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How to Buy or Sell a Medical Practice

Buying or selling a medical practice is complicated. Beyond the complexities that come with any major commercial transaction, there are also specialized legal considerations for the owners and operators of medical practices in California. In this article, our Fremont business law attorney discusses some of the most important things to know about buying or selling a medical practice in Northern California. If you have any specific questions, please do not hesitate to call our law office.

Due Diligence: Make Sure Your Counterparties are Reliable

You should never buy or sell any business without conducting thorough due diligence. Broadly defined, due diligence is an investigation, inquiry, and general exercise of care that a person should take before entering into an agreement.

Due diligence is essential when buying a medical practice. You must have a full understanding of the financial position of the business, including its assets and potential liabilities. Due diligence is no less important when selling a practice. Make sure your counterparties are reliable.

The Structure and Components of the Deal

The structure and components of a purchase agreement matter. Of course, this starts with determining the appropriate purchase or sale price for the medical practice. Parties should also pay very close attention to the structure of the transaction. You may be best off with a stock sale, whereby the entire medical practice is purchased. Alternatively, the parties may prefer an asset sale in which the buyer purchases specific assets held by the practice. It is always the best practice to have a medical practice purchase agreement reviewed by an experienced business lawyer.

Unique Concerns for Buying or Selling Medical Practices

Doctors and other medical professionals who are buying or selling a practice in California should be aware of some of the unique federal and state regulations that will impact their rights and responsibilities. Among other things, these include:

Restrictions on ownership: Any transfer of ownership of a medical practice in California must conform to the requirements of the state’s Moscone-Knox Professional Corporation Act. Medical practices are generally structured as PCs (professional corporations) — there are restrictions on who can own these business entities.
Patient notice: The Medical Board of California has regulations in place regarding patient notice when a practice is sold to another party or intends to close. Make sure that patients are notified of the transaction as soon as possible.
Medical records: The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires medical professionals (and medical practices) to protect sensitive medical records. HIPAA’s privacy requirements must be followed through all aspects of the sale.
Controlled substances: If the medical practice has access to any controlled substances, it is imperative that these highly-regulated drugs are handled properly in accordance with the applicable federal and state laws.

Finalizing the Sale of a Medical Practice

Before the medical practice sale can be finalized, there are several issues that need to be addressed. Once the final structure of the business purchase agreement is in place, be sure to attend to future-focused issues, such as tail insurance and whether there will be a non-compete agreement in place. An experienced California business lawyer can help you secure, organize, and complete all the legal and commercial documents that you need to finalize the transaction.

Consult With Our Bay Area Business Law Attorney Today

Lynnette Ariathurai is a top business lawyer with the skills and experience to represent medical practitioners with buying or selling a medical practice. Contact us today for your fully confidential initial consultation. We serve communities throughout the Bay Area, including Fremont, Newark, East Bay, Union City, Hayward, Santa Clara, Milpitas, San Jose, San Leandro, and Gilroy.

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Navigating Leases for a Medical Practice

A commercial lease is the legal foundation of a relationship between a business and a landlord. If you own and operate a medical practice in the Bay Area, navigating a lease agreement can be especially complicated. There are some unique issues that should be considered and addressed as part of your commercial lease. In this article, our California contract review attorney highlights some of the key issues to consider when drafting and negotiating a lease for your medical practice.

Key Commercial Leasing Issues for Medical Practitioners

Any successful medical practice needs an appropriate space to operate. The commercial property that you set up shop in should be well-suited for the particular needs of your practice. Additionally, the commercial lease that you operate under should provide an appropriate amount of legal protection. Some of the key issues that should be addressed in a commercial lease for a medical practice in California include:

Cost: You should have a clear definitions of the costs associated with your commercial lease. As a starting point, there must be a clear structure for how rent is calculated—either as a fixed monthly rate or as a percentage of revenue/profits. Additionally, a lease usually specifies responsibility for utilities, taxes, common area expenses, and other costs.
Liability: Liability is an important issue in a commercial lease — particularly for medical practitioners. A commercial landlord may try to include terms that shift liability towards your medical practice. Be sure to carefully review and fully understand liability risks.
Tenant improvements: In many cases, a medical practice needs to make certain improvements and alterations to a commercial space to operate. The lease should clarify two key things:
- Your right to make improvements
- Financial responsibility for any improvements
Weekend/night operations: Medical needs can arise at any moment. Many practices operate outside of normal working hours, including on nights and weekends. Make sure that your lease allows for weekend/night operations and ensure that the property is prepared. For example, the heat/air conditioning should be running.
Privacy (landlord access): Privacy is a major concern for medical practices. There are many state and federal privacy regulations in place to ensure that health care providers protect the sensitive health information of patients. It is a best practice to address landlord access to the property and other privacy concerns in a commercial lease agreement.
ADA compliance: The Americans with Disabilities Act (ADA) is a federal civil rights law that puts certain responsibilities on property owners, as well as businesses and business owners. Leases often include waiver of ADA compliance by landlord, and the burden shifts to the tenant to comply. A commercial space may need to be upgraded to ensure that your practice is in full compliance with the ADA. ADA complaints for non-compliance can be expensive.
Duration (termination and renewal): A commercial lease should always have a well-defined duration. Beyond that, the lease should clarify your rights and responsibilities regarding leaving the property before the lease ends and remaining in the property once the lease expires. Among other things, your lease should address forced moves to substitute premises, subletting rights, early termination options, and renewal rights.

Contact Our Fremont, CA Commercial Lease Lawyer Today

Lynnette Ariathurai has deep experience negotiating, drafting, and reviewing commercial leases. If you have any questions about navigating a lease for a medical practice, we are here to help. Contact us now for a confidential consultation. Our firm serves clients from our offices in Fremont throughout the Bay Area including Newark, Hayward, East Bay, Milpitas, Union City, San Leandro, Gilroy, San Jose, and Santa Clara.

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Best Practices for Navigating Changing COVID Laws for Businesses

The COVID-19 pandemic continues to affect communities around the world. According to data from the California Department of Public Health, there have been more than 4.1 million cases of the virus confirmed in the state as of mid-August of 2021—and with the Delta variant, case rates are rising once again. For businesses, navigating the ever-changing regulatory environment during the pandemic is challenging. Here, our Fremont, CA business lawyer highlights some of the best practices for companies looking to navigate COVID-19 regulations in the Bay Area.

Do Your Research (Local Law Matters)

You need to stay up-to-date on all applicable laws. Indeed, the only truly effective way for businesses to navigate the changing COVID-19 legal landscape is to work with an experienced business lawyer or do frequent independent research into the relevant rules and regulations. Notably, it is imperative that business owners refer not just to federal and state guidelines, but also to local rules and ordinances.

In California, the regulations sometimes vary from city to city or county to county. Here is an example: On August 2nd, 2021, Cal/OSHA released new guidance on masks. Under the statewide public health regulations, facial coverings are required in certain places, such as healthcare settings. For vaccinated people, masks are only “recommended” in most indoor workplace settings. However, some local governments have different requirements. For example, on August 3rd, 2021, the Alameda County Health Care Services Agency reinstated a full indoor mask mandate—regardless of vaccination status. Make sure you know the rules in your area.

Implement a Process for COVID-19 Planning/Rapid Decision-Making

As the COVID-19 outbreak is still a developing public health crisis, it is crucial that businesses in the Bay Area build and implement a process for pandemic planning and rapid decision making. Keep in mind that things can change quickly. Several factors are subject to change, including masking rules, vaccine regulations, social distancing guidelines, and capacity restrictions. A well-developed plan can make navigating the pandemic far easier. Among other things, your business should have:

A plan designed to meet your unique needs/industry
A proactive mindset, always ready to address changing rules
A clear chain of command to ensure swift and decisive decisions when necessary

Be Ready to Seek Professional Guidance on COVID Regulations

Owning and operating a business is difficult enough during normal times. With the COVID-19 pandemic posing a wide range of challenges on businesses in the Bay Area, it has become even more complicated. You should not hesitate to consult with an experienced California business lawyer who can help you and your partners manage the pandemic.

Schedule a Confidential Consultation with a Bay Area Business Lawyer

Attorney Lynnette Ariathurai is a skilled, solutions-focused advocate for business owners. If you have any questions about the best practices for navigating changing COVID-19 laws, our law firm can help. Contact us today for a strictly confidential consultation. From our Fremont law office, we represent businesses throughout the Bay Area, including in Hayward, Union City, Castro Valley, Milpitas, and Newark.

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Business Legal Items Needed to Open a New Medical Practice in California

Are you preparing to open a brand new medical practice in California? If so, there are important business and legal considerations that you should be aware of. State law impacts the structure and ownership requirements of your business. Here, our Fremont business formation attorney provides a brief overview of the business and legal items needed to open a medical practice in California.

Entity Selection and Business Formation

Business startup is complicated—especially in the health care industry. California has specific rules and regulations regarding the formation of a medical practice. In fact, state law generally prohibits doctors and medical professionals from operating their business as a limited liability company (LLC) or traditional corporation.

Instead, medical practices are usually formed as a specialized type of business called a professional medical corporation. Under California’s Moscone-Knox Professional Corporation Act, there are restrictions on who can serve as an officer/director of a medical corporation and restrictions on who can own shares in these corporations.

Commercial Lease

A new medical practice must operate from somewhere. Most likely, this means that your new business will need to enter into a commercial lease agreement. In entering a lease agreement, there are a wide range of different issues that should be considered, including:

The location and convenience for current and future patients
The monthly cost and duration of the lease
Specialized medical issues, including waste removal, potentially hazardous materials on the premises, and storage of sensitive patient information
Common area maintenance (CAM) charges (also known as a triple net lease (NNN))

An experienced California business law attorney can help you negotiate and draft a commercial lease agreement that works effectively for your new medical practice.

Employment Matters

If your medical practice is planning on hiring employees, you need to take the time to put the proper structure in place. Make sure you and your business partners understand the legal requirements of your business. As an example, all employers in California with five or more total employees are subject to the Fair Employment and Housing Act (FEHA). An employment lawyer with experience representing business owners in the healthcare industry can help you create and implement strategies to limit conflict with employees and reduce your liability risk.

Business Contracts

In the modern business world, contracts are at the basis of most commercial agreements. Whether your medical practice is working with partner companies, such as a medical service organization (MSO), or entering into agreements with outside suppliers/vendors, it is essential that you rely on well-drafted business contracts.

Call Our Fremont, CA Medical Practice Formation Attorney for Help

Attorney Lynette Ariathurai is committed to providing forward-looking guidance and cost effective legal representation. If you have any questions about what business and legal items you need to start a medical practice in California, we can help.

Contact us today for a confidential initial consultation with a business lawyer. From our office in Fremont, we serve businesses and startups throughout the region, including in Hayward, Union City, Castro Valley, Milpitas, and Newark.

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Business Attorney for Doctors, Nurses and Medical Personnel

Building, growing, and managing a successful business is complicated — particularly for doctors, medical specialists, and other health care providers who must navigate some unique regulatory and logistical challenges. Attorney Lynette Ariathurai is a skilled business law advocate with extensive experience representing physicians and other health professionals. For a confidential consultation with a California business lawyer for medical professionals, please call our Fremont office at 510-794-9290 or send us a message online.

We Provide Business Services for Doctors and Medical Professionals in the Bay Area

Business Formation

We help health industry professionals and entrepreneurs form businesses under California law. The state’s Moscone-Knox Professional Corporation Act imposes significant restrictions on the ownership and control of many companies in the medical industry. Our firm will help you and your partners form a professional corporation that provides strong liability protection. We also advise health practitioners and entrepreneurs with buying and selling businesses and organizations.

Regulatory Compliance

Professional corporations in the health care industry must navigate complex regulatory compliance issues, including things like the Stark Law, federal anti-kickback statutes, and California state rules. Our founding business attorney Lynette Ariathurai has the knowledge and legal skill to help you understand your obligations.

Professional Licensure Issues

Business attorney Lynette Ariathurai helps physicians and other health professionals navigate the full spectrum of professional licensing issues. If you are a doctor, a nurse, a dentist, an optometrist, or any other health industry business owner with questions about a professional license, we are here to provide guidance.

Contract Review and Negotiation

Contracts are at the foundation of most commercial relationships. Our business lawyer for medical practitioners provides representation on business contracts. If you have any questions or concerns about the drafting, review, or negotiation of business contracts, we are more than happy to help.

Employment Law

Many professional medical corporations in California have employees. Lynette Ariathurai provides a full range of employment law services for employers. Our focus is on helping you and your business partners put the proper structure in place to prevent claims, including employee handbooks, employment law agreements, and advising employers on wage & hour laws, worker discipline and termination.

Dispute Resolution

Disputes happen. If you are involved in a dispute with a patient, an employee, a vendor/supplier, a competing firm, or any other party, it is crucial that you take immediate action. With experience in mediation, arbitration, and litigation, our Fremont, CA business law firm will protect your rights and help your professional practice find the best path forward.

Get Help from Our California Business Lawyer for Medical Professionals

Attorney Lynette Ariathurai is committed to protecting the rights and interests of clients. We provide reliable, solutions-driven business representation to physicians and other medical personnel. Contact our law firm now to schedule a confidential appointment with a skilled attorney. From our Fremont office, we provide business services to doctors, nurses, and medical professionals throughout the region, including those in Newark, Hayward, East Bay, Milpitas, Union City, San Leandro, Gilroy, San Jose, and Santa Clara.

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Medical Partnerships, Leases and Entity Formations

If you are planning to open your own medical practice in California, it is critical to understand how California law affects your ability to choose a business structure for your medical practice and to enter into business with other healthcare professionals. Generally speaking, California law allows physicians to operate medical practices as sole proprietorships, partnerships with other physicians, and as professional medical corporations. Other types of common business structures are not permitted under California law for healthcare businesses. Beyond entity formation, physicians and other healthcare providers who are considering the possibility of starting a new practice will also have to consider specific issues when it comes to leasing commercial space for a healthcare business.

Our experienced California business formation lawyer can help. Attorney Lynnette Ariathurai serves business owners throughout Northern California.

Forming a Medical Partnership

If you are thinking about opening a new medical practice and want to keep the structure of your business relatively simple, California law allows you to form a partnership (or to operate your healthcare practice as a sole proprietorship). However, any physician or other healthcare professional in California should learn more about the limitations of medical partnerships in relation to personal liability and taxation as well as the benefits of creating different business structures for the assets of the business versus the medical practice. Many healthcare providers and medical professionals who open new or are expanding practices find benefits in forming a professional medical corporation.

Professional Corporations for Medical Practices

Under California law, healthcare practices cannot form traditional certain business structures such as a limited liability company (LLC) or a corporation when forming a business. Instead, professional healthcare providers, including licensed physicians, surgeons, nurses, chiropractors, psychologists, optometrists, clinical social workers, and many other professionals must create a professional medical corporation. There are many benefits to forming a professional medical corporation, including limiting liability (some limitations arising out of medical malpractice), as well as tax benefits similar to those of an S-Corporation.

The Moscone-Knox Professional Corporation Act explicitly outlines the types of professional services that are provided in a professional medical corporation, and what kinds of healthcare providers or medical professionals can be officers, directors, and own shares in these types of corporations.

Commercial Lease Considerations for Healthcare Practices

In addition to the complicated issues surrounding entity formation for healthcare practices and businesses, it is important to work with a California business lawyer on any commercial lease for a healthcare practice. There are a variety of issues that you should consider in your lease beyond those that might appear in another kind of commercial lease, such as:

Tenant and landlord responsibilities concerning HIPAA and patient files stored on the premises
Medical waste and removal
Use of medical devices and storage of medical materials on the premises
CAM or NNN expense distribution between landlord and tenant
Parking space for patients

Contact a California Entity Formation Lawyer

If you are a healthcare provider and are considering your options for starting a new practice, it is critical to seek advice from a California entity formation attorney about the nuances of entity formation for medical partnerships and corporations, as well as the complexities of medical commercial real estate leases.

Attorney Lynnette Ariathurai is committed to representing business owners in Northern California and can speak with you today about medical entity formation. We serve business owners in Fremont, Hayward, San Leandro, Gilroy, Milpitas, Union City, East Bay, San Jose, Santa Clara, and Newark. Contact us for more information about how we can assist you with your new medical practice.

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Obtaining Your Professional License

When you are starting your own business or entering into a new professional field, you may be required to have a professional license according to California law. Indeed, there are many kinds of businesses and professions that require proper licensing, and it can be complicated to determine on your own what steps you must take to obtain and to maintain your professional license. California has various licensing boards, and they each have their own sets of requirements for seeking a professional license and ensuring that the license remains current.

California professional license laws may require legal assistance for individuals, corporations, partnerships, and other business entities seeking to obtain a professional license for their business. For professionals in healthcare fields or those with fiduciary duties like accountants veterinarians, and doctors, it is critical to begin working with a California professional license lawyer as soon as possible.

Working with a Lawyer to Obtain Your Professional License

As a business owner or professional in California you may need to obtain a professional license in order to perform your work or services in the state. Some of the professions that require licenses include, but are not limited to:

Doctors
Nurses
Pharmacists
Physical therapists
Veterinarians
Acupuncturists
Chiropractors
Dentists
Attorneys
Real estate agents
Certified public accountants (CPAs)
Insurance agents
Private investigators
Construction Contractors

Depending upon your specific profession and the license you are seeking, you may need to apply for your professional license with the California Department of Consumer Affairs (DCA), or the boards (state government agencies) for your profession. Navigating the professional licensing process in California can be extremely complicated. As such, it is important to work with a lawyer who can help.

What You Need to Do

The specific process for seeking a professional license in California will depend upon the license you are seeking, but generally speaking, you will be required to submit an application for the professional license along with a completed application package. While the contents of the application package will vary depending upon the type of license, in most cases will include:

The completed application forms
Fees
References
Official education transcripts
Examination results, and
Fingerprints

The timing for your professional license will also vary depending upon the type of license. The websites might publish estimated turn-around time.

Professional Licensing Challenges

Without assistance from a lawyer, you may run into a variety of challenges while trying to obtain a professional license in California. You may not meet the eligibility or experience requirements for the license you are seeking, you may not have passed a required examination, your application could contain errors, your application package could be missing required documents, or you may not have submitted the appropriate fees.

In short, the application package for a professional license is substantial, and there is significant room for error.

Contact a California Professional License Attorney Today

If you need to obtain a professional license in California, it is essential to have an experienced California professional license lawyer on your side. Get advice from a lawyer who can ensure that the process goes smoothly.

Attorney Lynnette Ariathurai has years of experience serving businesses and professionals in Fremont, East Bay, Hayward, Milpitas, Union City, San Leandro, Gilroy, San Jose, Santa Clara and Newark. Contact us today for more information about obtaining your professional license.

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Three Things You Must Know When Starting a Home Health Agency

Home health agencies have revolutionized elder care options, permitting many older adults to live in their own homes longer than before. These agencies are responsible for placing health care professionals – registered nurses, nursing assistants, physical therapists, or home care aides – in the patient’s home to provide primary care, medical treatment, and assist with day-to-day living activities so that the patient may remain in his or her home.

If you are interested in starting your own health care agency, you will need to master the following three topics to successfully grow your business and meet market demands:

Regulations that apply to home health agencies
The importance of providing employee training, and
The labor laws that apply to the home health care industry.

Know the Regulations That Apply to Home Health Agencies

The federal government and the state of California heavily regulate the home health agency field. There are different laws that apply when hiring a home health care worker directly than when hiring a health care worker through an agency. Additionally, you must have a license to operate a home health agency before you start operating your business.

Copying information from another home health agency to create your compliance documents may not be sufficient. The information may not apply in California, may be outdated, or may never have been correct. It is important to consult with a business lawyer who is knowledgeable about the legal needs of a home health agency and can help you comply with all legal requirements, including record keeping, on-going legal requirements, and compliance with HIPAA.

One of the costliest problems is that if the home health agency collects Medicare, their rules regarding what protocol must be followed and required documentation must be kept in compliance. Medicare performs audits routinely and then charges back the agency many thousands of dollars if records are not in compliance.

Develop and Train Your Team of Employees

It is important for your employees to be fully trained to perform their tasks and to understand what documents need completing and maintaining when providing care for an individual in his or her home. You must provide training that demonstrates how to properly complete these documents and why their inclusion in the patient’s care plan is necessary. Other topics that you should cover in training include HIPAA compliance and labor law compliance.

Know Applicable Labor Laws

Owners of home health agencies must know the labor laws that apply to their workforce. Your payroll department must understand when to pay overtime, the rest and meal break laws, the difference between independent contractors and employees, and what labor records to keep.

If you are an entrepreneur planning to start a home health agency or already running one in the East Bay Area including the communities of Fremont, Hayward, Union City, Milpitas, or Newark, California, seek legal advice and counsel of a business lawyer today.

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