Health Care Industry Brochure

Long-Term Care Services

BKD National Health Care Group works with approximately 1,600 long-term care (LTC) and senior living providers nationwide. We apply our reimbursement, finance, clinical, operational, billing and information technology knowledge to provide long-term care services that can help facilities succeed in an ever-changing environment.

Audit Services

Health care providers need auditors who understand long-term care operations and risk. BKD National Health Care Group performs audits for thousands of health care providers nationwide.

Our auditors are trained to address specific risk areas for long-term care facilities, including the following:

BKD’s audits, among our assurance solutions, help clients secure financing rated by national rating agencies and obtain insured bond issues approved by HUD or AAA-rated bond insurance companies.

Cost Report & Reimbursement Services

BKD National Health Care Group prepares approximately 3,000 Medicare and Medicaid cost reports annually, making us one of the largest providers of this service in the country. Preparing these reports is the foundation of our reimbursement services. We help providers keep up with Medicare regulations and reporting requirement changes, and we assist in analyzing reimbursements to compare payments with the costs of rendering services.

The expertise of our cost report preparers, reviewers and reimbursement professionals is recognized by Medicare Administrative Contractors, state and national health care associations and industry leaders. We can coordinate with your reimbursement team to help you prepare and deliver cost reports, following guidance from the Centers for Medicare & Medicaid Services as well as state Medicaid agencies.

Billing Services

BKD Health Care Billing Services is a special division of BKD National Health Care Group that assists clients in managing more than $60 million in revenues for health care providers, including the following:

Our team of billing operation consultants and other industry professionals advise hundreds of clients nationwide, giving us a wealth of experience, expertise and best practices to draw on.

We know billing has a profound effect on your operations, and we are uniquely positioned to help provide strategies to improve the billing process and enhance cash flow.

Our solutions include the following:


We can facilitate the routine billing function by preparing and submitting your claims to Medicare, Medicaid and other third-party primary and secondary payors

Accounts Receivable Recovery

We can assist in collecting a backlog of unpaid claims with accounts receivable recovery services, including helping to identify and realign the processes contributing to the backlog.

Operations Assessments

We can help you identify potentially inefficient or ineffective practices that may contribute to poor cash flow, payment inaccuracies or other significant billing problems.

Compliance Assessments

We can help you assess billing operations in relation to internal corporate compliance and external federal and state regulatory compliance to help identify and mitigate potential risks or satisfy external reporting requirements.


We can provide tailored hands-on training for your personnel on basic and advanced billing issues.

Clinical & Operational Consulting

BKD National Health Care Group has helped hundreds of skilled nursing facilities (SNFs) with clinical and operational consulting issues.

Operational Assessments

BKD can assess your current operations, including a review of selected existing policies, programs, rate structure and available services through an on-site visit and an environmental assessment of the market. We’ll make recommendations for possible program or revenue enhancements and cost-saving measures, as well as financial ratio targets in collaboration with your management.

BKD will employ both qualitative and quantitative research techniques in the collection and analysis of data for the specified variables. This includes staff interviews, data abstraction from extant databases and personal observation.

Upon completion, BKD provides specific recommendations in report form, sufficient for use by management and board members in future planning and decision making.

PPS & MDS Assessments

Our skilled nursing facility (SNF) Prospective Payments System (PPS) analysis uses Medicare cost report data to compare facility-specific data to national averages as well as to industry best practice benchmarks. Management can use this information to improve operations by identifying opportunities to enhance reimbursement, control costs and identify concerns relative to possible compliance issues.

Our minimum data set (MDS) operational assessments help identify coding inconsistencies and documentation issues that can result in lost Medicare revenues and expose the facility to certain risks, including Medicare contractor probe reviews, Recovery Audit Contractor (RAC) audits and other third-party reviews.

Medicare Management Training

Our Medicare certification and management training program is tailored to the issues SNFs face. Our team can help by working with you to achieve the following:

  • Become Medicare certified
  • Complete a five-session Medicare training program to learn:
    • How to manage Medicare within the guidelines and federal regulations
    • The Medicare admission and inquiry process
    • Part A PPS
    • ICD-9 coding and documentation guidelines
    • Notice of Exclusion of Medicare Benefits (NEMB), Advance Beneficiary Notice (ABN), quality assurance and medical review
  • Complete on-site follow-up program review and training

Tax Services

Ever-changing tax laws add a new layer of complexity to an already complicated process. BKD tax consultants keep up with these changes and develop strategies that can help our clients take advantage of the law. We can advise you on actions you can take to mitigate tax risks or maintain your tax-exempt status.

Exempt Organizations

BKD’s tax planning and compliance services proactively work to serve the needs of exempt organizations including health systems. Through preparation of more than 2,000 IRS Form 990s and 990-Ts each year, BKD has experience helping exempt organizations meet their needs.

To help you comply with Form 990 requirements, we have a number of specialized tools:

  • A comprehensive data organizer to effectively and efficiently gather needed information
  • Templates to request required business and family relationship information and disclosure information about transactions with officers, directors, trustees and key employees
  • Educational sessions for board members and management regarding tax issues such as bond compliance, related-party transactions and higher education unrelated business income tax
  • Our Risk Analysis Report (RAR), which can help management and board members understand significant elements of your organization’s tax return

For-Profit Organizations

BKD annually prepares thousands of tax returns for all types of businesses. Beyond our compliance services, we provide a variety of tax planning and consulting services, from assistance with state and local tax issues to international tax advice and succession planning. Our services include:

  • Corporate tax planning
  • International tax services
  • Multistate taxes
  • Property taxes
  • Real estate cost segregation analysis
  • Research and development credits
  • State tax and incentive services

Brian Hickman


Jon Unroe


Front Porch Communities and Services

“BKD adds value beyond the routine audit. Our audit partner suggested a creative way to structure a potential contractual arrangement in connection with a financing opportunity we are exploring. BKD also identified a potential opportunity to enhance care plans for our Medicare patients, while improving our Medicare skilled nursing reimbursement. BKD has also provided examples of best practices in improving internal controls and other areas, while balancing these suggestions with the reality of a relatively lean staff.”

— Mary Miller, Chief Financial Officer
Front Porch Communities and Services
Burbank, California

Shell Point Retirement Community

“The main difference from our previous auditor, a large international firm, has been the personal involvement from the partner. She has been intimately involved in the audit process. We are very pleased with our ability to directly access a partner at BKD and have such great feedback and professionalism from them.”

“BKD has surpassed our previous auditor in terms of knowledge in the CCRC industry. CCRCs have a lot of special issues, and BKD is up-to-date with these issues. Having access to someone on the AICPA expert panel has helped us stay on top of important changes affecting our industry.”

“The training we received from BKD was a great way to educate our board about legislative changes affecting our industry. The partner’s knowledge and expertise with CCRCs went over very well. Now the board is extremely comfortable with her, not only as our auditor, but as someone who can keep us up to date on industry trends and developments.”

— Tim Lochridge, Vice President of Finance/Chief Financial Officer
Shell Point Retirement Community
Fort Myers, Florida

Lawrence County Manor

“BKD has provided professional services for our facility since 1980. Obviously we have been very satisfied over these years. Professionalism, vast knowledge in long term care business, courtesy and friendship are the things that first come to mind when I am asked about BKD. To our facility along with excellent auditing services, they have provided Medicare billing including utilizing their nursing staff to help us realize full billing potential. Their staff have been quick to notice any abnormalities in our business practice and provide support to correct the issue. I feel very fortunate to have BKD as a resource.”

— Lorena Hill, Administrator
Lawrence County Manor
Mount Vernon, Missouri

Friendship Village of Tempe

Our company has used BKD for our annual audit for several years. The staff has always been very professional, knowledgeable, efficient and helpful, especially in uncommon situations. BKD also audits our 403(b) plan, completes our corporate 990 tax returns and recently completed a review of our financial statements for a bond refinancing. Every single BKD employee that I have dealt with has been top notch.

— Terry Belles, Chief Financial Officer
Friendship Village of Tempe
Tempe, Arizona

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