Charmaine Mech Aguirre


Direct: 404.873.7018
Fax: 404.873.7019
171 17th Street NW
Suite 2100
Atlanta, Georgia 30363


Charmaine is an associate in the Healthcare practice. Additionally, she serves as a member of the Hospitals & Health Systems, Healthcare Real Estate, Change of Ownership (CHOW), Life Sciences, and Post-Acute & Long-Term Care industry teams. Charmaine is also a member of the Pro Bono Committee. She represents a wide range of clients in the healthcare industry, providing guidance on federal and state issues relating to compliance, facility licensure, certificate of need, Medicare and Medicaid reimbursement, the Stark law, the Anti-Kickback Statute, HIPAA, and healthcare transactions.

Charmaine has counseled providers in regulatory compliance matters, government investigations, and self-disclosures including identifying, quantifying, and disclosing overpayments to state Medicaid agencies and the Centers for Medicare and Medicaid Services. Charmaine also has experience representing multiple provider types, including hospice, home health, and laboratory services providers, in reimbursement appeals before the Centers for Medicare and Medicaid Services. In addition, Charmaine has counseled national providers, private equity investors, REITs, and other investors in multi-state acquisitions.

Charmaine received her Bachelor of Arts in English and History from the University of Georgia. She also received her Juris Doctorate from the University of Georgia School of Law, where she served as an editorial board member of The Georgia Journal of International and Comparative Law. During law school, Charmaine was an extern with Gwinnett Health System General Counsel, the U.S. Securities and Exchange Commission, and Honorable Judge Reuben M. Green.


  • Advised a leading owner-operator of integrated senior healthcare campuses in multiple facility refinancings (including with HUD) in a number of states, including Indiana, Kentucky, Michigan, and Ohio. AGG assisted with determining any filing requirements for the refinancings, the compilation of filings, and the opinion-writing process for the many facilities, including nursing facilities, assisted living facilities, residential care facilities, and homes for the aged.

  • Advised a large pharmacy operator in its acquisition of more than 20 Missouri pharmacies out of bankruptcy. In order to effect the acquisition, AGG handled preparation of transaction documents, filings, and interactions with the U.S. Drug Enforcement Administration, Centers for Medicare and Medicaid Services, State Board of Pharmacy, and the State Medicaid Agency. AGG also reviewed the purchase agreement from both a healthcare regulatory and FDA-perspective.

  • Represented a healthcare operator in its acquisition of a Georgia continuing care retirement community (CCRC) and provided transaction support, including limited diligence, the filing of certificate of need, Medicare, Medicaid, and multiple licensure applications, as well as ancillary license applications, structuring advice, and negotiated regulatory components of the underlying deal documents. The CCRC had a skilled nursing facility, assisted living community, personal care home, and independent living component and was regulated by both the Georgia Department of Community Health and Office of Insurance and Safety Fire Commissioner. The transaction required a unique focus on the nursing facility’s certificate of need, which was initially obtained in the 1990s during changing certificate of need requirements. The client ultimately received a favorable determination from the Georgia CON agency and closed the transaction on its originally scheduled closing date.

  • Assisted a national REIT in its minority investment in a portfolio of a variety of healthcare providers, including assisted living, memory care, hospice, and private-pay in-home care. The providers were located in multiple states, including Arizona, California, Illinois, Texas, Utah, Washington, and Wisconsin. AGG’s involvement included in-depth diligence, including a review of the providers’ licenses, permits, certifications, and accreditations, PEPPER reports, government investigations and surveys, hospice cap calculations, compliance program, background screening, HIPAA, medical directorships, admission agreements, commercial payor audits, and corporate practice of medicine. AGG also assisted with preparing the underlying investment agreement and related disclosure schedules.

  • AGG advised on an asset transaction for a skilled nursing facility operator which operates senior-care facilities in several small Georgia communities. Because the transaction involved a hospital authority owner of the real estate, AGG handled the filing of a full certificate-of-need application, a 60-day process that requires gathering a significant amount of information and data.

  • Advised a longstanding private equity client on all regulatory aspects of a consensual receivership with three different operating companies in 8 states. AGG oversaw the transition of the facilities to new operators during the receivership. The affected facilities were located in Wisconsin, Minnesota, Idaho, Oregon, Washington, West Virginia, Delaware and Pennsylvania.


  • University of Georgia School of Law, Juris Doctor,
    cum laude
  • University of Georgia, Bachelor of Arts - English and History,
    cum laude
    • Young Women Leaders Forum, Cohort, 2024


  • Best Lawyers in America®: Ones To Watch, Health Care Law, 2023-24

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