Polsinelli 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. Recognizing that providers face tremendous challenges from strained and uncertain government payments for services to increased regulatory pressures, we aim to provide straightforward legal advice that helps our clients anticipate risks, identify opportunities and make fully informed decisions for the benefit of their long-term care organizations.

Polsinelli’s Long-Term Care and Senior Housing practice applies its extensive knowledge and experience to help providers navigate these challenges. Our firm is dedicated to maintaining a deep understanding of the long-term care and senior housing industries, so that we may offer comprehensive representation and creative solutions for providers. Our attorneys represent clients across the country including the largest national providers, as well as regional and local providers and nonprofit organizations, including:

  • Skilled nursing facilities
  • Assisted living facilities
  • Continuing care retirement communities
  • Providers of independent senior housing

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

Our team is also equipped and regularly provides clients 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 ongoing compliance. We prepare, review and advise on residency agreements, vendor and ancillary services contracts, and facility policies and procedures. We also have extensive experience assisting clients with identifying and implementing necessary actions to achieve compliance with the Life Safety Code.

Polsinelli's Real Estate practice also has nationwide depth and experience in health care related real estate transactions. The real estate group serves a variety of clients operating in the senior living space, including developers, operators, REITs, nonprofits, local governments (including City and County housing authorities), tax credit investors and lenders. Our real estate attorneys represent both lenders and developers utilizing conventional, LIHTC and HUD senior housing finance programs, including the HUD Section 202 and 232 Programs, HUD Section 8 Project Based Housing Assistance Payments Program, HUD’s Mark to Market Program, and the USDA Rural Development Part 1942 Community Facilities Direct Loan and Grant Program.  We have experience with all levels of care and community types from independent senior housing to Continuing Care Retirement Communities. We also have experience with sale–leaseback transactions as well as REIT transactions with a RIDEA structure.

Polsinelli's finance attorneys also have extensive experience representing both lenders and borrowers in financing transactions for taxable and tax-exempt long-term care and senior housing providers across the country, including revolving lines of credit and term loans (both unsecured and those secured by real estate and/or business assets, including Medicare and Medicaid receivables), bridge-to-HUD loans, HUD-intercreditor arrangements, construction loans, and bond direct purchase and underwriting transactions. Polsinelli’s multidisciplinary approach to health care finance transactions benefits from a diverse collaboration of attorneys and other professionals who understand the business implications behind regulatory compliance and licensing issues facing long-term care and senior housing providers.

In addition, our firm provides guidance and counseling in the following areas:

Related Capabilities
Affordable HousingHealth Care LitigationHealth Care Real EstateHealth CareHome Health, Home Care & HospiceHospitals & Health SystemsPhysician OrganizationsTax Credit Finance
Publications
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Investors are betting big on senior housing. There’s just one problem—the baby boomers they’re chasing can’t pay the rent
Jared Rothkopf discusses how the aging baby boomer population is fueling growing investor interest in senior housing, creating what many see as a major long-term opportunity in real estate. He notes that increasing demand for assisted living, independent living and other senior-focused communities is driving capital into the sector as developers and investors prepare for the coming “silver tsunami.” Rothkopf also emphasizes that despite strong demographic tailwinds, investors must carefully navigate operational challenges, financing pressures and evolving resident expectations to successfully capitalize on the market’s projected growth. (subscription required)
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CMS Issues a Proposed Rule Impacting Quality Reporting, Care Compare and MDS Requirements for Skilled Nursing Facilities
Key Takeaways: CMS has proposed FY 2027 SNF PPS updates, including a 2.4% payment increase and changes to quality reporting and data submission. The proposal also removes certain COVID-19 measures and updates Care Compare reporting. The proposed changes would expand reporting obligations and accelerate submission timelines for skilled nursing facilities, potentially increasing administrative burden and compliance risk. Providers should assess the impact on operations and reporting processes and consider submitting comments before the June 1, 2026 deadline. The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule updating the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for FY 2027. The proposed rule signals CMS’ continued shift toward tighter reporting timelines, broader data collection and reduced reliance on pandemic-era quality measures
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