Senior Care Regulatory Compliance

Your Facilities Pass.
Every Time.

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$0M+
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CMS, EPA, CERCLA, and state-level compliance — handled with the precision your residents and your balance sheet demand.

Meridian Senior Living·Covenant Care Group·Sunrise Healthcare Systems·Prestige Senior Management·Cascadia Care Partners·Heartland Senior Properties·Summit Ridge Health·Oakwood Senior Ventures·Pinnacle Care Operators·BlueStar Senior Networks·Crestview Management·Lakeview Senior Holdings·Arbor Health Partners·Sequoia Senior Group·Northgate Care Systems·Riverstone Senior LLC·Horizon Care Operators·Keystone Senior Health·Windmill Senior Living·Cornerstone Care Group·Meridian Senior Living·Covenant Care Group·Sunrise Healthcare Systems·Prestige Senior Management·Cascadia Care Partners·Heartland Senior Properties·Summit Ridge Health·Oakwood Senior Ventures·Pinnacle Care Operators·BlueStar Senior Networks·Crestview Management·Lakeview Senior Holdings·Arbor Health Partners·Sequoia Senior Group·Northgate Care Systems·Riverstone Senior LLC·Horizon Care Operators·Keystone Senior Health·Windmill Senior Living·Cornerstone Care Group
Cornerstone Care Group·Windmill Senior Living·Keystone Senior Health·Horizon Care Operators·Riverstone Senior LLC·Northgate Care Systems·Sequoia Senior Group·Arbor Health Partners·Lakeview Senior Holdings·Crestview Management·BlueStar Senior Networks·Pinnacle Care Operators·Oakwood Senior Ventures·Summit Ridge Health·Heartland Senior Properties·Cascadia Care Partners·Prestige Senior Management·Sunrise Healthcare Systems·Covenant Care Group·Meridian Senior Living·Cornerstone Care Group·Windmill Senior Living·Keystone Senior Health·Horizon Care Operators·Riverstone Senior LLC·Northgate Care Systems·Sequoia Senior Group·Arbor Health Partners·Lakeview Senior Holdings·Crestview Management·BlueStar Senior Networks·Pinnacle Care Operators·Oakwood Senior Ventures·Summit Ridge Health·Heartland Senior Properties·Cascadia Care Partners·Prestige Senior Management·Sunrise Healthcare Systems·Covenant Care Group·Meridian Senior Living
Primary CTA

Request a
Compliance
Assessment

We review your current regulatory posture, identify exposure, and deliver a written risk summary within five business days. No commitment. No discovery call. Just answers.

214 facilities currently in active compliance management
Average penalty reduction: 94% in first audit cycle
Response within one business day

No commitment required. We do not sell or share facility information. Assessment delivered within 5 business days.

Client Testimony
"We inherited four facilities with open EPA notices and a CMS survey backlog. Counsel resolved every outstanding item in eleven weeks. The next survey cycle was the cleanest we'd had in a decade."
Margaret Osei-Bonsu
94%average penalty reduction in first audit cycle
Penalty Cost Trajectory — Composite Client Portfolio
Without Counsel
With Counsel
$200K$150K$100K$50K$0
2020
2021
2022
2023
2024
Case Studies
All outcomes documented. All names used with permission.
Case 01EPA / CERCLA

A 28-facility operator received simultaneous EPA notices of violation across three states — hazardous waste misclassification, improper manifest documentation, and a discharge permit lapse at two properties.

The incoming compliance director inherited a 19-month documentation backlog and an operations team with no dedicated regulatory staff. The penalty clock was running. External counsel was quoting $380,000 in anticipated fines before any remediation costs.

RCRA Subtitle C misclassification
40 CFR Part 262 manifest violations
NPDES permit lapse — 2 facilities
CMS Form 2567 deficiencies pending

Counsel embedded a dedicated compliance team within six days of engagement.

01Conducted emergency waste stream audit across all 28 facilities in 14 days
02Corrected and resubmitted all manifests; reclassified waste streams under 40 CFR 261
03Negotiated compliance schedule with EPA Region III — penalty reduced to corrective action only
04Reinstated NPDES permits with zero discharge violations on record
05Delivered full CMS survey readiness package before next survey window
$341,000
VP of Operations
Multi-state senior care operator, 28 facilities
11 weeks to full resolution
Case 02CMS / State Survey

A regional chain of 12 assisted living facilities faced an Immediate Jeopardy finding following a state survey — the most severe CMS designation, triggering potential termination from Medicare and Medicaid.

The CFO was facing daily civil monetary penalties of up to $21,393 per day under 42 CFR Part 488. Remediation invoices from the previous consultant had exceeded $190,000 without resolving the underlying systemic deficiencies.

IJ designation — 42 CFR §483.25
CMPs accruing at $21,393/day
State licensure review initiated
Prior remediation: $190K spent, unresolved

Counsel achieved IJ removal within 72 hours of engagement.

01Deployed on-site within 24 hours; immediate corrective action plan filed
02IJ designation lifted at 72-hour resurvey — CMPs stopped accruing
03Implemented facility-wide QAPI framework addressing root-cause deficiencies
04Passed follow-up standard survey with zero deficiencies cited at IJ level
05Rebuilt survey-readiness documentation system for all 12 facilities
$2.1M
Chief Financial Officer
Regional assisted living chain, 12 facilities
72 hours to IJ removal
The 2024 Senior Care
Penalty Report
Federal penalty trends across CMS, EPA, and state agencies
The 7 most common citation patterns in multi-facility chains
Cost-per-bed analysis of non-compliance by facility type
Survey readiness benchmarks: where your peers stand
Free Download

Build the internal case
before you sign anything.

The 2024 Senior Care Penalty Report gives compliance officers the data they need to justify a partner engagement to finance. 48 pages. Fully cited. No sales language.

Not partnering is the riskier
legal position.

Zero failed audits. 214 facilities. $47M in fines avoided.

Request a Compliance Assessment