Case Studies

Providing Key Regulatory Advice During the Sale of Veterinary Hospitals

Epstein Becker Green’s client Quad-C Management, Inc. (“Quad-C”), a leading middle-market private equity fund, and JAB Holding, the investment arm of the Reimann family, signed a definitive agreement under which Quad-C sold its stake in Compassion-First Pet Hospitals (“Compassion-First”), a family of well-known and respected specialty, emergency, and general practice veterinary hospitals across the United States, to JAB, based on a total enterprise valuation of $1.215 billion. The deal closed on April 1, 2019.  Epstein Becker Green has been instrumental in Compassion-First’s growth and provided key regulatory advice during Quad-C’s exit.

Epstein Becker Green has represented Quad-C and Compassion-First since Quad-C first acquired the multiple veterinary practices that would become known as “VSNA” (now Compassion-First) approximately five years ago. We provided regulatory advice on the structuring of the new, combined entity for the existing practices and supplied health regulatory support (including diligence and entity structuring advice) on a continuous basis as Compassion-First grew over multiple acquisitions.

This agreement is a clear win for Quad-C, and a deal that highlights what a long-term strategic partnership with Epstein Becker Green can look like. 

For additional details, please see the Business Wire article.

The Epstein Becker Green team included Mark Lutes, Lenny Lipsky, Josh Freemire, Ali Wolf, Paulina Grabczak, Clay Lee, and Elizabeth Scarola.

Epstein Becker Green Serves as Health Care Regulatory Counsel in Acquisition of Capella Healthcare

Epstein Becker Green ("EBG") participated as health care regulatory counsel in the $900 million acquisition of Capella Healthcare Inc. (“Capella”), a private equity-owned operator of acute care facilities and one of the largest for-profit hospital companies in the United States. The purchaser was Medical Properties Trust Inc. (“MPT”), an Alabama-based real estate investment trust that acquires and develops net-leased health care facilities. The $900 million acquisition price breaks down as $600 million for Capella’s real estate and approximately $300 million for Capella’s operating entities, which will be jointly owned by MPT and Capella’s management. EBG attorneys provided health care regulatory advice and due diligence to Capella on the transaction, which is expected to close during the second half of 2015.

As a result of the Capella acquisition, MPT will obtain seven acute care hospitals in five states. In total, MPT will have 183 properties in 30 states, with acute care facilities making up a majority of its portfolio.

The EBG team included Mark E. Lutes, Joshua J. Freemire, Richard H. Hughes IV, and Evan J. Nagler.

EBG Is Victorious in Two Electronic Health Record Incentive Program Matters

In May 2014, Epstein Becker Green scored major victories in two matters relating to the Centers for Medicare & Medicaid Services ("CMS") Electronic Health Record ("EHR") Incentive Program, which provides incentive payments to eligible professionals, eligible hospitals, and critical access hospitals as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology.

In the first matter, Epstein Becker Green, on behalf of a hospital client, persuaded CMS to admit that it was possible to meet an EHR Incentive Program requirement in a way that was not clearly addressed in the program's rules. Specifically, the EHR Incentive Program requires the transmission of a "transition of care" document to a patient's new providers when a hospital refers or transfers the patient. Ideally, this document is sent electronically and directly to the provider. But, in certain circumstances, the EHR Incentive Program rules also allow the transition-of-care document to be provided to the patient to deliver to the next provider. Epstein Becker Green obtained a written response from CMS that Epstein Becker Green's hospital client is permitted, instead of printing this document and providing it physically to each patient, to post the document in the "patient portal"—a private website accessible by the patient that hosts copies of certain health care documents (and is itself another EHR Incentive Program requirement). This result greatly pleased our hospital client, since it was no longer required to print and hand out all of that paper.

In the second matter, Epstein Becker Green represented a small orthopedic group practice that was participating in the EHR Incentive Program, had received incentive payments, and was recently audited by one of CMS's outside auditing vendors. The audit determined that the group practice did not meet all of the "meaningful use" requirements under the EHR Incentive Program. Therefore, the group practice was ordered to refund its incentive payments, which totaled over $100,000. However, Epstein Becker Green, using its extensive knowledge of the EHR Incentive Program, was able to successfully appeal the audit determination, resulting in no recoupment by CMS of any of the payments.

The Epstein Becker Green attorney representing the hospital client and the group practice was Joshua J. Freemire.