Nursing Home & Health Law

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bulletRepresentation of Nursing Homes and Residents in regards to Medicare and Medicaid issues, finding the right nursing home for the client, and other related matters that concern the relationship between the patient and the nursing home facility.

 

bulletThe healthcare industry is heavily regulated and we recognize the need of providers to respond effectively and efficiently to regulatory requirements. Our attorneys have extensive experience in regulatory maters. We are committed to analyzing a rapidly and frequently changing regulatory environment and keeping our clients advised of regulatory changes affecting their operations. We conduct educational seminars on statutory and regulatory changes sponsored to different healthcare providers.

Admission Agreements and Policies

We have assisted providers in developing nursing facility, personal care and other agreements which facilitate compliance with regulatory requirements for admission and care. We are familiar with the many regulations governing relationships between providers and resident/patients. We have participated in developing policies for healthcare providers to comply with discrimination laws in the admission and transfer and discharge process.

Medicaid Certification and Bed Expansion

Our attorneys work with providers and their consultants and accountants to acquire regulatory approvals necessary for the expansion or development of new healthcare services and facilities. We are familiar with the regulatory process and the regulators, and we work to resolve Medicaid Certification issues expeditiously. We recognize that the viability of a project depends on the prior approval of state agencies who must approve any bed expansion or replacement. Sound business judgment often requires the avoidance of litigation over bed expansion or replacement because of its potential adverse consequences and corresponding delay in any project development. Where, however, litigation is unavoidable, we provide aggressive and practical representation. We also assist our clients in obtaining Certification applications to add new or replacement beds from the Department of Public Welfare, where those applications are appropriate for the proposed market area, as well as objecting to such applications where those applications are inappropriate for the proposed market area.

End of Life Termination Decisions and Advance Directives

Our firm has followed the development of the law in the area of self-determination in the dying process. We have assisted providers in responding to the Patient Self-Determination Act and the Advance Directive for Healthcare Act. We have assisted providers in making delicate decisions about the withdrawal of life sustaining treatment in difficult circumstances. We have provided guidance to providers in developing ethical committees and practical responses to the challenges of ever-expanding technology which preserves life beyond natural means. W also are familiar with and sensitive to conscious objection and possible moral constraints in developing policies on the withdrawal of life sustaining treatment, particularly nutrition and hydration. We have conducted seminars on Advance Directives for our clients and have assisted them in formulating policies to deal with this complex and problematic area of law.

Acquisitions

We also are familiar with the issues related to the acquisition or sale of healthcare facilities for both non-profit and for-profit and have acted as special or corporate counsel in numerous transactions. We work to structure transactions to enhance Medicare/Medicaid reimbursement and streamline payment.

General and Corporate Counsel

The Law Office of W. Craig Knaup represents a number of institutional healthcare providers. We are familiar with the general corporate and business issues which every business, including healthcare providers, must confront. We have assisted in restructuring some of our clients to better position them for the risks and challenges of a changing healthcare delivery system. We have helped to reorganize the corporate structure of some of our clients to enhance their ability to participate in joint enterprises or diminish the risk associated with expanding into new service areas.

Home Health, Adult Day Care, and Community Based Services

We can assist our clients in both acquiring and developing home health agencies and community based service organizations. We are familiar with the regulatory and reimbursement framework governing the delivery of home health, adult day care, and community based services.

Licensure and Certification

Our office is familiar with requirements for participation in the Federal and State reimbursement programs. We have assisted providers in obtaining and maintaining required licenses and certifications in the delivery of regulated healthcare services. In long-term care, we take pride in our familiarity with the survey and enforcement process. We have assisted providers in responding to both state and federal regulators, and in resolving alleged deficiencies. We have followed closely the new survey and enforcement system, and have provided educational seminars on the new enforcement system for the provider community. We have been instrumental in assisting providers to successfully utilize the informal dispute resolution process. We recognize the sound business sense of resolving survey disputes amicably without relinquishing the merits of a provider's position, and while preserving a provider's appellate rights. We bring to our clients familiarity with the regulations, the survey process, the regulators and the administrative appeal process. The broad experience we have gained from assisting providers through the difficult survey process is available to our clients.

Managed Care

Our attorneys have assisted providers in developing contractual relationships with managed care plans and are familiar with the contractual nuances and risks associated with managed care contracts. As providers adapt to the growth of managed care and its increasing market penetration, we are able to negotiate and structure relationships designed to integrate the provider into selected managed care networks which are beneficial to the provider.

Medicare/Medicaid Reimbursement

The Law Office of W. Craig Knaup has successfully litigated Medicare and Medicaid reimbursement appeals before the Provider Relations Review Board, the HCFA Administrator, DPW's Bureau of Hearings and Appeals, and the Board of Claims. The Firm has also handled numerous appellate court matters for its clients, both in the Commonwealth Court and the Pennsylvania Supreme Court. The Law Office of W. Craig Knaup has also handled administrative appeals and regulatory matters in New Jersey.

Strategic Planning

We can assist providers in considering the legal and related aspects of responding to the changing healthcare delivery system. We can also assist providers in developing plans to deal with the changing delivery system and to overcome the legal challenges associated with positioning a facility for its best possible future economic position.

Subacute and Rehabilitation Services

We have worked with providers in developing subacute and transitional care units, including obtaining exemptions and exceptions to the Medicare routine cost limits. We have worked with providers in negotiating managed care agreements which recognize the need to reimburse higher acuity care at higher rates. We are familiar with the reimbursement and regulatory framework governing hospital based skilled nursing facilities and rehabilitation hospitals. We have assisted providers in planning to take advantage of the growing subacute, transitional care market.

Collections

As an integral part of its health care practice, The Law Office of W. Craig Knaup is dedicated to providing effective collection services at a reasonable cost. Experienced attorneys, knowledgeable of important federal and state laws and regulations limiting health care provider collection activities in both New Jersey and Pennsylvania, guide our clients safely and efficiently through the health care collection process. We are experienced in utilizing Pennsylvania’s Interim Assistance regulations to obtain for our clients every advantage in obtaining Medical Assistance eligibility for their residents. In matters not involving Medical Assistance, we strive to provide our clients with aggressive, high quality representation, as governed by the Fair Debt Collection Practices Act, and to obtain the highest debt collection possible at the lowest possible cost.

 

Please click on the Elder Law section for additional relevant information.

 

 

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