Ohio Health Care Association's Long Term Care Recap

Recently, our HW Healthcare Advisors attended the Ohio Health Care Association's Long Term Care spring convention.

Director of Healthcare and principal, Rosemary Orlando, and Senior Manager, Ryan Kramer, had the privlege of speaking at the convention.

Their presentation was entitled ICF-IID Strategies for Changing Times....What is Your Game Plan?
Tips include:
-Ohio Overview
-National & State Trends
-HB 64 Provisions (ICF/Waiver
-And more!

If you would like to see the full presentation here! 

Visit www.hwco.com for more details!





This update is published periodically by HW&Co;. as an information service to our clients, business associates and friends. It is general information and professional advice should be obtained before acting on any comments contained in this document.

The perks of busy season

Every year our firm provides an array of busy season perks for our staff.

From catered dinners to jeans days on Fridays. Keeping our team happy and motivated is our biggest priority.

Our Principals sincerely thank all of our staff for all of their hard work and dedication this season!

(Indian's Home Opener)

(Sundae Monday_that's our CEO scooping ice cream!)

(National Cereal Day!)

(Raising Awareness for Epilepsy)

FASB Issues Update-April 7th, 2015

Anthony S. LaNasa, CPA, CFE

Principal

lanasa@hwco.com

 

 

 

On April 7^th, 2015 the FASB (Board) issued Accounting Standards Update (ASU) No. 2015-03, Interest: Imputation of Interest (Subtopic 835-30): Simplifying the Presentation of Debt Issuance Costs.  It was part of the accounting board initiative to simplify U.S. GAAP.

 

So what will this new accounting update mean?

 

It means that the costs for issuing debt should appear on a balance sheet as a direct deduction from the debt’s value. The Board stated that these amendments won’t affect the recognition and measurement of the costs for issuing debt.

 

This update is effective for all companies for reporting periods beginning after December 15, 2015.  Adopting these amendments early is also being allowed by the Board, including any financial statements that have not been previously issued.

 

As companies adopt the amendments, they should revise balance sheets for periods being presented prior to the effective date. Once a company adopts the changes, it is required to disclose the applicable information for a change in an accounting principle.

 

The FASB Board is really focusing on simplifying and making U.S. GAAP more readable and understandable.  Lastly, does this change make sense because are debt issuance costs really assets that provide a future economic benefit?  My opinion to that answer is no.

This update is published periodically by HW&Co. as an information service to our clients, business associates and friends. It is general information and professional advice should be obtained before acting on any comments contained in this document.

The HW Group Goes Purple!

Around the world people are wearing purple to show their support of epilepsy awareness. Annually, March 26th represents a global show of support of epilepsy awareness.

Did you know that 50 million people world wide live with epilepsy and that 50% of those affected don't know the cause? Did you also know that that 2.2 million Americans are living with epilepsy? The facts are scary, but true.

We are proud to raise awareness of such an important cause and invite each and every person to join us in wearing purple next year.

Want to learn more about epilepsy? Or want to know how you can help make a difference? Click on any of the links below for more information.

http://epilepsyinfo.org/

http://www.purpleday.org/aboutepilepsy

First Major Changes to Not-For-Profit Accounting

 

 

Anthony S. LaNasa, CPA, CFE

Principal at HW&Co.

 

On March 4^th, 2015 the Financial Accounting Standards Board voted to release a proposal that will overhaul how universities, charities, foundations, and other not-for-profit organizations convey how they spend their time and how they invest their money.  With this decision came some dissatisfaction with this standard. The uneasiness that came from the decision is even stronger than anyone had initially thought.  This was especially conveyed by the dissenting votes of FASB Chairman Russell Golden and Vice Chairman James Kroeker. It should also be mentioned that two of the five board members who voted in favor of the proposal did so with reservations.

 

The chief concern that Golden has concerning this decision was his belief that the proposal would create too many reporting differences between not-for-profit organizations and for-profit business.  He also believes that the projected changes would go too far.  Kroeker, who was unable to attend the meeting and voted by proxy, said in a prepared statement that he didn’t agree with the changes that would be made to the not-for-profit groups cash flow statements.

 

Although there was concern about the changes to the cash flow statements for members like, Lawrence Smith, the benefits of changing to the proposal weren’t enough to make him vote against it.

 

“I didn’t object to it and I voted for the changes made because I think when you look at the two cash flow statements side by side, one under direct and one under indirect, it’s pretty obvious the direct method conveys more easily understood information than indirect,” he stated.  He further commented on his decision to vote in favor of the proposal by praising the changes made to the basic performance statement.

 

"Is there flexibility? Yes. There's flexibility up the wazoo in terms of how management designates things, but it's clearly laid out and that's the important thing," he said. "It clearly lays out what funds are available to an entity in terms of furthering its mission."

 

The FASB also would like to improve the statement of activities by including the presentation of an operating measure with the information about expenditures related to the organization’s mission and donated funds available to be spent.

 

The changes in the proposal will be the first major changes to not-for-profit accounting and reporting in over 20 years.  My opinion is that the proposal is long overdue and the changes will enhance not-for-profit financial statements and provide the users of the financial statements, like donors, an increased understanding of the financial performance of Organizations.

 

 

This blog is published periodically by HW&Co. as an information service to our clients, business associates and friends. It is general information and professional advice should be obtained before acting on any comments contained in this document.

 

The Role of Quality Measures in Long-Term Care Reimbursement

Barb Notardonato-Cole

Principal

After attending the OHCA Winter Conference last week and listening to Medicaid Director John McCarthy speak, I was again struck by how important quality measures are going to be for future reimbursement dollars.  Deputy McCarthy’s presentation discussed the “Balancing Incentive Program”, a plan whose goal is to create a unified system for long-term care access and to link payments to person-centered outcomes.  He also touched on “Payment Innovation” initiatives being explored by the Governor’s Office of Health Transformation.  The Office of Health Transformation website lists the goal of Payment Innovations as “to design and implement new health care delivery systems to reward the value of services, not the volume”.   In other words—payment based on quality.

Quality is a great buzzword, and everyone wants to provide it, but sometimes it can be really tricky to measure.  I have many long-term care clients who do a great job of delivering quality.  What they don’t do, however, is a great job of tracking it.  It’s a balancing act.  Do you use resources to provide the care or to document the care?  With skilled nursing facility staffing already being squeezed by cuts in Medicaid and Medicare reimbursement, it can be difficult to allocate those resources to do the necessary documentation.

Quality can be very subjective; yet we are increasingly being called on to quantify it.  Sometimes the quantitative measures don’t reflect the true story.  For example, Hospital A may have much higher mortality rates than Hospital B.  However, Hospital A likely takes patients with much higher acuity, or specializes in a newer experimental treatment for those patients who are more critically ill. On the surface, mortality rates may seem like a good statistic to analyze because it is so easy to obtain.  But it is rarely a good indicator of hospital quality.  This is the downside of “quantifying quality”.

It is becoming clear (even without a crystal ball), that health care dollars are going to be tied to quality and divided up among larger groups of providers.  Skilled nursing facilities may find themselves splitting episodic payments with home and community-based providers, hospitals, and others, and their share will be based on quality and outcomes.  Facilities will need to focus efforts on properly measuring and reporting quality statistics. It has to become a priority.  I also believe that technology will continue to play a big role in this.  To the extent that measuring quality can be automated, it will alleviate some of the tug of war between using resources to provide the care versus documenting the care.

Payment models for long-term care are evolving.   The facilities that become the most successful may not be the ones providing the best quality, but they will be the ones that do the best at documenting it. Facilities that thrive and grow in the future will be good at both.

HW&Co. Volunteering

With the holidays upon us, more and more people choose to spend their time volunteering.

At HW&Co. our staff has spent most of the year donating their time and their efforts to donating to good causes.

Our most recent three include:

1) Toys for Tots

 

 

 

2) FETCH

 

3)Walk for Alzheimers

 

 

 

 

Honorable Mention:

 

The financial advisors from our affiliate, HWFA, also donated their time to volunteering at the Cleveland Foodbank.

 

 

(Picture of our group volunteering in 2014)

 

 

 

When you work for a company that is so adamant about donating their time and their efforts towards it makes you feel good about the people you work for and what you're doing.

You can also check out just a few organizations we have recently donated to:

Cleveland Kidney Foundation Gala

Milesstones Autism Resources

SPACES

Extended Housing