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Long-Term Care
BKD National Health Care Group works with more than 1,200 long-term care (LTC) and senior living providers nationwide. We apply our reimbursement, finance, clinical, operational, billing and information technology knowledge to help LTC 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:
- Accounts receivable valuations
- Third-party settlements
- Malpractice reserves
- Investment valuation
- Revenue recognition
- Internal controls
- Employee benefit plans
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 more than 3,000 Medicare and Medicaid cost reports annually, including more than 1,300 skilled nursing and long-term care reports, 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 reporting requirement changes and 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:
- Skilled nursing facilities
- Continuing care retirement communities
- Home health agencies
- Hospice agencies
- Rehabilitation facilities
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:
Outsourcing
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.
Training
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
Brian Hickman
Partner
Consulting
Health Care
Springfield
417.865.8701
Jon Unroe
Jon Unroe
Partner
Consulting
Health Care
Houston
713.499.4600
“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.”
— Tim Lochridge,
Vice President of Finance/Chief Financial OFfice
Shell Point Retirement Community
Fort Myers, Florida
“BKD’s staff really knows the long-term care industry. The team we work with is focused, not just on health care, but specifically the senior living industry. I’d say BKD’s entry-level staff has a better understanding of issues unique to our industry than our past firm’s staff did.”
— Mary Miller,
Chief Financial Officer
Front Porch Communities and Services
Burbank, California
“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
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