Hospice Self-Determined Aggregate Payment Cap Report Due February 28

Health Care Financial Services

The constantly shifting health care regulatory landscape requires experienced professionals for successful navigation. BKD National Health Care Group advisors understand the ins and outs of health care operations and the risks involved. We offer a multitude of financial services for home care and hospice groups, such as audit, tax compliance, accounting outsourcing and more.


Health care providers need auditors who understand health care operations and risk. BKD National Health Care Group performs audits for thousands of health care providers nationwide. Our clients range from large multifacility health systems with more than $2 billion in revenues to critical access hospitals, rural hospitals, community health centers, long-term care facilities, home care agencies and other health care providers.

BKD’s audit and assurance solutions can help clients secure financing rated by national rating agencies and obtain insured bond issues approved by HUD- or AAA-rated bond insurance companies. Our auditors are trained to address specific health care risk areas including:

  • Accounts receivable valuations
  • Third-party settlements
  • Malpractice reserves
  • Investment valuation
  • Revenue recognition
  • Internal controls
  • Employee benefit plans

Tax Compliance & Planning

Tax law changes are one of the few constants of American life, and every change adds a new layer of complexity to an already complicated process.

BKD tax consultants work full-time to keep up with these changes, developing strategies that allow you to take advantage of benefits within the tax law and using their professional judgment and experience to advise you as to what actions you can take to reduce your tax burden. This forward-looking approach allows you to plan for the future—and because most financial decisions have tax implications, careful tax planning can greatly affect the final outcome.

BKD annually prepares thousands of tax returns for individuals, businesses, trusts and tax-exempt entities. Beyond our compliance services, we provide a variety of tax planning and consulting services, including assisting with benefit plan design, compensation issues and estate planning for owners; applying for and maintaining tax-exempt status; and monitoring compliance with reporting and disclosure requirements.

Accounting Outsourcing

BKD provides a wide range of outsourcing services to meet your company’s accounting, tax, financial management and consulting needs. Our services allow you to concentrate on what you do best. Some of the outsourcing services we provide include:

  • Internal audits
  • Financial statement preparation
  • General ledger maintenance
  • Monthly & year-end closing assistance
  • Payroll & sales tax return preparation
  • Account reconciliations
  • Controller & bookkeeper staffing
  • Payroll & accounts payable processing
  • Accounting systems design
  • Accounting staff training
  • Depreciation schedules
  • Accounting software assistance

Cost Reports

Cost reporting in the health care industry is about compliance and reimbursement. BKD National Health Care Group is one of the largest providers of Medicare and Medicaid cost report preparation services in the country. We have prepared thousands of cost reports for hospitals, senior residential facilities including long-term care centers, nursing facilities and continuing care retirement communities, home health agencies, community health centers and rural health clinics.

Preparation of annual Medicare and Medicaid cost reports is the foundation of our reimbursement services. We help providers keep up with changes in reporting requirements while working to complete timely reports. Our services help providers like you interpret the results of your cost reports so you know if you make or lose money on individual service lines.

For some providers, the cost report has a direct impact on Medicare and Medicaid reimbursement. For many other providers, unique provisions can affect reimbursement if properly presented on the cost report. Our CPAs and advisors can assist you in analyzing your reimbursement situation so you understand how you are being paid compared to the cost of service to Medicare and Medicaid patients.

For our home health and hospice clients, we provide benchmarking analyses in addition to cost report preparation. This operations analysis is based on information in the Medicare cost report and compares your agency’s data to other home health and hospice agencies.


Benchmarking information for home health agencies is challenging to find. BKD National Health Care Group has developed an operational dashboard report for home health agencies designed to help you operate more effectively. The National Home Health Operations Dashboard Report is an individually customized comparison of your home health agency’s utilization, cost and profitability data to other selected home health agencies, the agencies in your home state and agencies nationwide.

BKD built the dashboard from some of the most complete data available for any benchmarking product on the market. The Medicare cost reports of freestanding and provider-based home health agencies, obtained directly from the Centers for Medicare & Medicaid Services, serve as the source. Powerful algorithms developed by BKD specifically for this project translate this data into meaningful indicators, organized in an easy-to-read and easy-to-reference format. Key indicators on the report include:

  • Visits per episode
  • Staff hours per visit
  • Detail cost per visit by discipline
  • Average case-mix weight
  • Episode adjustment mix
  • Average payment per episode
  • Detail cost per episode
  • Average profitability per episode
  • Overall agency profit margin
  • Salaries as a percent of total cost

John Knox Village

“The support staff of BKD provided John Knox Village with tools and training that allowed us to complete the implementation and transition in a timely manner. John Knox Village saw a drastic reduction in the outstanding accounts receivable and in the error rate on claims due to the pre-billing audit tool also provided by BKD."

“Since that time, BKD has continued to provide ongoing training and consultation and still provides monthly assistance in the billing and reporting process. We all really appreciate having BKD associates a phone call away; it is more than your typical client relationship. We highly recommend that if anyone is looking for a home health accounts receivable clean-up or assistance that you look to BKD and their excellent staff.”

— Ken Siverly, Director of Finance
John Knox Village
Lees Summit, Missouri

Howard County Home Health & Hospice

“We’ve worked with BKD for more than 20 years because their people understand the home care industry so thoroughly. BKD not only completes our financial statement audit, but we’ve tapped into a full range of additional services, including clinical and operations consulting, monthly financial statement compilations, tax return preparation, Medicare cost reports, pension plan administration and billing consulting. We are very pleased with BKD’s knowledgeable, professional staff.”

— Serese Wiehardt, RN, BSN, CHCE, Chief Executive Officer
Howard County Home Health & Hospice
Fayette, Missouri

Washington County Public Health & Home

“It is a pleasure working with our advisors at BKD. They exhibit a high level of professionalism and are knowledgeable about many facets of home health. The staff is cooperative in their efforts to fulfill our agency needs. BKD consistently provides excellent feedback and suggestions to help improve and sustain the financial stability of our agency.”

— Peggy Wood, Fiscal Administrator
Washington County Public Health & Home
Washington, Iowa

Excell Home Healthcare, Hospice and Personal Care

“BKD came in initially and helped us improve on the timeliness of our financials and now they perform a wide variety of services for us, including cost reports, clinical consulting tax preparation and financial consulting. The people at BKD are a great asset. Our advisor is easy to work with and very knowledgeable. He is accessible and takes the time to teach and advise, showing he really cares about our business.”

— Mina Acquaye, Chief Executive Officer and Administrator
Excell Home Healthcare, Hospice and Personal Care
Oklahoma City, Oklahoma

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