In December 2024, the Centers for Medicare & Medicaid Services (“CMS”) made many revisions to its “Guidance for SNF Attachment on Form CMS-855A” (“Guidance”). The Guidance is CMS’s subregulatory advice and FAQs to skilled nursing facilities (“SNFs”) on the completion and submission of the new Form CMS-855A SNF Disclosures Attachment (“SNF Attachment”) for every SNF. The Guidance continues to confirm the due date for all SNFs to submit the off-cycle revalidation information is May 1, 2025, unless an exception
Continue Reading Revisiting Disclosure Requirements for Skilled Nursing Facilities as Deadline Approaches
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Weekly Hospital Real Estate Briefing: Mayo Clinic to Invest $1.9B in Phoenix Campus | Developer Proposes New Chicago Bears Stadium | Webinar on Hospital Ground Leases
Executive Order Restricting Gender-Affirming Care for Minors: Litigation Update and Analysis
On January 28, 2025, President Trump issued Executive Order 14187 entitled “Protecting Children from Chemical and Surgical Mutilation” (the “Executive Order”), which sets forth administration policies opposing the provision of gender-affirming care to minors and directs agencies and certain federal health care programs to limit access to such care through measures including halting federal grant funding to medical institutions that provide gender-affirming care to minors.
As described in greater detail below, the Executive Order is being challenged
Continue Reading Executive Order Restricting Gender-Affirming Care for Minors: Litigation Update and Analysis
CMS Issues Guidance on Relocation of Physician-Owned Hospitals
Last month, the Centers for Medicare & Medicaid Services (“CMS”) issued a rare Stark Law Advisory Opinion, concluding that a physician-owned hospital (“Hospital”) seeking to relocate eight miles from its current location and add an emergency department would continue to satisfy the Stark Law’s Whole Hospital Exception (“Exception”). This is one of several CMS Advisory Opinions providing helpful guidance to physician-owned hospitals, but the first CMS Advisory Opinion to be issued since December 2021.
The Exception requires, among
Continue Reading CMS Issues Guidance on Relocation of Physician-Owned Hospitals
H-1B Cap Lottery: What You Need to Know for the FY 2026 Season
For thousands of skilled foreign professionals, the H-1B classification provides a pathway to work in the United States. However, with a strict annual limit, or cap, of 65,000 H-1B visas—plus an additional 20,000 reserved for those with advanced U.S. degrees—the demand for H-1B status far exceeds the available supply. As a result, the U.S. Citizenship and Immigration Services (“USCIS”) uses a lottery system to determine which applicants may file an H-1B petition.
The H-1B cap initial registration period for
Continue Reading H-1B Cap Lottery: What You Need to Know for the FY 2026 Season
Understanding the Fourth Circuit’s Ruling on the First-to-File Rule in FCA Cases
On February 14, 2025, the United States Court of Appeals for the Fourth Circuit (the “Court” or “Fourth Circuit”) issued a significant ruling in United States ex rel. Rosales v. Amedisys North Carolina, clarifying how the first-to-file rule applies to qui tam actions under the False Claims Act (“FCA”). The Court determined that the first-to-file rule must be assessed on a claim-by-claim and defendant-by-defendant basis, considering all properly filed complaints.
Background of the Case
Relator Rosales filed a qui
Continue Reading Understanding the Fourth Circuit’s Ruling on the First-to-File Rule in FCA Cases
Federal Court Slashes $448 Million False Claims Act Penalty, Citing Eighth Amendment
In United States of America ex rel. Cheryl Taylor v. Healthcare Associates of Texas, LLC, the U.S. District Court for the Northern District of Texas (the “Court”) upheld a jury verdict finding Healthcare Associates of Texas, LLC (“HCAT”) liable under the False Claims Act (“FCA”). However, in a significant ruling for health care providers facing FCA scrutiny, the Court substantially reduced the provider’s penalties after finding the FCA’s statutory civil penalty unconstitutionally excessive under the Eighth Amendment.
Background
Following
Continue Reading Federal Court Slashes $448 Million False Claims Act Penalty, Citing Eighth Amendment
Nursing Home Update: CMS Extends Implementation Date of Surveyor Guidance Changes in Appendix PP
On March 7, 2025, the Centers for Medicare & Medicaid Services (“CMS”) posted a memo dated March 10, 2025, that gives nursing homes and surveyors more time to prepare for implementation of new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes.
On November 18, 2024, the Quality, Safety & Oversight Group at CMS issued a memorandum entitled “REVISED: Revised Long-Term Care (LTC) Surveyor Guidance: Significant revisions to enhance quality and oversight
Continue Reading Nursing Home Update: CMS Extends Implementation Date of Surveyor Guidance Changes in Appendix PP
Skilled Nursing Facility Employee Loses Appeal: A Closer Look at the Fact-Specific Considerations in a Pretext Analysis
On March 5, 2025, the United States Court of Appeals for the Sixth Circuit (the “Sixth Circuit” or “Court”) in Bashaw v. Majestic Care of Whitehall, LLC affirmed the United States District Court for the Southern District of Ohio’s (the “District Court”) grant of summary judgment, finding the reasons for an employee’s termination were not pretextual. The employee was terminated from her non-clinical position at a skilled nursing facility and claimed the reasons for her termination were “pretext” for
Continue Reading Skilled Nursing Facility Employee Loses Appeal: A Closer Look at the Fact-Specific Considerations in a Pretext Analysis
Indiana Court of Appeals Affirms Regular Commitment of M.M. for Grave Disability
In Re: Commitment of M.M., (24A-MH-2046), the Indiana Court of Appeals (the “Court”) upheld the trial court’s order indefinitely committing M.M., ruling that sufficient evidence supported the finding that M.M. was gravely disabled. The decision underscores the legal standards for civil commitments and highlights the role of patient insight and independent functioning in determining grave disability.
Background
M.M., diagnosed with schizoaffective disorder, arrived at the mental health facility in July 2024 with stab wounds and severe psychiatric symptoms.
Continue Reading Indiana Court of Appeals Affirms Regular Commitment of M.M. for Grave Disability
Health Provider News
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- 37% of hospitals still losing money
- 550 rural hospitals join Microsoft’s cybersecurity program
- AHA, others file amicus brief opposing J&J 340B rebate model
- Amazon One Medical CEO steps down after less than two years
- American Board of Medical Specialties rejects cardiovascular board
- CMS issues Stark law guidance for physician-owned hospital
- CMS rescinds Medicaid’s health-related social needs guidance
- Federal judge blocks NIH grant funding cuts
- FTC forms new antitrust task force
- HHS scraps transparency practices for policymaking
- Industry Groups
Weekly Hospital Real Estate Briefing: JLL Predicts Double-Digit Outpatient Volume Growth | Half of Rural Hospitals Operating at a Loss
Commercial Loan Basics
Most transactional attorneys will encounter deals that involve commercial loans. But what does that mean, exactly, and what are the basics that such attorneys should know, even if they do not have primary responsibility for drafting or reviewing loan documents? This article addresses the basics, including what a commercial loan is, what types of commercial loans are available and the difference between a secured and an unsecured loan.
What is a Commercial Loan?
A commercial loan is debt-based financing,
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Private Equity Deal Spotlight | Weekly Update
Health care continues to drive private equity (“PE”) activity, creating opportunities for investors and traditional health care providers. Transactions in the health care space are especially complicated, layering health care regulatory and reimbursement considerations on top of a complex securities, antitrust, privacy and security framework.
Hall Render’s PE team of attorneys and advisors leverage the strength and depth of our bench to navigate and efficiently execute PE transactions. The summary below includes highlights of recent PE deals and legislative
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Post-Acute Compliance Program Update: OIG Recommendations on Medical Director Agreements and Roles
On November 20, 2024, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (“Nursing Facility ICPG”) for nursing home members of the health care compliance community. Motivating factors for issuing the Nursing Facility ICPG included long-standing issues such as medical director agreements and roles and other compliance and quality issues.
Nursing Facility ICPG
The Nursing Facility ICPG describes risk areas for nursing
Continue Reading Post-Acute Compliance Program Update: OIG Recommendations on Medical Director Agreements and Roles
Michigan’s Legislature Makes Last-Minute Revisions to Amend the Earned Sick Time Act
As explained in our previous post, Michigan’s Earned Sick Time Act (“ESTA”) was set to take effect on February 21, 2025. However, late on February 20, 2025, the Michigan Legislature passed House Bill 4002 to amend the ESTA. Governor Whitmer signed the amendment into law on February 21, 2025, and it went into immediate effect.
Key Changes in the Amended ESTA
The amended ESTA introduces several major changes, which include, but are not limited to, the following:
- Employees