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They’ve Got Next: Healthcare and Life Sciences Fresh Face Nina Marsden

April 22, 2021, 9:31 AM

Nina Marsden spent much of 2020’s Covid-19 lockdown managing the change-of-ownership regulatory review process for a three-hospital health system in California, enabling the deal to close at year end as planned.

“I was on the phone constantly,” she said.

Technically, the system reorganized, but the nature of the deal meant its facilities had to reapply for all their operating permits, certificates, and licenses, just as if a buyer was acquiring them for the first time, the Hooper, Lundy & Bookman Los Angeles partner said.

Marsden inventoried everything from the facilities’ in-house pharmacy and laboratory licenses to their federal contracts and Medicare and Medicaid approvals. Some tasks could be done long in advance, and others came right down to the wire, she said.

Completing the regulatory process for this type of deal is like “putting together a puzzle,” Marsden said. In the end, cooperation and coordination are key, she said.

Backstage work like this doesn’t attract a lot of “fanfare” when it’s done right, Marsden said. “The biggest wins are behind the scenes,” she said.

But it would be pretty obvious that something had gone wrong—a missed application deadline, for example—if a hospital couldn’t open its doors because it lacked the right operating permits, she said.

Marsden has a hard time contemplating the consequences of that happening. It’s a “potentially big exposure,” which can be costly because providers must be in compliance with all relevant regulations in order to get paid, she said.

Covid’s Big Challenge

“Very few other people could have done it,” Katrina Pagonis, chair of Hooper, Lundy & Bookman’s regulatory practice, said about the three-hospital system deal. Marsden’s thorough knowledge of “byzantine” regulatory structures and contacts in the agencies gave her a decided advantage, Pagonis said.

Marsden knew exactly what information regulators needed and when they needed it to approve the permits, Pagonis said. She was able to anticipate and avoid potential obstacles—like California’s pharmacy board, which is “notorious” for throwing up roadblocks, Pagonis said.

“This is a very complicated process at the best of times,” Pagonis said.

As the agencies were trying to figure out the best way to deal with the public health emergency and providers were “inundated” with patients, the Covid-19 pandemic added extra pressure, Marsden said.

“Everyone was strapped for resources” and busy dealing with the real-life issues, Marsden said.

California’s lockdown also complicated matters. Phone calls took the place of Marsden’s usual on-site, information-gathering visits, in which she often talked to compliance officers and people in the billing offices, as well as general counsel, she said. But the “pivot” to working from home was impressive, she said.

Firm’s Role

Marsden’s ability to sort through the various levels of federal and state oversight, and her understanding of the laws and regulations governing everything from pharmacies to Medicare reimbursement, led the firm to tap her to lead its Covid-19 task force.

The attorney started hearing early on from clients concerned about the pandemic, she said. They were worried about their capacity and resources to fight the virus, but confused because public health agencies started putting out guidance “right and left,” she said.

Marsden immediately started to track and pull all that data together, according to Pagonis. She put together a page on the firm’s website to address client’s concerns, creating a one-stop resource that made “the complicated navigable,” Pagonis said.

The page includes links to webinars on topics like how to create and sustain a telehealth program and how to get federal Covid relief money. It also links to multiple legal advisories on topics such as how to take advantage of the federal government’s Stark law waiver.

Finding Her Place

While at Boston University School of Law, Marsden at one time questioned whether she’d made the right choice because she’s not an adversarial person by nature.

The daughter of a doctor, she’d always been interested in health care. So she took a course in public health law. After that, Marsden focused on health-care policy, she said. The experience opened her eyes to how the law and health industry work together Marsden said.

Marsden took the initiative and wrote to Hooper Lundy—a well-known health-care firm whose representative clients include the University of Southern California, Cedars-Sinai Medical Center, and the California Association of Health Facilities. She got the job, and has been there ever since.

And she found a place where she could thrive in a profession that often values “flashy” wins over getting the job done, she said.

To contact the reporter on this story: Mary Anne Pazanowski in Washington at

To contact the editors responsible for this story: Lisa Helem at; Brent Bierman at