Ken is a health care attorney with more than 28 years of experience
advising clients on a wide range of regulatory, reimbursement, litigation, compliance and operations issues. His practice has focused heavily, but not exclusively, on issues affecting long term care providers. He has advised them on a wide variety of legal planning issues arising in the skilled nursing facility setting, assisted living setting, hospice, home health and other spheres of long term care. He also frequently represents ancillary service providers (pharmacy, DME, therapy and similar providers.) He represents health care providers of all types on Certificate of Need, Medicare and Medicaid enrollment and licensure issues, including appeals of quality of care issues. He also represents the N.C. Board of Dental Examiners on dental service organization matters. He is a frequent national lecturer and author of industry manuals, national trade journal magazine articles and similar training tools and is primary author and editor of Poyner Spruill’s international award winning newsletter, Shorts on Long Term Care
- Advised skilled nursing facilities, assisted living communities, and related long term care vendors on licensure, certification, survey, fraud and abuse, operations, risk management, certificate of need and business issues.
- Served as Senior Counsel to the national long term care trade association in Washington, D.C., where he was responsible for administering the Association’s legal assistance fund litigation, and overseeing all regulatory, facility operations, and clinical staff of the association.
- Served as General Counsel to ALFA, the national assisted living trade association in Washington, D.C.
- Served as regulatory and policy counsel for numerous sales and acquisitions of skilled nursing facilities and assisted living communities in multiple states.
read all representative experience
- Represented national assisted living and skilled nursing facility provider in high profile licensure revocation action of multiple facilities in Washington State resulting in a favorable settlement and avoidance of involuntary de-licensure and permanent exclusion of the provider from the state.
- Negotiated a national exclusion from music licensing fee requirements for assisted living communities across the U.S.
- Served as the long term care industry representative on the first Negotiated Rulemaking Committee convened by the U.S. Department of Health and Human Services to create safe harbors from the criminal provisions of the federal Anti-Kickback Statute.
- Negotiated the first global settlement of multiple facility licensure and certification survey citations in California with the state Department of Health Services and the California Attorney General.
- Assisted California provider in defending one of the earliest quality of care fraud actions, including negotiating with the federal Office of the Inspector General to develop the provider’s Corporate Compliance Agreement and related settlement documents.
- Represented state and national trade associations, and individual providers, on various issues impacting long term care providers, including negotiations with and representation before OSHA, the federal Office of the Inspector General, the U.S. Department of Health and Human Services’ Center for Medicaid and Medicare Services, and state licensure and survey agencies.
- Developed comprehensive advance directive policy for North Carolina long term care providers after enactment of the Patient Self-Determination Act.
- Worked with state trade association, providers and national accrediting organizations to develop assisted living accreditation standards.
CON Laws: A National Compendium, April 2009
Co-Author, North Carolina Chapter of American Health Lawyers Association Long-Term Care Advisor: The New Medicare Hospice Conditions of Participation, May 2009
American Health Care Association's Corporate Compliance Guidance for Nursing Facilities, 2008 – 2009
Former Editor, “Prognosis,” Joint Health Law Publication of North Carolina Bar Association and North Carolina Society of Health Care Attorneys
Primary author, Designing Corporate Compliance Program: A Comprehensive Process, for the American Health Care Association, 2000, and the current revision of that manual completed in 2002
Author, Negotiated Risk Agreements in Assisted Living Communities, 2002 for The Assisted Living Federation of America, first comprehensive treatment of negotiated risk agreements in long term care, scheduled for revision 2004
Regular contributor to Provider Magazine, the national monthly long term care publication of the American Health Care Association
Past monthly columnist for the monthly magazine of the Assisted Living Federation of America
Editor, Poyner Spruill's monthly long term care newsletter, Shorts on Long Term Care
Author, Rum Raisin, Monkey Crunch, and Mocha Frappucino Cherry with Gummy Bears on Top: Striving for Personal Autonomy and a Choice in a Regulated Long-Term Care Environment, North Carolina Medical Journal, March/April 2010
Firm Management ResponsibilitiesKen serves as head of Poyner Spruill's Health Law Section.
Prior Legal ExperiencePrior to joining Poyner Spruill, Ken was a partner at Hooper, Lundy & Bookman, Inc. from 1999 to 2002. He served as Special Counsel for Foley & Lardner from 1997 to 1999. He was the Senior Director of Legal Services and Facility Operations of the American Health Care Association from 1993 to 1997. Ken also served as the North Carolina Health Care Facilities Associations' General Counsel from 1991 to 1993.