Long-Term Care | Skilled Nursing Facilities
Assurance and Advisory Services
Successful long-term care providers know that managing patient care and its corresponding expense and reimbursement requires sound financial advice. As Western New York’s leading accounting firm, we provide incomparable expertise in the area of long-term care. Our unique team has gained recognition across the state for its ability to strengthen the weakened and improve even the strongest long-term care facilities. We provide a complete range of services designed specifically for our long-term care clients, some of which utilize the clinical expertise of our strategic alliances.
Services include:
- Medicaid and Medicare Cost Report preparation
- Tax preparation and consultation
- Cost segregation services
- Base year audit and appeal preparation
- Financing support
- Certificate of Need application
- Rebasing opportunities
- Sale and acquisition assistance
- Profitability consulting
- Operational reviews
- Benchmarking
- Compliance/HIPAA programs
- Nursing/therapy department cost efficiency analysis
- MDS/Clinical analysis
- Survey preparedness and response
- Business valuations
- Litigation support
Our Long Term Care Practice
In the past 15 years, we’ve grown our healthcare practice into the comprehensive consulting group that exists today.
Early 90's
In the Early 90’s several nursing facilities were forced into receivership, some included bankruptcy. We became “interim CFO’s for several of these facilities, reconstructed records which were incomplete and filed various regulatory reports to satisfy the third parties, courts, banks, etc. We used our relationship with banks to help with new financing, and on occasion would testify in court on events. This was not easy work but earned us a reputation as taking on challenging assignments. During this period we appeared before the Medicare Provider Reimbursement Review (the highest court in settling federal reimbursement matters), and also created a new home health care cost reporting allocation method which Medicare accepted and published.
Mid 90's
Next, also in the early to Mid 90’s, we encouraged nursing facilities to increase their Medicare utilization and were at the forefront of assisting facilities financially gain from participation in the NYS Demonstration program. This effort included converting certain all inclusive providers (including county facilities) into charge structure providers to capture the Medicare revenue. This required the “show me” financial analysis as proof that Medicare could become a very important revenue source. The outcomes were substantial for our clients and allowed growth of new programs and reach other goals.
We then participated in a wave of several acquisition related engagements (including home care) in which our clients relied on us to assist with the due diligence and negotiation of purchase agreements. Normally, we were then asked to monitor the new base year period so that the Medicaid rate was appropriately calculated and maximized in accordance with regulations.
2000
In early 2000, Medicare fully converted to PPS for nursing facility reimbursement purposes. Extensive training was performed by our nurse consultants as clinical personnel were now influencing the amount of revenue a facility earned. We also found that many facilities were lax in utilizing therapy services to improve both quality outcomes and revenue enhancement. Our clients experienced increased revenue without increased costs. The work still continues.
Today
Currently, encouraged by recent legislation and successful legal challenges, the landscape for facilities rebasing their Medicaid rates has become fertile. We have no less than 20-25 clients at various stages of evaluating, applying, or receiving new base years.
Our health care group consists of 14 professionals. This progression of client growth has broadened our firm to understand the possibilities for change and the know how to evaluate opportunities. We have the service delivery system in place to help implement changes rather than stop after the recommendations stage. We believe implementation is an important consideration in selecting a consulting firm as we stand behind our clients providing the additional and temporary knowledge and resources during times of change.Our one of a kind Freed Maxick University, which spotlights our understanding of the long-term care industry, offers intricate financial training for administrators and financial managers and is sponsored by NYSHFA and NYAHSA.

Freed Maxick & Battaglia, CPAs is truly a unique firm. We have the distinction of operating an Alternative Practice Structure with RSM McGladrey, the 5th largest accounting firm in the US. Through our formal arrangement, we operate as RSM's offices in Western New York (Buffalo, Batavia and Rochester). So while some locally owned firms participate in "network alliances" with larger national firms, the clients of Freed Maxick & Battaglia, CPAs have the advantage of something far different....and far superior. With Freed Maxick, you'll benefit from the bench strength and resources of a national firm, and receive the service delivery you expect from a local firm. And the best part? We're able to keep our independence and make decisions locally. These factors translate into world-class service at rates that are commensurate with the market we do business in.
Skilled Nursing | Long-Term Care Contacts:
Freed Maxick & Battaglia, CPAs is Western and Upstate New York's (NY) largest public accounting firm and a Top 100 firm in the U.S. Freed Maxick provides, audit, tax and consulting services to private and public (SEC) companies in Buffalo, Rochester, Syracuse and Albany New York. Affiliated with RSM McGladrey, the 5th largest accounting firm in the U.S., Freed Maxick has vast national and international resources to help your business expand nationally and internationally.
Contact us Via the Web or Toll Free: 1-800-777-4885
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| John Kropski, CPA | Steve Holt, CPA | |