A legal team that advises clients delivering long-term care to patients might not sound like a major firm rainmaker, but one at Baker Donelson closed more than $3 billion in transactions last year and handled many complex litigation and regulatory matters.

Although some smaller, healthcare-centric firms have long-term care groups, Baker Donelson is one of only a few Big Law firms—Seyfarth Shaw is another—to have an active practice in the area.

Baker Donelson’s multidisciplinary group could serve as an example for other Big Law firms that want to work in this industry, which is likely to grow even more as the U.S. population continues aging.

Howard L. Sollins, the team’s leader based in Baltimore, said the graying of Baby Boomers is driving the firm’s practice, as well as the growth in complexity and scope of long-term care services, and an increase in regulatory scrutiny.

Long-term care has also evolved, according Sollins, as old stereotypes of providers like nursing homes as places where people go to live to only leave by dying are “no longer relevant.” Skilled nursing facilities have become centers for the delivery “of higher acuity services for shorter lengths of stay in a highly regulated environment,” he said.

For Baker Donelson’s long-term care team, this means the attorneys support owners, operators, and lenders on a range of transactional, financing, regulatory, reimbursement and compliance issues with an understanding of how long-term care and post acute care is delivered.

Bolstered by these trends and a firm merger, the long-term care team has seen a more than 16-fold increase in revenue since forming, Sollins said.

Growth and Integration

Baker Donelson established the team in 2007 with about 10 litigators.

When the firm combined with Ober, Kaler, Grimes & Shriver in 2017, the group grew noticeably, and now consists of about 90 attorneys including litigators as well as transactional, regulatory, and labor and employment attorneys. These lawyers provide a coordinated array of services.

Many of these lawyers focus on their core practice areas and have a strong knowledge of long-term care and post-acute care, but handle other matters for other types of clients, Sollins said.

The result is that the long-term care clients benefit “from the broader practice experience our attorneys bring within their subject areas,” he said.

This cross-disciplinary but integrated model works well, he explained, as it mirrors the continuum of care provided to patients.

For instance a patient with a particular clinical need may receive services from a hospital, skilled nursing facility, home health, hospice, rehabilitation providers, physicians and other health care practitioners. “Each provides its services and support, but is aware of, and collaborates with, other care providers that may be involved at some point,” Sollins said.

The long-term care attorneys represent these providers as well as those who develop, invest in, and lend to the facilities.

Their work includes defending clients accused of malpractice; representing clients in business disputes and in government investigations; helping clients respond to licensing and certification inspections, helping handle Medicare, Medicaid and other payer reimbursement audits; and working on various labor and employment matters for providers like breach of contract, wage and hour disputes, and discrimination claims.

The team’s ultimate goal is to look at the broader picture and think about how their clients deliver services and how the firm can support them in that endeavor, Sollins said.

“We don’t have a crystal ball but we do have a long-time historical perspective and hope we’re able to help people react to challenges in front of them and with how to deliver services in the future,” he said.

This is the latest in a series of occasional features on intriguing practice groups at major law firms.