COVID

Article Dean Dorton

On January 30, 2023 the Biden Administration announced the anticipated ending of the Public Health Emergency declarations. These declarations are set to expire on May 11, 2023. Due to heavy reliance on 1135 Waivers throughout the time that the Emergency extended, the ending of the Public Health Emergency will have a large impact on Hospitals. 1135 waivers are used to waive various administrative requirements to increase access to medical services during a time of national emergency. Now that the emergency is coming to an end, healthcare entities should take steps to ensure their compliance with laws and regulations while returning to normal operations.

It will be important for hospitals to review their policies and procedures to ensure compliance with regulations and standards that will be changing and to update these policies if necessary. It is important to note that some waivers end at the conclusion of the Public Health Emergency, while others end 151 days following the conclusion of the Public Health Emergency.

Prior to May 11th, administration and leaders in each department throughout hospitals should be asked the following questions in order to ensure that they are prepared for the coming changes:

  • Is your department currently relying on any waivers that are still in effect?
  • Is your department currently relying on any waivers that have expired?
  • Has your department developed a plan and sent out communications to wind down any reliance on waivers by the expiration date?
  • Does your department understand state laws in areas that will be affected when waivers default back to state laws after expiration?

CMS and others have released guidance on the current 1135 waivers and on the end of the Public Health Emergency in order to help prepare practices. For hospitals that are highly reliant on 1135 waivers, this guidance will be key to preparing for a return to normal operations. Linked below are a few articles that will provide support in this area.

COVID-19 Emergency Declaration Blanket WaiversCoronavirus Waivers & FlexibilitiesUnwinding & Returning to Regular Operations after COVID-19

Adam Shewmaker | Healthcare Consulting Director
ashewmaker@ddafhealthcare.com
502.566.1054

Article Dean Dorton

State tax laws continue to change rapidly throughout the country. Have you wondered about potential tax liability to other states? This survey asks just a few of the  questions states ask when determining whether a business is subject to its taxes – income, franchise, or sales and use. The weight of interpretation given to specific questions may vary from state to state.

Thinking of the states other than those in which you are already paying or collecting and remitting taxes, answer the following ten questions for each of state.

  1. Are you registered with the Secretary of State?
  2. Do you hold a business license?
  3. Do you have fixed assets or leased property?
  4. Do you have payroll in the state?
  5. Do you have independent contractors working on your behalf?
  6. Do you make sales via the internet, an app, a catalogue, or by phone?
  7. Does your total revenue from the prior year exceed $25,000?
  8. Does your total payroll exceed $25,000?
  9. Do your total sales exceed $100,000?
  10. Does your total property, total payroll, or total sales exceed 25%?

If you answered “yes” to any one of these questions, it is possible that you have a reporting or filing obligation in the state. While a lot of business owners say the prefer to “roll the dice,” that strategy can be expensive. To learn more about your potential exposure in other states, contact us or your tax advisor.

Contact your Dean Dorton advisor or other professional adivsor for more information.
If you don’t have an advisor, but would like to speak with us, send an email to:
insights@deandorton.com

Article Dean Dorton

On January 20, 2022, the U.S. Department of Education (the Department) announced $198 million in American Rescue Plan funds that will primarily support community colleges and other institutions to meet the basic needs of students – especially those exacerbated by the COVID-19 pandemic. The Supplemental Support under American Rescue Plan (SSARP) program will require institutions to submit applications to receive funding.  The Department plans to prioritize community colleges and rural institutions that serve a high percentage of low-income students and have continued to experience enrollment declines.  SSARP funds are to be used toward evidence-based practices to monitor and suppress Coronavirus, strategies for addressing students’ basic needs, supporting students in continued and re-enrollment, forgives of institutional debts, and expansion of programs that lead to in-demand jobs.

As part of the announcement, the Department also released additional guidance surrounding meeting students’ basic needs.  The guidance provides specific examples for areas of insecurity with housing, food, and childcare.  The guidance can be found here.

Additionally, the Department reminded institutions that they can now use the Free Application for Federal Student Aid (FASFA) data to communicate other federal programs for which they may qualify, like Supplemental Nutrition Assistance Program (SNAP) and the Affordable Connectivity Program at the Federal Communications Commission.  Find the letter from the Department here.

Dean Dorton’s Higher Education team is monitoring all updates from the U.S. Department of Education and will update you if there is new information released. Find additional information about the latest release below.

HEERF FAQGEN-22-02Read More

Megan Crane, CPA
Assurance Associate Director
mcrane@deandorton.com • 859.425.7643

Article Dean Dorton

Based on annual aggregated data collected by Gallup, 2020 represents the first year in their many decades of polling that church membership among U.S. adults has fallen below 50%. Rather than chalking membership up as a casualty of the pandemic, Gallup concluded in its report (released March 29, 2021) that this is just the latest result in a disturbingly steady trend. Americans are not placing value on specific church affiliation as they once did and that means they aren’t engaged to share their time and treasure.

This nationwide trend doesn’t have to be the trend for your faith community. With thoughtful planning at this worldwide point of transition, your community could be the positive outlier in Gallup’s future research.

A T2 deficiency may be a product of less membership, but it also indicates a less engaged current membership. There are a multitude of programing ideas to attract and retain members, but without a solid financial foundation, these programs risk being inadvertently undermined through no fault of their own.  Programs that flounder financially may actually alienate the membership they were designed to engage. Additionally, interest in further innovation could be mortally wounded and your community could be destined to become a statistical average.

To counter this possibility, take steps now to develop financial credibility. Well organized financial results should be available to all members in dynamic formats that makes sense to them individually. Your members care about different aspects of their faith life so initiate frequent informal discussions to determine what those aspects are. Then map and simplify financial data to demonstrate results specific to areas of interest.  If results are poor in a given area, highlight it instead of hiding it! Invite other to share in definition of the problem and identification of solutions. Doing so gives members a great opportunity to share their talent and strengthen ties to their faith community.

Integrity is the cornerstone for credibility. Integrity demands that you present accurate financial data in accordance with best practice accounting standards so that data can be understood, compared and relied upon by anyone who picks up your reports. Make sure your process included review so that, once published, financial information for your faith-based organization can be a solid point of reference. When members can clearly see the financial impact of specific action or inaction, engagement is an easy choice.

If you’re at a loss to picture how you can accurately and credibly present financial results for the aspects of faith life that most interest your members, contact me for a complimentary discussion. Talking through your accounting structure will help clarify your next steps toward successful financial transparency and credibility.

Lastly, whenever possible, infuse financial reports with non-financial data. This marriage of results will add depth to your financial foundation and give members a hearty springboard for engagement. It will arm the meekest in your fold with an easy talking point and they may feel emboldened share that good news with others. In the end, vanquishing your T2 deficit will take the efforts and engagement of your entire community. Empower them in this mission!

As a manager in Dean Dorton’s Financial & Accounting Services team, Kaydee Ruppert enjoys assisting faith-based and other nonprofit organizations to empower their financial stories. 

Kaydee Ruppert, CPA, MSA
Nonprofit Expert | Accounting & Financial Outsourcing Manager
kruppert@deandorton.com • 859.425.7730

Article Dean Dorton

You know the drill – the longer you go unpaid the harder it is to collect but your medical practice needs every dollar accounted for to keep running efficiently and effectively.

Dean Dorton Healthcare Solutions empowers clients in five important ways:

  1. Responsiveness: How often do you have a claim that gets older than 60 days? By co-sourcing A/R cleanup with the Dean Dorton Healthcare Solutions team, instead of worrying about that unpaid claim, you can focus on big picture, overall financial and operational goals. Hate dealing with A/R entirely? Our team can be your A/R resource in a variety of capacities.
  2. Reporting: Quality A/R cleanup requires detailed and accurate reporting and coding to get claims paid. Our experienced team brings the knowledge from many different backgrounds, specialties, and systems to give your practice the best-in-class service.
  3. Analyzing: Our team can easily model calculations so you understand what is working with your A/R, what is not working, and where you can maximize benefits.
  4. Forecasting: By identifying what is happening with A/R we can quickly generate forecasts to influence and inform decisions by functional managers, senior management, and board members.
  5. Big picture: Your revenue cycle is about more than just A/R, but A/R plays an important role in maximizing your strategic plans that exploit business opportunities and sidestep risks.

To get started, take a look at your medical practice’s current A/R and identify weaknesses. Did you have any of the following happen in the last six to nine months?

  • Staff turnover
  • A systems change
  • Numerous bad claims
  • Are you generally behind due to COVID-19?

If the answer is yes to any of these, it’s worth your time to explore your options as it relates to A/R and cleanup projects.

Learn more

Christie Atzinger, CPC
Medical Billing and Consulting Services Manager
catzinger@deandorton.com • 502.916.3130

Article Dean Dorton

During the past several months, we’ve heard directly from clients that COVID-19 has not only changed the operational and financial performance of community hospitals, but the last year has also opened eyes to numerous risks that were previously unknown or thought to be of little importance.

1. “We didn’t know that XYZ person didn’t have a back-up.”
Team member absence due to illness or quarantine quickly exposed the fact that some people or departments were spread too thin and/or didn’t have trained reliable back-up processes and staffing in place. Long term absences created backlogs and a lack of documented policies and procedures made it nearly impossible for others to assume the workload. This was true in supply chain, materials management, clinical departments, accounting, and others.

2. “Our technology infrastructure wasn’t prepared to support significant amounts of telecommuting and/or telemedicine.”
Many team members, and in fact entire departments were forced to work remotely for much of the last year, and in some instances continuing to do so. Has your technology team been able to support that shift? Are you comfortable with data security measures and productivity monitoring with increased telecommuting? Has your telehealth strategy been fully optimized? Many departments experienced decreases in productivity which lead to financial impacts and patient dissatisfaction.

3. “Revenue cycle departments have been scrambling to stay afloat and strategic investments and improvements have been delayed.”
In many instances, community hospitals have seen A/R aging worsen, staffing has experienced significant turnover or furlough, and now that volumes are coming back, the team cannot keep up. It is very difficult to stay current while also addressing the backlogs that have developed. Don’t let predictable cash collections and days in A/R mask underlying trends or potential backlogs within the revenue cycle. Outsourced vendors were also impacted by COVID. Evaluate their performance to determine if potential improvement opportunities exist.

If these or any other similar revelations sound familiar to your organization, it may be prudent to conduct an enterprise-wide risk assessment or begin the process of prioritizing risks based on financial, operational, and compliance impact.

Adam Shewmaker, FHFMA
Healthcare Consulting Director
ashewmaker@ddafhealthcare.com • 502.566.1054