Sample Consulting Engagements in Nursing Homes and Assisted Living

The Fox Group, LLC has been engaged to assist the Long-Term Care community in a wide variety of fashions.  Whether it be vetting potential opportunities, or wrestling with difficult This Way or That Way in Long-term Carecircumstances, we consistently deliver an accurate, well thought out depiction of the situation, provide superior options, and guide our clientele to the best outcomes.  Sometimes our team of long-term care experts lead our clients to very successful ventures.  And sometimes we help them avoid costly, even devastating mistakes.  However, in all cases we provide invaluable guidance to those who nobly choose to provide service to our elderly, frail, and severely disabled citizens.

What follows are a handful of examples intended to provide an overview of our engagements in support of those in the Skilled Nursing and Assisted Living industries ...


Guided Not for Profit Healthcare System Wishing to Master Plan Entire Long-Term Care Campus

Master Planning Long-Term Care CampusConducted market assessments and financial feasibility analyses for multiple potential business lines as part of a plan to transition this non-profit health care system to a post acute care provider. Provided guidance and assistance in master planning a large, formerly acute care campus to provide a wide range of post acute care services. Consulted on the development of a skilled nursing and assisted living facility, including design and FF&E.


Advised Start Up Company Wishing to Target Several Markets to Develop Long-Term Care Operations

Long-Term Care Planning and Market Assessments with Push-Pins on MapThis newly established, well capitalized company with development experience desired to develop several long term care facilities. Performed several market studies and feasibility analyses to address multiple long term care facilities at several sites. Worked with ownership and financing sources to provide appropriate documentation and support to facilitate financing efforts. Assisted in initial design efforts including guidance on establishing a design team and provided direction on preliminary plan layout for facilities.


Provided General Management for the Development of a Long-Term Care Site

Management team for planning long-term care projectsTook over the overall management of the entire development activities for this planned long term care campus, including assisted living and dementia care services. Replaced design team and organized the overall development efforts associated with the project. Coordinated activities between ownership, selected operator and design team. Led efforts to obtain financing for the project while monitoring development budget.


Guided Skilled Nursing Facility (SNF)  Operator Wishing to Diversify Services

Long-term Care SuccessAssessed markets to identify potential for new, complimentary business opportunities.  Assisted in the development of an in-house physical, occupational, and speech therapy business that serviced our client's own five hospitals, and expand the service to 15 additional skilled nursing facilities.  Conducted site review, feasibility study, and floor plan review for a large Assisted Living Facility (ALF) that was successfully constructed, opened and rapidly reached stabilized occupancy adjacent to our client's existing Nursing Home.  Established a nurse registry service that serviced fluctuating staffing needs at both client SNF's, and other healthcare providers in the local market.


Meeting the Requirements of a Corporate Integrity Agreement

Medicare and Medicaid RulesEngaged by this multi-facility, multi-state operator of skilled nursing facilities to provide Independent Review (IRO) services in accordance with a signed Corporate Integrity Agreement (CIA) with the Office of the Inspector General (OIG).  Required a five year, annual onsite team of skilled nursing reimbursement specialists to conduct an audit of Medicare and Medicaid billing and payments in a cross reference check with the patient medical records.  The purpose was to determine compliance with federal and state regulations as they apply to facility reimbursement for services via public funds.  The Fox Group both provided the required report for delivery to the OIG, and provided guidance and education to the provider upon completion of each year's audit.


Acute Care Hospital & Private Investor Wishing to Collaborate on Skilled Nursing/Assisted Living Campus

Nursing Home and Assisted Living strategyEngaged to provide a market feasibility study regarding the potential of a District Hospital and private investor to build a new nursing home to replace the aging facility currently owned by the hospital, and to expand upon that notion to include an Assisted Living Facility on the same campus.  This extensive study showed that while local demographics  supported the need and payor base,  the cost to develop such a project was beyond the current financial capabilities of the parties involved.


Nursing Home Project Having Difficulty Getting Off the Ground

Skilled Nursing Facility Floor PlanMultifaceted engagements with the operator of an Assisted Living Facility and several Group Homes for the Developmentally Disabled.  Work consisted of market and feasibility studies focused on placing a Skilled Nursing Facility on the property adjacent to their existing ALF.  The study, complete with detailed financial projections, showed tremendous need and value to pursue.  Further engagements were to reduce projected construction costs via value engineering the plans so as to allow financing of the project, which led to a savings of $645,000.  To conduct a Request for Qualifications (RFQ) in pursuit of a partner to oversee the ultimate operations.  And to coordinate the rebuttal with the state agencies who were at odds over approval of the final floor plans.


Lawsuit Against Civil and Mechanical Engineers in Convalescent Hospital Construction

Concalescet Hospital JudgementThe General Partner representing the ownership of a 99 bed Nursing Home sought to have coordination of a lawsuit against the civil and mechanical engineers involved in the construction of their facility due to cost overruns and time delays that the owner felt were due to faulty planning and execution by the engineers.  The time delays, in particular, resulted in lost operating revenue and a chain reaction of resulting cost overruns.  The case ultimately went to court and the judgment was in favor of the plaintiff.  Our work resulted in substantial funds being recouped by the owner of the skilled nursing facility.

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