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The Link:  Practical Insight for Long-Term Care & Senior Living Providers

Your multidisciplinary hub for long-term care and senior living resources

The health care environment is increasingly complex. BKD’s professionals are ready to help you navigate your industry with confidence. Our knowledgeable advisors include CPAs, former administrators and directors of nursing, nurses and billing and revenue cycle specialists. This diverse group has created The Link so your team can connect with best practices forged from our expertise.

Key Tax Reform Provisions Affecting Taxable Health Care Providers

Andrea Lewman - March 2018

We’ve outlined what we believe to be the five most important Tax Cuts and Jobs Act provisions for higher education. Read on for the list, including recommendations and insights to help you be ready for coming changes. Read More

Tax Law Eliminates Advance Refunding

Amber Sherrill - March 2018

The Tax Cuts and Jobs Act (TCJA) makes previously tax-exempt interest on advance refunding bonds taxable, essentially eliminating the advantages and appeal of advance refunding bonds after December 31, 2017. Read More

Back to Basics:  Medicare SNF Cost Report Submission

Angie Yarbrough - March 2018

Skilled nursing facilities (SNF) that provide services to beneficiaries participating in the Medicare program are required to file an annual Medicare cost report. Read More


Suzy Harvey - February 2018

The Centers for Medicare & Medicaid Services (CMS) recently released a revised Skilled Nursing Facility Advance Beneficiary Notice (SNFABN). Read More

Strategies for Success in Senior Living in 2018

John Harned - February 2018

The new year brings new opportunities and challenges to the senior living industry. With all the changes in process, it’s a good time to revisit your strategy and evaluate what decisions can make you successful in 2018. Read More

Tech Talk:  Are Your Tools Ready to Tackle Change?

Jeff Bruntzel - February 2018

Change is happening, and it’s affecting the long-term care (LTC) and senior living industry in two key ways:  1. The number of Americans over age 65 is expected to nearly double by 2030. Over the next 20 years, approximately 10,000 people will reach age 65 in the U.S. every day. Read More

Top Five Tax Reform Provisions Affecting Tax-Exempt Health Care Providers

Brian Todd - February 2018

On December 22, 2017, President Donald Trump signed the Tax Cuts and Jobs Act (TCJA) into law. The TCJA represents one of the most significant revisions to the Internal Revenue Code (IRC) in more than 30 years. Many provisions took effect January 1, 2018, and the TCJA will affect virtually all U.S. taxpayers. Tax-exempt health care providers are no exception. Read More

Medicaid Cost Reporting Changes for Missouri Nursing Facilities

Jenny Jensen - February 2018

The Missouri Medicaid nursing facility cost reporting forms and submission process have been revised by the Missouri Department of Social Services MO HealthNet Division. These changes are required beginning with cost reporting periods ending on or after the month of December 2017, i.e., fiscal year-end December 31, 2017, providers. Read More

Is Your CCRC Ready for the New Revenue Recognition Standard?

John Harned - February 2018

As your Life Plan Community (CCRC) begins to evaluate the effect of the revenue recognition standard, Accounting Standards Update 2014-09, Revenue from Contracts with Customers (Topic 606), it would help to visualize peeling back an onion’s layers. One’s intentionality, diligence and timeliness may determine the amount of tears this particular onion causes. Read More

Fine Tuning:  Scheduling for SNF Success

Sherri Robbins - January 2018

Staff scheduling for skilled nursing facilities (SNF) is more of an art than a science. How should providers staff their buildings? There are numerous scenarios that arise when attempting this task: Set schedules, weekday and weekend staffing and creating a schedule every month based on employee-requested days off are just a few examples of the many options available to providers. Read More

Prepare for 2018 SNF Part B Payment Changes

Julie Bilyeu - December 2017

Skilled nursing facility (SNF) providers are starting the new year with a slight increase in Part B therapy, paid under the physicians’ fee schedule. New rates are effective for service dates beginning January 1, 2018, through year-end. Read More

Fine Tuning:  Clearing the SNF Consolidated Billing Fog

Cyndi Major - November 2017

Skilled nursing facility (SNF) consolidated billing essentially places the Medicare billing responsibility for the entire package of services SNF residents receive during a covered Part A stay on the SNF itself. Read More

What Investments Are Agile Communities Making?

John Harned - October 2017

In an industry set for historic growth, Life Plan Communities (CCRC) that want to remain relevant for generations are charting a course to not only serve their current residents, but also a younger population. Read More

How Old Is Your Community?

John Harned - October 2017

When did you last calculate the average age of plant for your organization? It’s a ratio that needs to be calculated at least once a year when preparing your organization’s budget. Read More

Who’s Reviewing Your Form 990?

John Harned - October 2017

Health care is highly regulated and leaders responsible for not-for-profit governance have a multitude of areas clamoring for their attention. However, there’s one form far more critical and visible than many organizations realize—Form 990. Read More

Combat Slowing Sales in Your Life Plan Community

John Harned - October 2017

How are you monitoring market conditions and indicators that can forecast your community’s ability to sell vacant apartments and cottages? Read More

CMS Issued Corrections to August Final Rule

Chris Murphy - October 2017

On September 30, the Centers for Medicare & Medicaid Services (CMS) placed the fiscal year 2018 skilled nursing facility (SNF) prospective payment system (PPS) Final Rule correction notice on public display at the Office of the Federal Register. Read More

Fine Tuning:  Starting on the Right Road to Reimbursement

Jenn Lender - September 2017

Efficiently collecting monies for services rendered starts prior to admission. A skilled nursing facility (SNF) should have a defined admission process, which can be supplemented with an admission checklist tool. Read More

Waivers for SNFs Affected by Hurricanes

Julie Bilyeu - September 2017

As hurricanes continue affecting parts of our nation, skilled nursing facilities (SNF) should be aware of certain waivers that may help them sustain important skilled care for their residents. Waivers granted under section 1135 of the Social Security Act temporarily waive or modify certain Medicare and Medicaid requirements for providers. Read More

Stay Compliant with an Up-to-Date Facility Assessment

Sherri Robbins - September 2017

All skilled nursing facilities (SNF) are required to complete a detailed written facility assessment by November 28, 2017, according to the Centers for Medicare & Medicaid Services (CMS) Reform of Requirements for Long-Term Care Facilities Final Rule released October 4, 2016. Read More

Fine Tuning:  Collecting Your Credits: Are You Missing Out?

Michael Ormsby - August 2017

If you’re a long-term care facility (LTC) owner and not taking advantage of the Work Opportunity Tax Credit (WOTC) program, you could be leaving money on the table. The WOTC program offers employers a tax credit for hiring employees that meet certain criteria. Read More

CMS Shifts to “Choose Your Own Risk” for Bundles

Steve Smith - August 2017

On August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to cancel three mandatory bundled payment programs with scheduled effective dates of January 1, 2018, as well as change the Comprehensive Care for Joint Replacement (CJR) model, which has been in place since April 2016. Read More

Don’t Miss the Revised ABN for Part B SNF Services

Sherri Robbins - August 2017

The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including laboratories, home health agencies and hospices), physicians, practitioners and suppliers to traditional Medicare (fee for service) beneficiaries in situations where Medicare payment is expected to be denied. Read More

FY 2018 SNF-QRP Data Submission

Carol Smith - July 2017

The Centers for Medicare & Medicaid Services (CMS) recently sent noncompliance notifications to skilled nursing facilities (SNF) concerning Quality Reporting Program (QRP) requirements. These requirements will affect SNF providers starting October 1, 2017, for fiscal year (FY) 2018 Annual Payment Update (APU). Read More

New LTC Survey Process & Phase 2 Implementation

Camish Jones - July 2017

The Centers for Medicare & Medicaid Services released revised interpretive guidance in a June 30, 2017, survey and certification memo regarding the Phase 2 implementation of the revised Medicare and Medicaid requirements for participation for long-term care (LTC) facilities and a new computer-based LTC survey process implementation. Read More

Fine Tuning:  What’s the PS&R Report & How Can It Help Me?

Rikki Holmes - July 2017

The Provider Statistical and Reimbursement (PS&R) System report provides key payment and statistical data for skilled nursing facilities applicable to processed and finalized Medicare Part A and Part B claims. Read More

Preliminary Testing Audits of PBJ Data

Jessica Cullen - June 2017

The Centers for Medicare & Medicaid Services (CMS) has begun a pilot testing program to audit Payroll-Based Journal (PBJ) data. Granite Dolphin and Myers and Stauffer audit teams are focused on examining payroll records and other auditable data to identify if staffing is accurately reported based on paid hours. Read More

CMS Extends SNF QRP Submission Deadline

Suzy Harvey - May 2017

On May 12, 2017, the Centers for Medicare & Medicaid Services (CMS) announced that “due to extenuating circumstances,” the reporting deadline for the fiscal year (FY) 2018 Skilled Nursing Facility Quality Reporting Program (SNF QRP) payment determination has been extended from May 15, 2017, to June 1, 2017. Read More

Protecting Your Organization from Ransomware Attacks

Jan Hertzberg - May 2017

Ransomware is a form of malware that targets your critical data and systems for the purpose of extortion. Read More

Fine Tuning: Developing a Robust Financial Statement Review Process

Juli Pascoe - May 2017

In observing successful senior living organizations nationwide, we’ve noticed many common threads in how they run their businesses. Read More

PBJ Data Submission Can Affect Star Rating

Suzy Harvey - April 2017

The Centers for Medicare & Medicaid Services (CMS) stated approximately 91 percent of long-term care (LTC) providers submitted Payroll-Based Journal (PBJ) staffing data by the February 14, 2017, deadline. Read More

Administrative Law Judge Request Form Changes

Suzy Harvey - April 2017

Effective January 1, 2017, Medicare replaced form, “Request for Medicare Hearing by an Administrative Law Judge - CMS-20034 A/B,” with, “Request for an Administrative Law Judge (ALJ) Hearing or Review of Dismissal - OMHA-100.” Read More

Changes to 2017 Part B Rates & New System Edits

Julie Bilyeu - April 2017

The Centers for Medicare & Medicaid Services (CMS) has made changes to the relative value files affecting 2017 Medicare Part B fee schedules. Read More

Fine Tuning:  Medicare Certification Process – Setting the Stage for Success

Suzy Harvey - March 2017

According to a 2015 Comprehensive Error Rate Testing report recently released by the Centers for Medicare & Medicaid Services (CMS), the denial rate for skilled nursing facilities (SNFs) increased from 6.9 percent to 11 percent due to missing or incomplete certification/recertification. Read More

Fine Tuning:  SNF ICD-10 Diagnosis Coding Perils

Leslie Finnerty - March 2017

Despite the International Statistical Classification of Diseases 10th revision (ICD-10) diagnosis coding’s October 2015 implementation, some skilled nursing facility (SNF) providers struggle with capturing accurate information to reflect post-acute care. Diagnosis coding comes with perils but is key to reflecting the care needed to support services billed. Read More

Meeting New Requirements for Care Providers

Carol Smith - March 2017

The Centers for Medicare & Medicaid Services unveiled regulations a few months before the first official survey due date of November 28, 2016. A main focus of the mandates is for facilities to offer person-centered care with more emphasis on a facility’s Quality Assurance and Performance Improvement program. Read More

Second PBJ Submission Date Fast Approaching

Suzy Harvey - February 2017

February 14, 2017, is the second Payroll-Based Journal (PBJ) submission’s final date for all long-term care (LTC) facilities. The Centers for Medicare & Medicaid Services (CMS) began requiring quarterly staffing and census data to be submitted as of July 1, 2016. Read More

Fine Tuning:  How to Decode Accounts Receivable Aging

Jessica Cullen - January 2017

In the long-term care industry, it’s imperative organizations constantly monitor the accounts receivable aging (the aging) and follow up on past due accounts. If the aging isn’t appropriately reviewed and analyzed, accounts can become uncollectible, which strains the organization’s cash flows and ability to fund daily operations. Read More

Annual Tax Update & 2018 Form 990 Changes

Presenters:  Mike Engle & Rebekuh Eley – Thursday, March 22, 2018

Join BKD for a closer look at 2018 tax law changes, including Form 990 updates. Topics will include recent tax developments and how those could affect not-for-profit organizations, including health care providers, higher education institutions, associations, foundations and social service organizations. Read More

The Health Care Playbook:  Strategies for the 2018 Season

Presenters:  Joe Watt & Mike Engle – Thursday, March 28, 2018

As you develop your playbook for the season, we invite you to tap into insights from two of BKD’s leading health care industry thought leaders. Investing in this training can help you reduce regulatory fouls and take advantage of tax turnovers. Read More

New Year, New Plan, New Future for Your Life Plan Community

Presenters:  Brian Todd, Kimberly McKay, John Harned, Bradley Paulis, Continuing Care Actuaries – Thursday, January 11, 2018

Start the new year off right with a Life Plan Community (CCRC) update from BKD’s long-term care and senior living team, along with guest presenter Continuing Care Actuaries. Read More

Tax Policy & Charitable Giving

Presenters:  Joyce Dulworth & Dr. Una Osili, Lilly Family School of Philanthropy at Indiana University – Thursday, October 5, 2017

Join BKD for a CPE-eligible webinar to gain insight into charitable giving, donor behavior and the effects of proposed legislation on not-for-profits. Read More

Refresh Your Understanding of the SNF QRP

Presenters:  Deborah Lake & Justin Thompson – Wednesday, September 13, 2017

The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires continued specification of quality measures for the skilled nursing facility Quality Reporting Program (QRP). Read More

Cyber Risk: What Not-for-Profit Management & Boards Need to Know

Presenters:  Jan Hertzberg & John Dougherty, Unbound – Wednesday, September 20, 2017

Managing cyber risk has become a key challenge for not-for-profit (NFP) management. The nearly constant stream of data breaches, hacks and cyber-espionage has created enormous challenges for organizations. Read More

Annual Tax Update & Form 990 Changes

Presenters:  Aaron Hershberger – Tuesday, May 2, 2017

With ever-evolving tax law changes and recent Form 990 updates, is your organization prepared? Join BKD tax advisors for valuable information on a number of topics, including recent tax developments and how they can affect not-for-profit organizations, health care providers and colleges and universities. Read More

Quality Measures:  Are Your Stars Aligned?

Presenters:  Sherri Robbins & Suzy Harvey – Thursday, March 16, 2017

This complimentary webinar will provide attendees with an overview of quality measures—and the growing importance placed on these metrics. Read More

Long-Term Care Services

BKD National Health Care Group serves approximately 1,600 long-term care and senior living providers nationwide, including skilled nursing facilities and approximately 50 continuing care retirement communities, some of which are the largest in the country. Our approximately 500 dedicated health care professionals have the expertise and commitment to help your organization improve performance and enhance the value of the professional services you receive.

BKD National Health Care Group provides services related to:

  • Audit Services – Our auditors can advise you on how your financial statements comply with accounting rules and help you strengthen internal controls, address management concerns and improve operating efficiencies.
  • Cost Report & Reimbursement Services – BKD National Health Care Group prepares approximately 3,000 Medicare and Medicaid cost reports annually, including more than 1,600 skilled nursing and long-term care facility reports, making us one of the largest providers in the country.
  • Billing Services – BKD Health Care Billing Services, a special division of BKD National Health Care Group, helps clients manage more than $60 million in revenues for health care providers. Our solutions include outsourcing, accounts receivable recovery, operations assessments, compliance assessments and training.
  • Clinical & Operational Consulting – We offer operational assessments, Medicare PPS assessments and Medicare management training services, corporate integrity services, organizational supervisory training and staffing analysis, strategic planning and other services to help your organization.
  • Taxation – Exempt and for-profit health care organizations alike often face unique and complex tax questions. BKD National Health Care Group provides a variety of services to help your organization make sense of dynamic tax laws.

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