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Susan McNear Fradenburg

Susan McNear Fradenburg


T (336) 378-5482
F (336) 378-5400

Susan Fradenburg has over 20 years’ experience representing clients in the health care industry with a focus on long term care providers and hospitals.  Susan has assisted health care providers who want to offer a new service through the Certificate of Need process and helped existing providers maintain their licensure and certification.  Negotiating with State and Federal entities, Susan has helped clients remove denial of payment for new admission penalties and avoid termination from the Medicare and Medicaid programs.  Additionally, she has advised clients in avoiding fast track terminations, resulting from EMTALA and immediate jeopardy survey deficiencies; preparing documents for hearing and negotiating with the State and Federal attorney general offices.

Susan has argued Certificate of Need matters at the North Carolina Court of Appeals and a reimbursement issue at the 4th Circuit Court of Appeals.  She also appears in both Federal and State Administrative Courts challenging penalty appeals.

Susan has prepared asset purchase agreements and operation transfer agreements, working on the specific Certificate of Need, licensure, and federal certification issues that are involved in such transactions.  She has worked with NC Tracks and CMS to provide notice regarding change of ownership and other required updates, assisting clients with revalidation requests.

Susan also handles many day-to-day issues related to operating long term care facilities including updating policies and procedures to address new state and federal regulations, reviewing contractual arrangements, handling resident and family member questions and concerns, assisting with discharge of residents, answering questions regarding advance directives, Powers of Attorney and guardian documents, and dealing with surveyors.

Susan has spoken on and has authored manuscripts and articles regarding arbitration and false claims actions impacting long term care facilities, submissions of the Medicare 855 form, HIPAA and trends in long term care litigation and certificate of need law.

Actively involved in scouting in her community, Susan was a cubmaster for her sons’ pack for seven years and is the assistant troop leader and product manager for her daughter’s girl scout troop.

  • Named Greensboro Best Lawyers Health Care Law "Lawyer of the Year" (2018)
  • Listed, The Best Lawyers in America® (Woodward/White, Inc.), Health Care Law (2013-2018)
  • Martindale-Hubbell's top ("AV") Peer Review Rating *

* CV, BV, and AV are registered certification marks of Reed Elsevier Properties Inc., used in accordance with the Martindale-Hubbell certification procedure's standards and policies.


Representative Work

Regulatory Compliance

  • Assist with preparation of documents to bring providers back into compliance and avoid termination based on alleged EMTALA violations.
  • Prepare documents and present defense regarding potential EMTALA violations to both Quality Improvement Organizations and the Office of Inspector General.
  • Routinely work with skilled nursing facility and assisted living providers to respond to survey deficiencies by assisting in drafting plans of correction, credible allegations of compliance, and informal dispute resolutions material.
  • Present argument to the N.C. Department of Health Service Regulation penalty review committee on behalf of assisted living facilities.  Handle hearings before the Federal Office of Administrative Hearings and appeals to the Departmental Appeals Board on behalf of skilled nursing facility providers.
  • Assist hospital clients and nursing home clients faced with fast track termination of Medicare/Medicaid Certification by:
  • preparing legal documents for filing in federal court, to avoid termination from the Medicare and Medicaid program;
  • negotiating with CMS to resolve matters without termination; and,
  • meeting in person with Region IV representatives to negotiate on behalf of a skilled nursing home client.
  • Assist clients with submission to CMS and NC Tracks related to changes in ownership and changes in information.  Address questions that have arisen regarding who is deemed an owner for the purpose of reporting information, necessary documentation in loan documents, and calculating percentage ownership.
  • Prepare 855 revalidation documents on behalf of health care providers.
  • Licensure Litigation
  • Conducted hearing before the Board of Examiners for Speech Language Pathologists and Audiologists
  • Assisted clients in responding to request for information to the Nursing Home Administrator Board
  • Negotiated settlements with the N.C. Medical Board
  • Certificate of Need Work
  • Represented hospices, skilled nursing facilities, assisted living facilities and hospitals in Certificate of Need litigation from administrative hearing to appeal to the North Carolina Supreme Court.

Management Counseling/HIPAA

  • Prepare HIPAA documents, forms, training materials, conduct training sessions on use of such documents, and best practices for nursing homes and assisted living facilities
  • Prepare wide variety of general policy and procedure documents for long term care providers
  • Advise and assist with questions that arise regarding advanced directives, power of attorney and guardian documents
  • Assist in handling of discharge of residents for failure to pay and completion of paperwork and addressing potential options regarding the same.

Transactional Work

  • Prepare Asset Purchase Agreements and Operations Transfer Agreements and assist with addressing regulatory and licensure issues that arise as part of purchase and sale of skilled nursing facilities and home care agencies

Fraud and Abuse

  • Assisted psychiatric practice with preparing response to subpoena
  • Assisted Hospice Agency with response to subpoena

Provider Defense Litigation

  • Handled numerous malpractice actions for skilled nursing facilities, handling issues such as piercing the corporate veil, presenting motions for summary judgment, and motions to dismiss punitive damages claims.


  • Clerkship, Justice Louis B. Meyer, North Carolina Supreme Court
  • Clerkship, Justice Sarah E. Parker, North Carolina Supreme Court

* Past success does not indicate the likelihood of success in any future legal representation.

Thought Leadership

Published Works

  • Co-author, "Top Ten Health Law Issues 2017," AHLA Connections, January 2017
  • "Health Care Reform Bill Impact on Long Term Care Providers," Law Note:  Looking at Long Term Care, May 2010
  • "To Appeal or Not to Appeal," Options to take after Imposition of Large Civil Monetary Penalties, Law Note:  Looking at Long Term Care, April 2010
  • HIPAA Manual and Model Forms for North Carolina Nursing Homes for the North Carolina Health Care Facilities Association, December 2002
  • "District Memorial Hospital Decision" August 3, 2001
  • "Recent Authority Impacting Certificate of Need Law" July 6, 2001
  • "Pending Health Care Legislation – N.C. Senate Bill 714" June 14, 2001


  • "A Tale of Two States... It was the Best of Times, it was the Worst of Times - How legislative matters are impacting healthcare providers and planners from NC and SC, for better and for worse", Carolinas Society for Healthcare Strategy & Market Development Fall Conference, October 22, 2015
  • "Maintaining Privacy and Professionalism in an Increasingly Digital World", N.C. Assisted Living Association Fall Conference, Winston-Salem, North Carolina, October 7, 2015
  • Recent Administrative, Federal and State Court Decisions Impacting Operations of Skilled Nursing and Assisted Living Facilities.” American Health Lawyers Association’s Long Term Care and the Law Program, New Orleans, Louisiana, February 23 and 24, 2015
  • "Submission of an 855 Form for Revalidation, Change of Information or Voluntary Termination Purposes -- What information needs to be provided and when?," American Health Lawyers Association, Long Term Care and the Law Program, Las Vegas, Nevada, February 19, 2014
  • "Assessing Patient Care:  A Formula for Reducing Liability Claims Against Skilled Nursing Facilities," North Carolina Bar Association, Nursing Home Litigation Program, Raleigh, North Carolina, February 6, 2009
  • "Navigating Appeals of Nursing Facility Survey Deficiencies," Web Seminar, Greensboro, North Carolina, February 21, 2008"
  • HIPAA Privacy Rule Training for North Carolina Long Term Care Facilities," North Carolina Health Care Facilities Association, Greensboro, North Carolina, January 6, 2003
  • "HIPAA Privacy Rule Training for North Carolina Long Term Care Facilities," North Carolina Health Care Facilities Association, New Bern, North Carolina, January 9, 2003
  • "Confidentiality of Medical Records", Lorman Education Services, July 24, 2002 and June 2001
  • "Surveys: How to Respond," co-presenter, North Carolina Health Care Facilities Association program, Greensboro, North Carolina, July 17, 2002
  • "New JCAHO Patient Safety Guidelines", presented to administrative and medical staff of Central Carolina Hospital, August 2001
  • "Recent Authority Impacting Certificate of Need Law", North Carolina Bar Association's Health Law Section Annual meeting, Cary, North Carolina, May 2001
  • "Responding to a Survey - Plans of Correction, Credible Allegations of Compliance, and Informal Dispute Resolution," co-presenter, North Carolina Health Care Facilities Association program, Chapel Hill, North Carolina, March 23, 2002
  • "Nursing Home Liability – The Best Defense Is a Good Offense," North Carolina Health Care Facilities Association, Greenville, North Carolina, April 28, 1999; Hickory, North Carolina, April 29, 1999
  • University of Kansas, B.A., with highest distinction, 1990
  • Wake Forest University School of Law, J.D., 1993
  • North Carolina, 1993
  • North Carolina Bar Association, Health Law Section
  • Health Law Section Council, 2001-2004
  • American Health Lawyers Association
Academic Honors
  • Phi Beta Kappa
  • The Order of Barristers

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