Photo of Sandi  Krul

Sandi Krul

Partner

Education

University of California, Los Angeles, B.A., 1992

Loyola Law School, J.D., 1995

Seton Hall University, School of Law, Graduate Certificate in Health and Hospital Law, 2012

Bar Admissions

  • 1995, California
Profile
Presentations & Speaking Engagements
News
Publications

Sandi Krul is a leader in the firm’s health care real estate practice and has more than 20 years of experience managing and negotiating complex real estate transactions, including leases, acquisitions, dispositions and financings. Sandi represents hospitals, health care districts, skilled nursing and other long-term care providers, treatment centers, physician groups and other health care providers and suppliers on all forms of real estate transactions, as well as physician-hospital affiliations, mergers and acquisitions and other health care transactions consistent with regulatory requirements, including fraud and abuse laws and the corporate practice of medicine.

Sandi has managed hundreds of leasing arrangements, acquisitions, sales and other health care transactions of all sizes across California on behalf of hospitals, long term care and other health care providers, as well as transactions throughout the U.S., including hospital affiliation transactions in Idaho and Texas. Sandi also successfully represented California hospitals in obtaining HUD financings ranging from $17M to $200M – nearly half of all hospital HUD financings in California between 2010 and 2019, including construction financing needed to build a new patient tower.

Sandi deftly guides her clients in navigating the complex interactions between health care law and real estate. This includes counseling clients on Stark, the anti-kickback statute, fraud and abuse, co-location issues and other health care regulatory matters that can easily be unintentionally violated by general real estate practitioners.

In keeping with her commitment to volunteer work, Sandi is a Member of the Executive Go Red for Women Leadership Team for the American Heart Association in Los Angeles and serves as Chair of the Real Estate Affinity Group of the American Health Lawyers Association. She is also a former Board member of Women in Health Administration of Southern California.

Representative Matters

Facility and Real Estate Acquisitions, Including:

  • California rural hospital’s acquisition of several parcels of land for development of additional clinics and health care programs
  • $62.7M acquisition of 6 California skilled nursing facilities in coordination with larger $700M multi-state Kindred portfolio sale
  • Southern California hospital’s $28M acquisition and financing of medical office building
  • Skilled nursing operator’s $6.1 million acquisition of northern California leased facility

Leasing Transactions, including:

  • Negotiation and drafting of $36M long term lease for development of new Southern California hospital campus medical office building
  • Representation of national health system in negotiation and drafting of $24M long term California rural hospital lease

M&A and Affiliations, Including:

  • Multiple physician practice acquisitions and friendly PC management implementation in connection with Northern California health system’s foundation model clinic expansion
  • Representation of rural health care district with ambulatory clinic strategy and implementation
  • Several physician practice acquisitions on behalf of Southern California health system in connection with expansion of ambulatory care delivery services

Financings, Including:

  • $200M HUD financing for construction of new hospital patient tower
  • Representation of nursing home chain in $60M secured financing ($30M revolving line of credit and $30M term loan financing)
  • $15M revolving line of credit for California community hospital

Other Legal Experience includes:

  • Negotiation and drafting of professional service and related agreements for implementation of friendly PC/MSO arrangements
  • Drafting and negotiation of utility, access and avigation easements
  • Guidance on land use and zoning matters
  • Construction contracts
  • Advise on Stark, AKS and other health care regulatory compliance matters
  • Provide legal opinions in support of financing transactions
  • Negotiation of numerous cell tower agreements

Professional Affiliations

  • Chair of Real Estate Affinity Group, American Health Lawyers Association, June 2018-Present (Vice Chair from June 2015- June 2018)
  • Member, California Society for health Care Attorneys
  • Member, Los Angeles County Bar Association, Health Law and Real Property Sections
  • Member, American Bar Association, Health Law Section
  • Former Board Member Women in Health Administration of Southern California (Jan. 2015-Dec. 2017)

Community/Civic Activities

  • Executive Leadership Team Member, American Health Association Go Red for Women (Los Angeles), Sept. 2018-Present
  • Former Board Member, Vital Options International (Jan. 2013-Dec. 2016)

Presentations & Speaking Engagements

  • Moderator, A “Blueprint” for Success: Real Estate Leasing & Stark Law Best Practices for Hospitals and Health Systems (Webinar), American Health Lawyers Association, January 2018
  • Co-Presenter, The Health Care Real Estate Toolkit Version 2.0: Timeshare, Holdovers, Qui Tam Dangers, and Other Real Estate “Hot Topics” for 2016 (Webinar), American Health Lawyers Association, February 2016
  • Guest Lecturer, Fundamentals of Health Law and Compliance (Corporate Law, Corporate Practice of Medicine and Tax Exemption), UCLA School of Public Health, February 2014

Other Publications

Publications

  • Proposed Stark & Anti-Kickback Regulations Are A Big Deal, October 16, 2019
  • Antikickback Law Chapter, Compliance Manual – California Hospital Association, Contributing Author for 2019 and continuing updates
  • MOB Leases With Unusual Terms Withstand Appraiser Whistleblower Claims, August 19, 2019
  • Representing Hospitals and Health Systems Handbook,  Author (Chapter 38 – Real Estate Issues, AHLA (First Edition) 2016
  • Anti-Discrimination Considerations for Employer-Based Wellness Programs - Existing Law and New Proposed Regulations and Guidance, Author, Health Law Perspectives, Vol. 17, No. 5, June 2015
  • Navigating Due Diligence in Health Care Transactions: Sensitive Information and Pitfalls, Co-Author, Business Law News, Issue Number 2 (2015)
  • Navigating Due Diligence: Sensitive Information and Pitfalls, Co-Author, Compliance Today, Health Care Compliance Association, April 2015
  • OIG Signals Flexibility for Evolving Healthcare Reform Initiatives, Co-Author, Health Law Perspectives, Vol. 16, No. 9, October 2014
  • 2014 Update to California Physician's Legal Handbook chapter on Fraud and Abuse: Referral Issues (co-author).
  • Co-Management Agreements: Improving Quality and Value Through Clinical Integration (co-author with Charles Oppenheim), Bloomberg BNA's Health Law Reporter (23 HLR 14), April 3, 2014
  • Clinical Co-Management Arrangements: The OIG Speaks (co-author with Charles Oppenheim), Compliance Today, Health Care Compliance Association, May 2013
  • OIG Issues First Advisory on Physician/Hospital Co-Management Arrangements, W. Bradley Tully and Sandi Krul, Health Law Perspectives, Vol 15, No.1, February 2013.
For media assistance, please contact Maura Fisher at 202-580-7714.