immediate counseling in emergency situations and assistance with crisis management. We advise on removing Immediate Jeopardy situations, conducting incident investigations, implementing appropriate responses, resolving disputes with residents and families, and resident discharges. Our services help our clients to maintain regulatory compliance and limit liability. We also offer training to facilities and staff to assist with ensuring on-going compliance. We prepare, review, and advise on Residency Agreements, vendor and ancillary services contracts, and facility policies and procedures. We also have extensive experience with the Life Safety Code and assist with identifying and implementing necessary actions to achieve compliance with the Life Safety Code.

Administrative and Civil Litigation
We aggressively defend providers against enforcement actions taken by government agencies and have successfully represented our clients in a broad range of regulatory matters, including state licensure hearings and federal hearings on CMS certification remedies. Additionally, we pursue appeals of administrative decisions in state and federal civil courts. We have successfully appealed adverse decisions by a variety of regulatory agencies. We have obtained injunctive relief and receivership for distressed facilities.

Labor and Employment Law
We assist our clients with all aspects of labor and employment issues, both in litigation and advice/counseling. We have extensive experience dealing with union organizing campaigns, decertifications and handling a wide variety of labor issues including contract negotiation and labor arbitration/mediation. We defend our clients against discrimination and harassment claims as well as wage and hour class actions. Our attorneys manage labor and employment litigation skillfully and cost effectively.

Transactions Related to Long Term Care and Senior Housing
We provide sound legal and business advice to our clients when they pursue a transaction. This includes assisting the client in completing real and meaningful due diligence and ensuring that the corporate legal expertise is properly matched with regulatory expertise to ensure that a transaction is completed efficiently and favorably to our client.

Medicare and Medicaid Certification and Reimbursement
We assist our clients with federal Medicare and Medicaid certification, including applications and renewals. We also have extensive experience with reimbursement, and we regularly counsel clients on coverage issues, cost reporting, and responding to audits. We have assisted clients in all aspects of the audit process, from preparing for audits to appealing audit findings and fighting recoupment actions.

Certificate of Need and Facility Development
We have successfully represented a large number of clients in applying for Certificates of Need and Certificates of Exemption for new construction, expansion projects, and sales of facilities. Once a certificate is granted, we continue to advise our clients and assist with permit compliance throughout the project, including amending or revising a Certificate. We also assist with new developments, from real estate acquisition and zoning to Certificate of Need permits and on to initial licensure and certification. We perform transactions for clients involving purchase and sale of facilities and change of ownership approvals. We also prepare, review, and advise on management/operations agreements.

Fraud and Abuse and Corporate Compliance
We help long-term care and senior housing providers prevent health care fraud and abuse by developing effective compliance programs. We also assist with responding to fraud and abuse investigations and audits, including criminal investigations. We help clients identify potential pitfalls in their current policies and relationships as well as in their plans for future growth.

Fair Housing Act Compliance
We have successfully defended a number of senior housing providers against claims of Fair Housing Act violations brought by the Department of Justice. We advise clients regarding compliance with the federal Fair Housing Act as well as State and local statutes and regulations. We assist clients in reviewing and amending operations and policies for compliance with the Fair Housing Act and applicable federal laws prohibiting discrimination. We also provide staff training on Fair Housing Act compliance.

Medicaid Waiver Programs
We have extensive experience in assisting clients in the application for participation in Medicaid waiver programs to provide assisted living. We also have lobbied for clients in the development of various waiver programs.

Lobbying
Polsinelli Shughart's attorneys offer clients federal and state lobbying for industry regulation and reforms as well as representation of long-term care and senior housing providers before government, consumers, and other industry groups. Our lobbyists are actively connected to the legislative process. They also have first hand knowledge of the inner workings of the various state and federal agencies that impact this industry on a daily basis.

A decision by the Ninth Circuit Court of Appeals is likely to set a strong precedent and create a difficult landscape for defendants in HIPAA cases in the future.

Certain tax rules apply to the ownership and use of Bond Finance Property. Join us May 15 for a complimentary webinar titled, "Private Use of Bond Financed Property."

A report to Congress by the Centers for Medicare and Medicaid Services indicates many providers are taking advantage of the Stark Law Self-Referral Disclosure Protocol (SRDP) as a viable path to resolve outstanding liabilities and to mitigate potential penalties under the Stark Law. However, it also highlights that resolution under the SRDP can be a slow process.

March 28, 2011	Missouri Society of Health Care Attorneys Selects Polsinelli Shughart Attorney as Vice President
December 8, 2010	Chicago Lawyer Matt Murer Chosen to Lead National Health Care Group
September 30, 2010	Dreams come true for lawyer who wanted to bring event to Chicago

May 15, 2012	Protected Health Information Case Sets Strong Precedent For HIPAA Compliance A decision by the Ninth Circuit Court of Appeals is likely to set a strong precedent and create a difficult landscape for defendants in HIPAA cases in the future.
May 7, 2012	WEBINAR - Private Use of Bond Financed Property Certain tax rules apply to the ownership and use of Bond Finance Property. Join us May 15 for a complimentary webinar titled, "Private Use of Bond Financed Property."
April 13, 2012	WEBINAR: Medicaid Managed Care in an Era of Expansion Join us May 1 for a complimentary webinar on compliance issues related to providing services in the era of Medicaid expansion.
April 11, 2012	CMS Reports to Congress on the Stark Law Voluntary Self-Referral Disclosure Protocol A report to Congress by the Centers for Medicare and Medicaid Services indicates many providers are taking advantage of the Stark Law Self-Referral Disclosure Protocol (SRDP) as a viable path to resolve outstanding liabilities and to mitigate potential penalties under the Stark Law. However, it also highlights that resolution under the SRDP can be a slow process.
March 20, 2012	ABA Stark & Anti-Kickback Toolkit Now Available The new Stark & Anti-Kickback Toolkit is now available from the American Bar Association Health Law Section. Polsinelli Shughart Health Care Shareholder Joan Killgore is a member of the Editorial Board that undertook the project to help fill a void in available research tools.
February 28, 2012	CMS Expects Enhanced CNA Training - Dementia Care & Abuse Prevention The Centers for Medicare & Medicaid Services released a memo that explains the new training requirements for skilled nursing facilities imposed by the Patient Protection and Affordable Care Act of 2010.
Feburary 27, 2012	CMS Releases Proposed Rule for Meaningful Use Stage 2 The Centers for Medicare and Medicaid Services placed on display a proposed rule for Stage 2 of the Electronic Health Record Incentive Program.
February 27, 2012	Illinois Proposes Cutting Medicaid Expenses by $2.7 Billion During the Next Fiscal Year Illinois Governor Pat Quinn is calling for a restructuring of Medicaid in Illinois and proposed cuts during the state's 2013 fiscal year totaling $2.7 billion.
February 23, 2012	Webinar -- Hospital / Physician Alignment Strategies To Perform Well Under Health Reform This complimentary hour-long webinar will discuss the changing reimbursement paradigm as well as some of the ways providers can affiliate with physicians to improve reimbursement.
February 10, 2012	Obama Administration Announces Further Exemptions for Religious Organizations from Contraceptive Mandate On February 10, 2012, President Obama announced a revised policy to enable qualifying religious employers to not offer contraceptive coverage under their health insurance plan based on their organization's religious beliefs, but instead will allow women covered under their employer's plan to obtain free contraception coverage directly from their insurance companies if their employers don't provide such coverage otherwise.
January 31, 2012	WEBINAR -- Fraud and Abuse: A Year in Review Health care providers continue to face high leveles of scrutiny from CMS, a variety of auditors and recovery contractors, and state and federal law enforcement. Polsinelli Shughart Shareholders Jeffrey Fitzgerald and Daniel Reinberg will present a free webinar February 21, 2012, on "Fraud and Abuse: A Year in Review."
January 13, 2012	Mandatory Compliance Plans for Skilled Nursing Facilities Are Coming Section 6102 of the Patient Protection and Affordable Care Act of 2010, as amended by the Healthcare Reconciliation Act 2010 (the Healthcare Reform Law), created a mandatory requirement for skilled nursing facilities to establish a compliance and ethics program as a condition of participation in the Medicare, Medicaid and CHIP programs by the end of 2012.
December 19, 2011	IRS Reminds Hospital Organizations of 2011 Filing Requirements The Internal Revenue Service (IRS) has released a draft version of the 2011 Form 990, Schedule H, Hospitals and its instructions.
December 6, 2011	2012 Health Care Regulatory Update Join us in Denver January 10 for the 2012 Health Care Regulatory Update. Hear Polsinelli Shughart presenters speak on significant legal and regulatory changes that are important to health care facilities.
December 6, 2011	HHS Office of the Inspector General Releases 2012 Work Plan The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) issued its FY 2012 Work Plan recently, which outlines the new and ongoing reviews and activities that the OIG plans to pursue with respect to HHS programs and operations.
December 2, 2011	New CMS Program Promises Funding For Providers' Innovative Care Delivery Models The Health Care Innovation Challenge is a funding opportunity for compelling new models of delivery and payment that hold the promise of better health, better health care and lower costs for Medicare, Medicaid and the Children's Health Insurance Program.
November 14, 201	U.S. Supreme Court To Take Up Health Reform Challenges The U.S. Supreme Court announced today it will hear a legal challenge to the Patient Protection and Affordable Care Act (PPACA), President Obama's health reform legislation Congress enacted in March 2010.
November 4, 2011	Accountable Care Organizations: Summary of Final Regulations Click on the link for a high-level summary of the Final Rules related to Section 3022 of the Patient Protection and Affordable Care Act and the "shared savings" program. In addition you may access a recording of a webinar presented by Polsinelli Shughart Health Care attorneys on the Final Rule.
October 25, 2011	Webinar: Final ACO Rules Explained Join us for a webinar Monday, October 31, focused on the important changes made to the CMS final rules to implement Accountable Care Organizations.
August 15, 2011	Department of Health and Human Services Issues Proposed Rule on Consumer Operated and Oriented Plan On July 18, The Department of Health and Human Services issued a proposed rule to implement the Consumer Operated and Oriented Plan (CO-OP) program (CMS-9983-P). This program will provide loans to capitalize consumer-governed, private, nonprofit health insurance issuers to enable them to offer qualified health plans by means of Affordable Insurance Exchanges (Exchanges). There is to be at least one CO-OP in every state in order to expand the number of health plans available in the Exchanges, which are scheduled to commence operations in 2014.
July 29, 2011	IRS Issues Notice on Community Health Needs Assessment Requirements The IRS has issued guidance on the community health needs assessment (CHNA) requirements imposed on tax-exempt hospital organizations.
July 14, 2011	Credentialing and Privileging of Telemedicine Providers: CMS Final Rule The Centers for Medicare and Medicaid (CMS) released its final rule making changes to Medicare Conditions of Participation for hospitals and critical access hospitals to create a new process for the credentialing and privileging of telemedicine practitioners.
June 22, 2011	New Proposed HIPAA Privacy Rule Impacts Accounting of Disclosures Requirements The Department of Health and Human Services has released a notice of proposed rulemaking (NPRM) to implement the statutory requirement under the Health Information Technology for Economic and Clinical Health Act. HHS is seeking comments from the public through August 1, 2011, which will be considered by HHS prior to finalizing the new requirements.
May 13, 2011	Final Rule for Value-Based Purchasing Released The Federal Register published the Final Rule regarding the implementation of the hospital value-based purchasing (VBP) program after the Centers for Medicare & Medicaid Services released the Final Rule in April 2011. Hospitals must act now if they wish to have the greatest chance at reimbursement under the VBP program.
April 25, 2011	Key Uncertainties of the Proposed ACO Rule The proposed rule implementing the Medicare Accountable Care Organization (ACO) Program (also referred to as the Shared Services Program) raises many questions and concerns among healthcare stakeholders.
April 6, 2011	The Who, What, When and How of ACOs This e-Alert contains a summary of the basic design elements of Accountable Care Organizations (ACOs) as set out in the Centers for Medicare & Medicaid Services proposed rule implementing the Medicare Shared Savings Program.
March 15, 2011	HIPAA Enforcement: The Government Means Business Recent events signal that the government was not bluffing in signaling increased enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was enacted as part of the American Recovery and Reinvestment Act of 2009, emphasis was put on increased enforcement of HIPAA by providing for a tiered increase in the penalties that may be levied against an entity that violates HIPAA. Penalties could run between $100 and $50,000 for each violation, and $25,000 and $1.5 million per year.
January 19, 2011	BNA Health Law Reporter Interviews Polsinelli Shughart Attorney Douglas Anning On Trial Income and Tax Exemption
January 19, 2011	Medicare Proposes New Hospital Value Based Purchasing Program The Centers for Medicare & Medicaid Services issued a proposed rule regarding Medicare's Value Based Purchasing (VBP) Program to reward hospitals for providing high quality, safe patient care. Hospitals must act now if they wish to have the greatest chance at reimbursement under the VBP Program.
December 1, 2010	CMS Finalizes Rules Requiring Equal Visitation Rights For Hospital Patients The Centers for Medicare and Medicaid Services released the final rule on hospital visitation that allows patients to designate their own visitors during a hospital stay. The rule, which will apply to any hospital that participates in Medicare or Medicaid, will go into effect January 16, 2011.
November 3, 2010	No Flushing Allowed: EPA Issues Guidance On Disposal of Unused Pharmaceuticals The Environmental Protection Agency (EPA) recently issued a draft guidance document describing methods for health care faculties to legally manage and dispose of unused pharmaceuticals and avoid violating federal or state laws.
September 10, 2010	Court of Appeals Rules Against Illinois Department of Public Health On August 20, 2010, the Illinois Court of Appeals confirmed that the Illinois Department of Public Health (IDPH) faces a mandatory time frame to determine a licensure violation after a survey. Anytime a facility receives a notice from IDPH of state licensure violations and fines, the facility should carefully check the dates and time frame of IDPH's determination.
August 23, 2010	Illinois Health Facilities and Services Review Board Developments In recent weeks, there have been a number of reports and developments relating to the Illinois Health Facilities and Services Review Board (the CON Board) including new CON Board member appointments and the issuance of two reports which the CON Board is now mandated to produce and disclose to the public.
July 23, 2010	Illinois Department of Public Health Issues Proposed Amendments To Hospital Licensing Requirements On June 18, 2010, the Illinois Department of Public Health issued a Notice of Proposed Amendments to the Hospital Licensing Requirements, which implements two statutes enacted by the Illinois General Assembly in 2009.
July 20, 2010	Final Meaningful Use Regulations Released The Centers for Medicare and Medicaid Services (CMS) have released the Final Rule for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program (the Meaningful Use Final Rule). Simultaneously, the Office of the National Coordinator for Health Information Technology (ONC) released its Final Rule addressing certification criteria for EHRs (the Certification Criteria Final Rule). These two Final Rules establish what criteria and technical standards constitute the meaningful use of EHR technology and establish eligibility for incentive payments.
July 8, 2010	Cutting It Close - President Obama Signs Law Delaying Medicare Physician Payment Cut On June 25, 2010, President Obama signed The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 into law. The Act provides a six-month delay of earlier legislation which, effective June 1, 2010, imposed a 21 percent reduction in reimbursement under the Medicare Physician Fee Schedule (MPFS). The Act also increases MPFS reimbursement by 2.2 percent through November 30, 2010.
May 25, 2010	Joint Commission Standard MS.01.01.01 On March 18, 2010, the Joint Commission issued the revised Medical Staff standard MS.01.01.01, which was originally known as MS.1.20. This standard addresses the governance structure of the Medical Staff and its accountability to the hospital's Governing body.
May 7, 2010	Illinois Legislature Passes Nursing Home Care Act Reform - What Providers Need to Know Now On May 7, 2010, the Illinois Legislature passed Senate Bill 326, which includes significant changes regarding how Illinois nursing homes are regulated. This bill is a response to the report done by the Task Force Governor Quinn formed following a series of negative news stories in the Chicago Tribune regarding Illinois nursing homes. The majority of these changes affect all nursing home providers. The critical provisions that all providers should be aware of include, but are not limited to, high risk designation for regulations, double fines and staffing requirements. Click through to read details on all the changes you should be aware of.
04/29/2010	View A Playback Of The Health Care Reform and Tax-Exempt Organizations Webinar Bruce R. Hopkins and Douglas K. Anning of Polsinelli Shughart's Nonprofit Organizations group presented a special webinar April 29 on the landmark Patient Protection and Affordable Care Act and its implications for nonprofit organizations. Click on the headline above and follow the instructions to view the webinar in its entirety.
04/16/10	Health Care Reform and Tax-Exempt Organizations The landmark Patient Protection and Affordable Care Act signed by President Obama has relevance for nonprofit organizations, principally hospitals. The new developments in the tax-exempt arena may leave organizations struggling to understand and comply. Bruce R. Hopkins and Douglas K. Anning of Polsinelli Shughart's Nonprofit Organizations group have analyzed the new legislation and will share important implications for your nonprofit organization in a special complementary one-hour webinar event April 29.

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