Long-Term Care Facilities

Long-term care facilities have come under increasingly intense scrutiny from federal and state enforcement authorities with respect to both quality-of-care and regulatory compliance. Balick & Balick has extensive experience providing long-term care facilities with compliance counseling in all aspects of their operations, as well as representing them in health care fraud investigations and litigation and medical malpractice defense.

Our attorneys are routinely called upon to advise long-term care facilities regarding issues such as operational requirements mandated by federal and state fraud and abuse laws, Medicare and Medicaid conditions of participation, state licensure requirements, staff education and training mandates, and HIPAA. Balick & Balick also regularly counsels clients regarding incident reporting; investigation of allegations of abuse, mistreatment, neglect or financial exploitation of residents; and responding to survey deficiencies, including representation in informal dispute resolution with the state Medicaid survey agency.

Representative Matters:

• Analyze survey reports, make recommendations to long-term care facilities in response to survey findings, and represent facilities in informal dispute resolution before the Division of Long Term Care to challenge survey findings.
• Represented a long-term care facility in connection with an investigation by the Delaware Medicaid Fraud Control Unit into Medicaid “add-on” claims that the government alleged were fraudulently submitted.
• Developed an investigative procedure for a nursing home network seeking to implement uniform protocols for internal investigations to comply with state and federal timeliness and documentation requirements.
• Implemented a compliance program for a nursing home group. Drafted Mission Statement, policies and procedures; trained all employees and the Board of Directors; and provided ongoing guidance to newly hired compliance officer.