Navigating Hospital in Hospital Leasing Arrangements: LTACH, Skilled Nursing, Rehab, Behavioral Health, and Hospice

Ensuring Stark and Anti-Kickback Statute Compliance, Navigating Fair Market Value Considerations

A live 90-minute CLE webinar with interactive Q&A


Tuesday, July 25, 2017
1:00pm-2:30pm EDT, 10:00am-11:30am PDT

Early Registration Discount Deadline, Friday, June 30, 2017


This CLE webinar will provide guidance to healthcare providers on navigating hospital in hospital (HIH) leasing arrangements, including leasing space to long term acute care hospitals (LTACHs), skilled nursing, rehab, behavioral health and hospice. The panel will examine trends, Stark and Anti-Kickback Statute (AKS) compliance issues, and fair market value (FMV) considerations with respect to HIH arrangements.

Description

As acute care hospitals evaluate how to best utilize aging buildings and unused space, a significant number of hospitals consider entering into an agreement with a third party to occupy space in the hospital. LTACHs located within an acute care hospital are referred to as an HIH.

Healthcare providers and their counsel must address issues pertinent to the leasing of space within an acute care hospital for a variety of uses. These uses typically include LTACHs, skilled nursing, rehab, behavioral health and hospice. Among the issues involved are commercial reasonableness, FMV concerns, Stark and AKS.

Listen as our authoritative panel of healthcare advisers examines HIH leasing arrangements, including fair market value concerns, Stark and AKS issues, commercial reasonableness, and consistency between the space lease and the purchased service agreement. The panel will offer guidance for addressing these issues and ensuring compliance in these transactions.

Outline

  1. What is an HIH?
    1. Overview of common leases of hospital space
    2. Trends—has there been an increase in these types of arrangements?
  2. Defining the space
    1. Measurements in typical commercial real estate
    2. Measurements in the HIH sector
    3. Exclusive and non-exclusive use areas
  3. Operating expenses
    1. Accounting for operating expenses in a hospital real estate lease
    2. Real estate vs. non-real estate expense
    3. Monitoring operating expenses and compliance concerns
    4. Understanding other non-traditional real estate services that may be included in a lease arrangement
  4. Fair market value—real estate
    1. Evaluating an FMV lease rate within the HIH sector
    2. Tenant improvement considerations: who pays for the finish out?
    3. Lease rate considerations: per bed versus per square foot
    4. Management agreements, purchased service agreements, and real estate leases
    5. Options to lease additional space
    6. Leases involving non-clinical space
  5. Non-real estate considerations in HIH arrangements
    1. Covenants not to compete (CNCs)
    2. Bed licenses or de-licensure
    3. Certificates of need (CONs)
    4. Trade name and other intangibles

Benefits

The panel will review these and other key issues:

  • Recent trends to own and occupy space in an acute care setting; equity joint ventures and pure lease arrangements for hospital space
  • Valuation issues when a hospital department is sold or contributed to a joint venture in lieu of cash contribution
  • Relevant post-transaction contractual arrangements including management or other administrative services, employee lease agreements, and more

Faculty

Victor H. McConnell, MAI, ASA, Director, Real Estate Valuation Services
VMG Health, Dallas

Mr. McConnell’s valuation experience spans the healthcare sector, including acute care & specialty hospitals, MOBs, ASCs, LTACHs, IRFs, imaging centers, cancer clinics, and other specialty facilities. His experience includes determining fair market value for Stark Law compliance, financing, possible sale or purchase. His expertise includes in-depth knowledge of the regulatory issues unique to the valuation of healthcare real estate. He has provided fair market value and fair market rent analyses to for-profit and not-for-profit health systems, as well physician groups, REITs, and private equity groups. 

John S. Trabold, III, MAI, Managing Director, Real Estate Valuation Services
VMG Health, Dallas

Mr. Trabold has experience with the valuation of complex healthcare properties, including acute care & specialty hospitals, MOBs, ASCs, LTACHs, IRFs, imaging centers, cancer clinics, and other specialty facilities. He has experience in the valuation of properties to estimate market value and fair market value for allocation of purchase price, financing, Stark compliance and investment decisions. He has served clients across the United States and has extensive experience as an expert witness.


Live Webinar

Live Webinar $247.00

Includes Early Discount Savings of $50.00 (through 06/30/17)

Add a colleague on the same connection in the same room for only $97.00 in the shopping cart or by calling customer service.

This webinar is eligible for at least 1.5 general CLE credits.

CLE credits are not available for PR.

*In KS, OH, PA, for more than 1 attendee on the connection you must contact Strafford CLE via email or call 1-800-926-7926 ext. 35 prior to the program for special instructions.


Recordings

CLE On-Demand - Streaming Video

Includes recorded streaming video of full program plus PDF handouts.

On-demand is the only recorded format recognized for CLE credits in DE, IN, KS, LA, MS, NC, OH, OK, SC, TN, VA, WI.

AK, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN*, KS, KY, LA, ME, MN, MO, MT, NC, ND, NH**, NJ, NM, NV, NY, OH*, OK, OR, PA, SC, TN, TX, UT, VA, VT, WA, WI, WV, WY (Note: Some states restrict CLE eligibility based on the age of a program. Refer to our state CLE Map for additional information.)

*Only available for attorneys admitted for more than two years. For OH CLE credits, only programs recorded within the current calendar year are eligible - contact the CLE department for verification.

**NH attendees must self-determine if a program is eligible for credit and self-report their attendance.

CLE On-Demand Video $247.00
Available 48 hours after the live event

Includes Early Discount Savings of $50.00 (through 06/30/17)

How does this work?


Recorded Event

Includes full event recording plus handouts (available after live webinar).

Strafford is an approved provider and self-study CLE credit is available in most states.

AK, AZ, CA, CO, CT, FL, GA, HI, IA, ID, IL, KY, ME, MN, MO, MT, ND, NJ, NM, NY, OR, PA, TN, TX, UT, VT, WA, WV, WY (Note: Some states restrict CLE eligibility based on the age of a program. Refer to our state CLE Map for additional information.)

Strafford will process CLE credit for one person on each recording.

Additional copies of a recording can be purchased at a discount. Please call Strafford Customer Service toll-free at 1-800-926-7926 ext 10 or email customerservice@straffordpub.com to place your order.

Recorded Webinar Download $247.00
Available 48 hours after the live event

Includes Early Discount Savings of $50.00 (through 06/30/17)

How does this work?

Recorded Audio Download (MP3) $247.00
Available 24 hours after the live event

Includes Early Discount Savings of $50.00 (through 06/30/17)

How does this work?

DVD (Slide Presentation with Audio) $247.00 plus $9.45 S&H
Available ten business days after the live event

Includes Early Discount Savings of $50.00 (through 06/30/17)

How does this work?


Registration Plus Recorded Event

Best value!

Live Webinar & Webinar Download $344.00

Includes Special Savings of $250.00 (through 06/30/17)

Live Webinar & Audio Download $344.00

Includes Special Savings of $250.00 (through 06/30/17)

Live Webinar & DVD $344.00 plus $9.45 S&H

Includes Special Savings of $250.00 (through 06/30/17)


Webinar

Strafford webinars offer several options for participation: online viewing of speaker-controlled PowerPoint presentations with audio via computer speakers or via phone; or audio only via telephone (download speaker handouts prior to the program).  Please note that our webinars do not feature videos of the presenters.

Early Registration
Discount Deadline
June 30, 2017
(5 days)

or call 1-800-926-7926

Can't Attend the Live Program?

CLE Credits By State

See CLE State Map >

or call 1-800-926-7926

Customer Reviews

The seminar provided good practical examples and advice plus good Q&A.

Don Weinbren

Trenam Kemker

The seminar tackled a difficult issue that we need to understand better.

Evan Smith

Beazley

I liked the topic and the tools provided in the handouts.

Mildred Johnson

Texas Tech University Health Sciences Center

The teleconference was efficient with a well-focused agenda. The speakers really seem to know the material and communicated it clearly.

Owen Hughes

Pfizer

Well done ---

Aron P. Goldfeld

TeamHealth

or call 1-800-926-7926

Health Law Advisory Board

Lowell C. Brown

Partner

Arent Fox

Jennifer L. Evans

Shareholder

Polsinelli

Ryan S. Johnson

Shareholder

Fredrikson & Byron

Gina M. Kastel

Partner

Faegre Baker Daniels

Karen S. Lovitch

Member

Mintz, Levin, Cohn, Ferris, Glovsky and Popeo

David A. Manko

Partner

Proskauer Rose

John J. Miles

Senior Counsel

Baker Donelson

C. Elizabeth O'Keeffe

Counsel

Wyatt, Tarrant & Combs

J. Peter Rich

Partner

McDermott Will & Emery

Donald H. Romano

Of Counsel

Foley & Lardner

Judith A. Waltz

Partner

Foley & Lardner

John R. Washlick

Shareholder

Buchanan Ingersoll & Rooney

Jesse A. Witten

Partner

Drinker Biddle & Reath

or call 1-800-926-7926

Our Guarantee

Strafford webinars are backed by our 100% Unconditional Money-Back Guarantee: if you are not satisfied with any of our products, simply let us know and get a full refund. For more information regarding complaints and refunds, please contact us at 1-800-926-7926 ext 10. Complaints regarding this program can be submitted via the course evaluation found in the “Thank you” e-mail at the end of the course.