Schedule

• Post-acute and long-term care provider types (facility-based and home-based)
• Current and future demographics, industry history, and current trends
• Federal and state licensure, certification, oversight, and enforcement
• Structures, terms, timing, and considerations pertaining to post-acute provider transactions

Violence in long-term care (LTC) facilities—whether resident-to-resident, staff-to-resident, resident-to-staff or a third-party—poses serious risks to safety, dignity, and quality of care. This session will explore AI technology-based solutions and challenges, active shooter swatting hoaxes, the root causes of violence in senior living health care settings and present evidence-based strategies for prevention and response. Drawing on legal, clinical, and operational perspectives, the presentation will offer practical tools for administrators, care providers, and policymakers to foster safer, more respectful environments for both residents and staff.

• Innovative solutions and tools available such as video surveillance weapon detection
• Harassment as a form of workplace violence and liability under Title VII
• Identification of common types and causes of violence in senior living facilities
• The legal and regulatory implications of violence in care settings including potential labor and employment issues
• Proactive approaches to staff training, resident engagement, and environmental design
• How to implement trauma-informed care and behavioral health support
• Review case studies and best practices for violence prevention and crisis response

• Deep dive with an SVP of Value Based Care and legal counsel to a national post-acute care provider into the legal and operational issues associated with Value Based Enterprise (VBE) care coordination arrangements among hospitals, long term care facilities, home health, hospice, and other home-centered care providers
• VBE arrangements can lower health care costs, improve care coordination, and align interests around a value-based purpose, but remain underutilized since OIG and CMS broadened regulatory protections for VBEs in December 2020 as part of the Regulatory Sprint to Coordinated Care
• The legal, regulatory and operational aspects of VBE care coordination arrangements involving hospitals and various post-acute care partners, such as home health agencies, hospices and long-term care facilities
• The critical role of Artificial Intelligence (AI) tools and data-analytics in VBE care coordination arrangements. Explore the challenges and successes in the emerging value-based arena and the emerging role of AI tools and analytics
• Hear from a VP of Value Based Care for a large post-acute care provider who have negotiated and implemented with multiple health systems VBE care coordination arrangements, and the importance on obtaining alignment among health care executives, legal teams, clinical and operational leaders for VBE arrangements
• Effective ways to ensure fraud and abuse risks are mitigated with a perspective on how government authorities may approach VBE arrangements

• Overview of the actions that impact provider enrollment and billing, and their differences
• While termination, deactivation, and suspension were previously thought to be reserved for the most egregious conduct, these actions are being taken against facilities and HH/hospice providers in unexpected circumstances
• How to avoid termination, deactivation, and suspension
• What can be done when facing a termination, deactivation, and suspension
• With Medicare Advantage and Medicaid MCOs now playing a bigger role in Medicare/Medicaid, this presentation will include a discussion of provider rights with respect to contract cancellations

This presentation delves into the regulations governing nursing home transfers and discharges, a critical area ripe with compliance challenges and opportunities for providers. Nursing home residents hold appeal rights against involuntary transfers or discharges, and missteps can lead to significant regulatory scrutiny and risks. Teaming up with the Tennessee Long Term Care Ombudsman, this session will provide practical guidance for health law attorneys. The session will review regulations, explore common pitfalls, and identify opportunities to elevate your practices and procedures. We will discuss:

• Revised transfer and discharge regulations and surveyor guidance (F-Tag 627 – inappropriate transfers and discharges and F-Tag 628 – transfer and discharge process)
• Actual citations and enforcement actions related to improper transfers and discharges
• Case studies from the Ombudsman's desk: Practical insights from appeal
• Differences between transfers and discharges in nursing homes versus assisted living settings
• Common errors and implementing strategies to elevate your transfer and discharge processes

Many skilled nursing facilities are unaware of Part B revenue opportunities available. The session will provide an understanding of what services and supplies are billable to Medicare Part B for those nursing home residents not in a Part A stay. The session will primarily focus on:

• Items that me be billed directly by the SNF, DME or other supplier
• Necessary coverage, documentation and billing guidelines
• Reporting and accounting for revenue and expense
• Contractual requirements with outside vendors
• Other hot topics related to Medicare Part B billing
• Provide a framework for managing risks related to contractual relationships, kickbacks, fraud and abuse

Mergers and acquisitions in the health care sector are fraught with unique risks, and cybersecurity is at the top of the list. A hidden vulnerability, an undisclosed breach, or a misaligned security program can destroy deal value, trigger significant legal penalties, and cause irreparable reputational damage. This session will provide a comprehensive roadmap for both buyers and sellers, outlining their respective responsibilities and strategies for managing cybersecurity throughout the M&A lifecycle. We will explore pre-deal due diligence, the crucial role of reps and warranties insurance, and the post-merger integration challenges that can make or break a transaction.

Combatting fraud, waste, and abuse in the health care sector remains a central priority for the Trump Administration. In June 2025, the Department of Justice announced the National Health Care Fraud Takedown (the largest health care fraud takedown in history) which charged over 300 individuals in connection with over $14.6 billion in alleged fraud. Drawing from perspectives in enforcement and compliance, this session will explore how the DOJ is targeting misconduct in the health care sector and provide practical guidance for in-house personnel to strengthen internal controls, identify emerging risks, and respond effectively to government inquiries. The session will include:

• Key themes from the DOJ’s 2025 health care fraud takedown, including notable cases that are relevant for LTC facilities
• Methods the DOJ employs to investigate health care fraud cases, including its expanding use of data analytics and reliance on whistleblowers
• DOJ use of the False Claims Act in enforcement of health care anti-fraud priorities
• Strategies for organizational response to inquiries from the DOJ and OIG
• Practical tips and guidance for in-house personnel to navigate the shifting enforcement landscape and implement robust compliance programs to mitigate risks

• Introduction and overview of clinical research in skilled nursing facilities
• How to implement a research compliance program for your facility
• Overview and review and of billing for research compliance in skilled nursing facilities
• Explanation of the unique aspects of research in skilled nursing facilities
• Common pitfalls and items to avoid when allowing research in a skilled nursing facility
• Receive tools and policies to assist in the implementation of your research compliance program

• More of the Same – False Claims and Kickback continue to be an area of concern
• New Technologies and Service – Remote Patient Monitoring, skin substitutes, and other advancements present new risks for providers
• New Government Priorities – An uptick in revocations is on the horizon
• What’s a Compliance Officer To Do? – Areas of focus for compliance programs

The rare – but public- CCRC bankruptcies over the last few years have raised a resounding and provocative question: What role should states’ laws take in protecting the LPC from bankruptcy? To explore that question, this session will begin with an overview of the current bankruptcy protections provided in some states’ CCRC statutes. Then, an expert panel will discuss the real-world implications when a state must enact its CCRC laws to prevent an LPC bankruptcy, or conversely, where a state’s own CCRC statutes interfered with or worsened an LPC’s fragile financial position. We will discuss:

• The core, common statutory provisions in states’ CCRC laws that aim to protect an LPC from bankruptcy
• Recent-past and current legislative activity that has attempted to react to LPC bankruptcies, and learn the outcomes
• Real-world examples of when a state agency effectively deploys CCRC statute to prevent an LPC bankruptcy, as well as when a state’s statutory environment has worsened an LPC’s financial fragility

This national overview will provide the most current information on the most impactful issues to home health agencies and hospices. Leading up to 2026, we saw proposals for what would have the gravest impact on home health agencies since payment model changes were implemented in 2020. Hospices implemented HOPE, the most significant change to their quality reporting program since its inception with Congressional interest in modernizing the Medicare hospice benefit. The focus on fraud remains intense in hospice and is heating up again in home health. Topics covered in this update will include:

• The 2026 Medicare Home Health Payment Rate Update final rule provisions and cumulative provider impact
• Updates on the Medicare Home Health Value Based Purchasing Demonstration
• Updates on and potential changes for the Medicare Home Health Review Choice
• Demonstration
• Hospice policy and payment updates including
• Medicare Advantage
• Telemedicine prescribing and DEA updates
• HOPE
• Program integrity updates for hospice and home health
• Legislative update for hospice and home health

This session delivers a high-impact snapshot of the most consequential assisted living state licensing shifts in 2025 and what they mean operationally. Using NCAL’s 50-state Annual Regulatory Review, we will isolate the top three regulatory/legislative licensing change areas and show concrete examples of how states are modifying requirements. We will then connect those policy shifts to real-world risk exposure by reviewing senior living liability trends from the CNA Aging Services Report, Liberty Mutual/Ironshore Senior Care Claims Study, the WTW/Willis Senior Living Claims Benchmarking Study - 2025 and the NSO Nurse Liability Report, identifying the liability areas that are driving claims and cost. The session closes with practical, operator-ready mitigation actions—policies, documentation, training, and oversight moves you should implement now, not “monitor.” By the end of this session, participants will be able to:

• Name and explain the top three 2025 state regulatory/legislative licensing change areas identified in NCAL’s 50-state review, and describe why these shifts matter for assisted living operations
• Translate state policy changes into operating requirements (staffing practices, assessment/service planning, documentation, oversight) and identify where non-compliance risk is most likely to surface
• Identify the leading liability trend categories impacting assisted living/senior living using CNA, Liberty Mutual, WTW and NSO findings, including the recurring drivers that escalate events into claims
• Prioritize risk controls that materially reduce exposure—the specific mitigation actions that yield the strongest impact (training, documentation standards, clinical escalation protocols, QA processes, and incident response)

• Notable trends in CMS survey and enforcement activity
• Key developments in CMS regulation of skilled nursing facilities, including the implementation status of rules concerning minimum staffing requirements, disclosure of ownership and management information, and Medicare appeals rights for changes in patient status
• Initiatives from other federal agencies with impact on skilled nursing facilities, including the HHS Office of Inspector General and the Department of Labor
• Outlook for Congressional activity on selected issues affecting the sector in 2026
• Reimbursement and revenue cycle trends across the country

• Common Documentation Pitfalls: Identify frequent errors in long-term and post-acute care records that trigger external audit findings and financial penalties
• Coding Accuracy and Risk Areas: Explore high-risk coding practices and how to align them with current regulatory requirements to withstand auditor scrutiny
• Audit Preparedness Strategies: Learn proactive approaches to prepare for external audits, including internal reviews, staff training, and response protocols
• Billing Compliance and Overpayment Risks: Understand the connection between documentation, billing practices, and overpayment recoupments, and how to minimize risk

The speaker will explore current topics in legal ethics. Participants will be able to:

• Identify and navigate emerging ethical challenges posed by generative AI in legal practice, including issues of competence, confidentiality, and the unauthorized practice of law when using AI tools for research, drafting, and client communication
• Understand recent guidance on protecting client confidentiality, including when filing withdrawal motions
• Understand ethical issues when attorneys contractually agree to limit their discretion
• Identify and explore issues that arise when lawyers act as third-party neutrals

Combatting fraud, waste, and abuse in the health care sector remains a central priority for the Trump Administration. In June 2025, the Department of Justice announced the National Health Care Fraud Takedown (the largest health care fraud takedown in history) which charged over 300 individuals in connection with over $14.6 billion in alleged fraud. Drawing from perspectives in enforcement and compliance, this session will explore how the DOJ is targeting misconduct in the health care sector and provide practical guidance for in-house personnel to strengthen internal controls, identify emerging risks, and respond effectively to government inquiries. The session will include:

• Key themes from the DOJ’s 2025 health care fraud takedown, including notable cases that are relevant for LTC facilities
• Methods the DOJ employs to investigate health care fraud cases, including its expanding use of data analytics and reliance on whistleblowers
• DOJ use of the False Claims Act in enforcement of health care anti-fraud priorities
• Strategies for organizational response to inquiries from the DOJ and OIG
• Practical tips and guidance for in-house personnel to navigate the shifting enforcement landscape and implement robust compliance programs to mitigate risks

This session will address long-term care contracting with various service vendors. We will discuss the provisions of a contract from a long-term care facility’s perspective that must be included, the provisions that are optional, and the provisions that should never be included because they are detrimental to the long-term care facility. Certain contract provisions can be a problem from a regulatory perspective for either or both parties, and we will address recommendations for contract provisions that will enhance regulatory compliance for both parties. Finally, we will build on the Post Acute Facility Care and Hospice Partnership Puzzle presentation that was presented at last years' conference to address long-term care and hospice facility contracting.

• Deep dive with an SVP of Value Based Care and legal counsel to a national post-acute care provider into the legal and operational issues associated with Value Based Enterprise (VBE) care coordination arrangements among hospitals, long term care facilities, home health, hospice, and other home-centered care providers
• VBE arrangements can lower health care costs, improve care coordination, and align interests around a value-based purpose, but remain underutilized since OIG and CMS broadened regulatory protections for VBEs in December 2020 as part of the Regulatory Sprint to Coordinated Care
• The legal, regulatory and operational aspects of VBE care coordination arrangements involving hospitals and various post-acute care partners, such as home health agencies, hospices and long-term care facilities
• The critical role of Artificial Intelligence (AI) tools and data-analytics in VBE care coordination arrangements. Explore the challenges and successes in the emerging value-based arena and the emerging role of AI tools and analytics
• Hear from a VP of Value Based Care for a large post-acute care provider who have negotiated and implemented with multiple health systems VBE care coordination arrangements, and the importance on obtaining alignment among health care executives, legal teams, clinical and operational leaders for VBE arrangements
• Effective ways to ensure fraud and abuse risks are mitigated with a perspective on how government authorities may approach VBE arrangements

The rare – but public- CCRC bankruptcies over the last few years have raised a resounding and provocative question: What role should states’ laws take in protecting the LPC from bankruptcy? To explore that question, this session will begin with an overview of the current bankruptcy protections provided in some states’ CCRC statutes. Then, an expert panel will discuss the real-world implications when a state must enact its CCRC laws to prevent an LPC bankruptcy, or conversely, where a state’s own CCRC statutes interfered with or worsened an LPC’s fragile financial position. We will discuss:

• The core, common statutory provisions in states’ CCRC laws that aim to protect an LPC from bankruptcy
• Recent-past and current legislative activity that has attempted to react to LPC bankruptcies, and learn the outcomes
• Real-world examples of when a state agency effectively deploys CCRC statute to prevent an LPC bankruptcy, as well as when a state’s statutory environment has worsened an LPC’s financial fragility

Recent studies show continuing increases in the frequency and severity of claims and regulatory citations in assisted living. Moreover, the severity of assisted living liability claims continues to outpace such claims by skilled nursing facilities. This session will examine the following types of events at assisted living facilities:

• Falls
• Abuse (sexual, physical, financial)
• Elopement
• Improper administration of medication
• Transporting Residents
• Emotional Support Animals

• Update on topics covered in presenters' previous session, Respecting Patient/Resident Autonomy: Legal, Medical and Ethical Issues in End-of-Life Care, including Medical Aid in Dying (MAID), Voluntary Stopping Eating and Drinking (VSED) and Medical Orders for Scope of Treatment (MOST)/Physician Orders for Life-Sustaining Treatment (POLST)
• Discuss and review recent court cases challenging MAID on constitutional grounds as well as current legislative efforts pending in several state legislatures
• The balance between respecting resident rights as mandated by 42 CFR part 483, and certain end-of-life choices (e.g., MAID, VSED) that long-term care providers may be uncomfortable complying with
• Cases involving wrongful death and wrongful life will be examined from the perspectives of a medical director and an attorney who litigated such cases

Provide education in risk prevention and mitigation strategies before and after a potentially compensable event. The best defense is a good offense.

• How to identify highest risk areas in each facility
• Strategies to address those high-risk areas
• Key documentation requirements
• Conducting internal investigations
• Communicating with Counsel

• Overview of the actions that impact provider enrollment and billing, and their differences
• While termination, deactivation, and suspension were previously thought to be reserved for the most egregious conduct, these actions are being taken against facilities and HH/hospice providers in unexpected circumstances
• How to avoid termination, deactivation, and suspension
• What can be done when facing a termination, deactivation, and suspension
• With Medicare Advantage and Medicaid MCOs now playing a bigger role in Medicare/Medicaid, this presentation will include a discussion of provider rights with respect to contract cancellations

This session will cover key corporate and regulatory considerations throughout the lifecycle of transactions in the long-term and post-acute care industries. Topics will include:

• Key considerations for due diligence, including clinical and audit reviews, regulatory diligence, and identifying potential deal killers
• Transaction structure and its impact on regulatory filings (CHOW/CHOI), avoidance of the 36-Month Rule for hospice and home health, and governance considerations
• Drafting definitive agreements to address operational considerations and minimize risk to clients
• Recent regulatory trends affecting deals, including post-closing application of CMS's Provisional Period of Enhanced Oversight

In the session, panelists will discuss how to adapt current CRP models to the senior living and long-term care environment, ensuring benefits from the use of a CRP-type program. Emphasis will be provided on one major element of the CRP model that is effective communication with residents and families after a harm / incident event. A communication resolution program (CRP) is a structured process for quickly identifying care issues and ensuring a transparent, accountable, and empathetic response after a harm event / incident takes place. CMS recently released its Patient Safety Structural Measure, which among other things will require hospitals to attest whether they are using a CRP. Understanding the complex resident needs served in senior living and long-term care environments, this industry can expect that requirements to use the CRP approach is likely in the future. And, as we continue to see challenging trends such as rising claims and claim costs and employee turnover, solutions like CRPs are as important as ever in transforming the way providers both support staff and respond to residents and families after an incident. In this presentation, panelists will explore how to adapt a CRP program for senior living and long-term care, the benefits it offers, and examples of successful implementation.

This presentation delves into the regulations governing nursing home transfers and discharges, a critical area ripe with compliance challenges and opportunities for providers. Nursing home residents hold appeal rights against involuntary transfers or discharges, and missteps can lead to significant regulatory scrutiny and risks. Teaming up with the Tennessee Long Term Care Ombudsman, this session will provide practical guidance for health law attorneys. The session will review regulations, explore common pitfalls, and identify opportunities to elevate your practices and procedures. We will discuss:

• Revised transfer and discharge regulations and surveyor guidance (F-Tag 627 – inappropriate transfers and discharges and F-Tag 628 – transfer and discharge process)
• Actual citations and enforcement actions related to improper transfers and discharges
• Case studies from the Ombudsman's desk: Practical insights from appeal
• Differences between transfers and discharges in nursing homes versus assisted living settings
• Common errors and implementing strategies to elevate your transfer and discharge processes

• Office structure of MFCU: statutory guidance, how cases are initiated
• Various types of investigations and industries (Assisted Living, Home Health, Hospice, Long Term Care)
• The role and importance of surveys; major initiatives and focus
• How AGs are similar/different that federal FCA cases
• Resolution ideas and alternatives
• How administration change/elections have/don’t have impacts
• Some state specific issues or initiatives; what types of enforcement are effective in improving care and how is it measured
• Defense arguments: The good the bad and the ugly, what is persuasive and what is not; practical advice for operators, owners, and in-house counsel

Violence in long-term care (LTC) facilities—whether resident-to-resident, staff-to-resident, resident-to-staff or a third-party—poses serious risks to safety, dignity, and quality of care. This session will explore AI technology-based solutions and challenges, active shooter swatting hoaxes, the root causes of violence in senior living health care settings and present evidence-based strategies for prevention and response. Drawing on legal, clinical, and operational perspectives, the presentation will offer practical tools for administrators, care providers, and policymakers to foster safer, more respectful environments for both residents and staff.

• Innovative solutions and tools available such as video surveillance weapon detection
• Harassment as a form of workplace violence and liability under Title VII
• Identification of common types and causes of violence in senior living facilities
• The legal and regulatory implications of violence in care settings including potential labor and employment issues
• Proactive approaches to staff training, resident engagement, and environmental design
• How to implement trauma-informed care and behavioral health support
• Review case studies and best practices for violence prevention and crisis response

• More of the Same – False Claims and Kickback continue to be an area of concern
• New Technologies and Service – Remote Patient Monitoring, skin substitutes, and other advancements present new risks for providers
• New Government Priorities – An uptick in revocations is on the horizon
• What’s a Compliance Officer To Do? – Areas of focus for compliance programs

Mergers and acquisitions in the health care sector are fraught with unique risks, and cybersecurity is at the top of the list. A hidden vulnerability, an undisclosed breach, or a misaligned security program can destroy deal value, trigger significant legal penalties, and cause irreparable reputational damage. This session will provide a comprehensive roadmap for both buyers and sellers, outlining their respective responsibilities and strategies for managing cybersecurity throughout the M&A lifecycle. We will explore pre-deal due diligence, the crucial role of reps and warranties insurance, and the post-merger integration challenges that can make or break a transaction.

In the session, panelists will discuss how to adapt current CRP models to the senior living and long-term care environment, ensuring benefits from the use of a CRP-type program. Emphasis will be provided on one major element of the CRP model that is effective communication with residents and families after a harm / incident event. A communication resolution program (CRP) is a structured process for quickly identifying care issues and ensuring a transparent, accountable, and empathetic response after a harm event / incident takes place. CMS recently released its Patient Safety Structural Measure, which among other things will require hospitals to attest whether they are using a CRP. Understanding the complex resident needs served in senior living and long-term care environments, this industry can expect that requirements to use the CRP approach is likely in the future. And, as we continue to see challenging trends such as rising claims and claim costs and employee turnover, solutions like CRPs are as important as ever in transforming the way providers both support staff and respond to residents and families after an incident. In this presentation, panelists will explore how to adapt a CRP program for senior living and long-term care, the benefits it offers, and examples of successful implementation.

The speaker will explore current topics in legal ethics. Participants will be able to:

• Visa options for staff: Innovative ways to attract and hire qualified foreign nationals in our industry
• Immigration updates: Recent changes to immigration laws that affect employment, travel, and more
• Immigration compliance: Insight into ICE visits at workplaces and how our industry can be prepared for an audit or raid

The speaker will explore current topics in legal ethics. Participants will be able to:

• Identify and navigate emerging ethical challenges posed by generative AI in legal practice, including issues of competence, confidentiality, and the unauthorized practice of law when using AI tools for research, drafting, and client communication
• Understand recent guidance on protecting client confidentiality, including when filing withdrawal motions
• Understand ethical issues when attorneys contractually agree to limit their discretion
• Identify and explore issues that arise when lawyers act as third-party neutrals

Provide education in risk prevention and mitigation strategies before and after a potentially compensable event. The best defense is a good offense.

• How to identify highest risk areas in each facility
• Strategies to address those high-risk areas
• Key documentation requirements
• Conducting internal investigations
• Communicating with Counsel