Categories
Medicare

Starting a Home Healthcare Agency

Starting a Home Healthcare Agency and the Home Healthcare Business Plan

Our Home Healthcare Business Plan expertise will guide through Starting a Home Healthcare Agency or a Change in Ownership (CHAO). OurHome Health Care Business Plan expertise will help you understand the businesses, home care revenue/expense calculators, and our Home Healthcare Business Plan business forms, templates and caregiver training manual will help and guide you along your journey by saving you time in staring a Home Healthcare Agency. This is one resource you won’t want to be without when staring a Home Healthcare Agency.

Staring a Home Healthcare Agency, medical and non-medical, is on the rise as the first wave of Baby Boomers leading the “Silver Tsunami” will hit in 2011. With life expectancies longer than even a generation ago, the number of people in the US aged 65 or older is expected to be 71 million by 2030 – more than twice what is was in 2000. Now is the perfect time to capitalize on this trend and staring a Home Healthcare Agency.

As the Baby Boomer generation ages, the need for home care services increase. If you are interested in Starting a Home Healthcare Agency to provide service to the baby boomers, you will definitely have a Home Healthcare Business Plan. Starting a Home Healthcare Agency seems to be one of the biggest trends in helping fill the current home health care shortage.

If you are an existing home health care business owner, an entrepreneur that’s Starting a Home Healthcare Agency, or simply want to become an Independent Nurse,  Personal Care Worker, or Caregiver Contractor you will likely be asking: “Where do I start?”, “How do I create a Home Health Care Business Plan?”, “What tools do I need?”, “What guides, documents, procedures, forms, and templates are available to help me start or improve my Home Healthcare Business Plan?”

Starting a Home Healthcare Agency – Don’t Go it Alone

One of the most challenging parts of Staring a Home Healthcare Agency is Home Healthcare Business Plan required by ACHA along with your Proof of Financial Ability to Operate. Knowing how to start a home care business quickly and cost effectively, creating a Home Health Care Business Plan and developing all the required home health care documents, forms, templates, and manuals that allow you to operate your business professionally and efficiently. If you’re ready to start your home health care business, you want to start with a Home Healthcare Business Plan. The easiest way to do this correctly is to follow a professional’s advice. A VieraCPA we’ve been preparing Home Health Care Business Plans for over 20 years.

If you want to get your medical or non-medical home care business started quickly and easily while eliminating as many mistakes as possible you will benefit from ourHome Healthcare Business Plan expertise. It includes theHome Healthcare Business Plan along with the  Proof of Financial Ability to Operate form 3109 required by AHCA.  The Home Health Care Business Plan is professionally prepared by a CPA with over 20 years in the industry. TheHome Healthcare Business Plan FULLY CUSTOMIZABLE to meet your business model and contemplated services offering.

Starting a Home Healthcare Agency, medical or non-medical, home health care business could be the right business opportunity for you. If you are uncertain a home care business is for you, and want to know how to start a home care business, our home care business experts can guide you. At VieraCPA we have the expertise that will help you make that decision. And, if you decide to go ahead, then it will be a tremendous asset and save you a lot of trial and error headaches. Whether you’re just starting out, need funding or want to monitor the health of your home care business, creating a Home Health Care Business Plan is your first step on the path to success. Our CPA’s and Accountants diligently research your plans and it’s backed by over 20 years of home health care management experience. Our Home Healthcare Business Plan will guide you and put you on the fast track in starting a home health care business.

Categories
Business Trends

Sample Healthcare Business Plan

Healthcare Business Plan

For application of licensure with AHCA and certification with Medicar

As Miami Healthcare Accountants specializing in Healthcare Accounting, we prepare custom Healthcare Business Plan for startup Home Healthcare Agencies or Change of Ownership. VieraCPA have been Healthcare Accountants for more than 20 years. We provide a wide range of Healthcare Accounting services to HHA throughout Florida.

AHCA now requires a Healthcare Business Plan along with the Proof of Financial Ability to Operate for new HHA’s or change of ownership to be prepared by a CPA. The Healthcare Business Plan requires very specific knowledge of healthcare accounting which our Healthcare Accountants are diligent in keeping up with every new law.

We have prepared a partial sample Healthcare Business Plan to help Home Healthcare Agency owners understand the requirements and in depth analysis required by AHCA. The Healthcare Business Plan should start with the Executive Summary.

“EXECUTIVE SUMMARY”

XYZ Corp. is a Home Healthcare Agency, organized on June 1, 2011 as a private for profit corporation looking to be licensed by AHCA in Florida and certified by Medicare and Joint Commission accredited.

XYZ Corp. is planning on operating a Home Health Agency in the Miami-Dade Area and licensed by AHCA in Florida and certified by Medicare and Joint Commission accredited.

The initial capital contribution, as calculated on Form 3100-0009 AHCA Proof of Financial Ability to Operate, is $000,000 to be deposited in full prior to submission of licensed by AHCA in Florida and certified by Medicare and Joint Commission accredited, prepared and signed by a Healthcare Accountants CPA. (read more….)

The Healthcare Business Plan should continue with the objectives and mission statement section which looks something like this:

“OBJECTIVES”

The objectives of the company are:

1)      Recruit and train a specialized technical force to provide Skilled Nursing, Therapies and Home Health Aide services beyond the expected standard.

2) Develop among the company personnel a culture of efficiency, work quality and personal responsibility on service rendered.

“MISSION”

XYZ Corp. is dedicated to providing quality home health care and other health services to patients in Florida, offering a high level of professionalism, efficiency and compassion; complementing services provided by hospital, doctor’s clinics and other health institutions that require home care.

Next we have to get into the nuts and bolts of Healthcare Accounting and projected revenue streams:

“SERVICES TO BE PROVIDED”

The company plan to offer the following services:

a) Skilled Nursing at RN and LPN level

b) Home Health Aide and CNA

c) Physical Therapy

d) Occupational Therapy

e) Social Worker Services

f) Speech Therapy

The Market Analysis is the most complex and where we as Healthcare Accountants with over 20 years of Healthcare Accounting experience really add value. The Healthcare Business Plan market analysis data is statistical in nature. Here is a sample:

“MARKET ANALYSIS”

The State of Florida has, an estimated population of 18,801,310 in 2010: from this total about 17.2 % are 65 or older (U.S. Census Bureau, Quick Facts).

However, projections show that that percentage will grow even more 13.82% by 2015 and 2030 (taken from Data on County Aging Services Needs Assessment, University of South Florida, October 3, 2007), even the Florida state general population rate of increase in the last 8 years was over 14.7% and the above mentioned projection foresees a growth of over 15% from 2000 to 2010. It is our conclusion that the market for serving the needs of older population (those over 65) will have an increase in demand in these Counties in the next 5—10 years.

The Healthcare Business Plan continues with Level of Competition, Market Strategy, Timeline, Personnel, Recruiting & Retention Strategy, Admission Policies and more.

If you’re thinking about starting or buying an HHA, give us a call for a free initial consultation.

Good Luck!

Gustavo A Viera CPA

 

Categories
Medicare

Medicare Cost Report Preparation Strategies

Medicare Cost Report Preparation Strategies

Our Medicare Cost Report Preparation, Reimbursement & Cost Report Services Strategies for enhanced reimbursement. With the increasing pressure on hospital margins, it is imperative that providers obtain accurate reimbursement from Medicare and Medicaid as well as other third-party payors in order to file an accurate Medicare Cost Report.

You can benefit from our experience with Medicare Cost Report Preparation since the inception of Medicare for hospitals and health systems of all sizes and types, including critical access hospitals (CAHs). We have a team dedicated to Medicare Cost Report Preparation and defending them through reviews and appeals. Our Medicare Cost Report Preparation team keeps up with changes in Medicare Cost Reports and requirements to better serve you and includes members who have hands-on experience with reimbursement issues on both sides – Medicare and hospitals.

We have helped numerous clients increase their reimbursement by assisting them with conversion to special Medicare status such as sole community provider, regional referral center, and critical access hospital.

We’ve also assisted them with various Medicare prospective payment systems (PPS) reimbursement issues such as:

  • Wage index analysis
  • Disproportionate Share Hospital (DSH)
  • Medicare bad debt optimization

For academic medical centers, we’ve assisted in proper reporting for post acute transfer issues, graduate medical education (GME), independent medical examiners (IME), and organ transplant costs. On behalf of hospitals and health systems, VieraCPA also has negotiated with various third-party payors including state Medicaid programs.

As part of our Medicare Cost Reports preparation service, we provide a summary of observations and recommendations about the data provided for the cost report as well as opportunities to enhance reimbursement in the future. We’ll help you interpret the results of your Medicare Cost Reports so you know if you make or lose money on individual service lines.

State Statutes require applicants to show anticipated provider revenue and expenditures, the basis for financing anticipated cash-flow requirements of the provider, and an applicant’s access to contingency financing. All schedules must be prepared in accordance with generally accepted accounting principles (GAAP). CPA Firms must compile, examine, or apply agreed-upon procedures to prospective financial statements, including summaries of significant assumptions and accounting policies. An applicant will have demonstrated Proof of Financial Ability to Operate by completing schedules 1-7 in conformity with the below instructions and GAAP, all relevant rules and statutes, and projections that show assets, credit, and projected revenues meet or exceed projected liabilities and expenses and Independent evidence of sufficient funds for starting a Home Health Care Agency, working capital & contingencies.

Categories
Medicare

Proof of Financial Ability to Operate

Healthcare Accounting Specialist Explains Proof of Financial Ability to Operate

As you may know, part of the process to complete the Health Care Licensing Application, the Florida Agency for Health Care Administration (AHCA) and the Florida Statutes requires that each applicant to establish AHCA Proof of Financial Ability to Operate and to show per Healthcare accounting requirements the anticipated provider revenue and expenditures, the basis for financing anticipated cash-flow requirements of the provider, and an applicant’s access to contingency financing. To establish AHCA proof of financial ability to operate, information is provided in detailed forms and schedules which include the monthly projected summary of revenue and expenses, the monthly projected cash flow statements for 24 months and the two annual balance sheets and detailed footnotes that include summaries of significant assumptions, accounting policies and other informative disclosures as required by Generally Accepted Accounting Principles (GAAP). Typical Excel based spreadsheets may be cumbersome to design for this purpose.  Because of the special requirements to produce monthly income statements and cash flows for 24 months, customized projection software is needed to meet the reporting requirements. Subsequent to approval, certain Medicare providers will have to file an annual Medicare Cost Reports.

To show AHCA proof of financial ability to operate per Healthcare accounting requirements the forms and schedules must accompany any initial or change of ownership (CHOW) application for the following types of health care providers.

•  Adult Day Care Centers

•  Assisted Living Facilities

•  Health Care Clinics

•  Home Health Agencies

•  Home Medical Equipment

•  Hospice

•  Intermediate Care Facilities for the Developmentally Disabled

•  Prescribed Pediatric Extended Care Center

•  Skilled Nursing Facilities

All schedules must be prepared in accordance with generally accepted accounting principles (GAAP). A Certified Public Accountant (CPA) must compile, examine, or apply agreed-upon procedures to prospective financial statements, including summaries of significant assumptions and Healthcare accounting policies. Such a requirement is usually not required for the annual Medicare Cost Reports

To establish AHCA proof of financial ability to operate each applicant can select the type of financial statement to be given to the Provider.  As mentioned above, the three choices are :

1.  Compiled

2.  Agreed-upon procedures

3.  Examined

To establish AHCA proof of financial ability to operate and to learn more about your financial statement options and Healthcare accounting requirements:

Before you select the level of service from the CPA , the following will serve as a brief analysis of each option.

1.  Compile – A compilation engagement is the lowest level of service that an accountant can perform on prospective financial presentations that is intended for third parties. Despite it being the lowest level of service, it is a very common deliverable provided by a CPA and often a cost effective solution for many companies, when required or accepted by third parties and acceptable healthcare accounting practices utilized. Compilation procedures includes assembling, to the extent necessary, the prospective financial information based on the responsible party’s assumptions. Performing the required compilation procedures, including reading the prospective financial statements with their summaries of significant assumptions and healthcare accounting policies, and considering whether the prospective financial statements appear to be (1) presented in conformity with American Institute of Certified Public Accountants(AICPA) guidelines and (2) not obviously inappropriate. The compilation procedures are not performed for the purpose of providing any assurance on the presentation or on the underlying assumptions. The accountant may prepare the financial statements or then reads them when they are prepared by the Company’s management  to make sure that they appear appropriate in form and content. Because the accountant does not perform any other procedures, the accountant does not obtain any assurance that the financial statements are free of material misstatement. A compilation report is issued by the CPA.

2.  Agreed-upon procedures – With an agreed-upon procedures engagement the accountant is engaged by a client to perform specific procedures and report findings. The accountant does not perform an examination or provide an opinion. Rather, the accountant reports only procedures and findings. In this type of an engagement, the accountant performs whatever procedures the users of the prospective statements specify. It is a flexible form of engagement; the procedures may be as extensive or cursory as the specified parties want, but should include more than a mere reading of the prospective financial statements. The service may be lower than a compilation, between a compilation and an examination, or as high as an examination.

3.  Examined – An examination engagement is a professional service that involves extensive corroborative procedures, resulting in the CPA’s expression of positive assurance about the presentation and the underlying assumptions. It is similar to an audit of historical financial statements and is the highest level of service that CPA’s can provide on prospective financial statements. The examination involves (a) evaluating the preparation of the prospective financial statements,(b) evaluating the support underlying the assumptions,(c) evaluating the presentation of the prospective financial statements for conformity with AICPA presentation guidelines, and (d) issuing an examination report.

Some additional insight factors to consider when choosing the levels of service

In an examination engagement an opinion is given by the CPA and it states that (i) the prospective financial statements are presented in conformity with AICPA guidelines and (ii) the assumptions provide a reasonable basis for the responsible party’s projection, the assumptions provide a reasonable basis for the responsible party’s projection given the hypothetical assumptions. Because an examination is an extensive service, it is more expensive to provide than the other two alternatives. Examinations are typically performed when the prospective presentation is associated with a decision involving a large amount of money or when a regulatory agency (such as a securities commission or health care authority) requires it.

Notwithstanding the statutory requirement for either a compilation, or agreed-upon procedures or examination to establish the AHCA proof of financial ability to operate, you may want to consult with your counsel and the healthcare accounting authority before hiring the accountant to prepare the Florida AHCA Proof of Financial Ability application.

We can help you with …..

•Due diligence on acquisitions of Home Health Agencies  that are  primarily Medicare based.

•To provide the AHCA proof of financial ability to operate, we can assist  you with the Florida AHCA Proof of Financial Ability application including assistance with compiled prospective(projected) financial statements that are required to be completed by a Certified Public Accountant for Home Health Agencies that are primarily Medicare based. We have developed specialized projection software that was customized to meet the AHCA requirement(s) for a Medicare based Home Health Agency that shows the monthly projected summary of revenue and expenses and the monthly projected cash flow statements for 24 months and the two annual balance sheets.

•Setting up accounting systems with QuickBooks and related training after obtaining your license from the State of Florida.

We have prepared dozens of projections  over the years in various industries and recently successfully assisted a Medicare based Home Health Agency and HME   in completing and filing a AHCA proof of financial ability to operate (CHOW) and to attain a license from The Florida Agency for Healthcare Administration (AHCA) by completion of the  Proof of Financial Ability To Operate application, which included preparation of the projections, forms and schedules referred to above and communication with the AHCA reviewer.

Categories
Medicare

Preparation of AHCA Proof of Financial Ability to Operate Form 3100-0009

As you may know, part of the process to complete the Health Care Licensing Application, the Florida Agency for Health Care Administration (AHCA) and the Florida Statutes requires that each applicant to establish AHCA Proof of Financial Ability to Operate and to show the anticipated provider revenue and expenditures, the basis for financing anticipated cash-flow requirements of the provider, and an applicant’s access to contingency financing. To establish AHCA proof of financial ability to operate, information is provided in detailed forms and schedules which include the monthly projected summary of revenue and expenses, the monthly projected cash flow statements for 24 months and the two annual balance sheets and detailed footnotes that include summaries of significant assumptions, accounting policies and other informative disclosures as required by Generally Accepted Accounting Principles (GAAP).

To show AHCA proof of financial ability to operate the forms and schedules must accompany any initial or change of ownership (CHOW) application for the following types of health care providers.

•          Adult Day Care Centers

•          Assisted Living Facilities

•          Health Care Clinics

•          Home Health Agencies

•          Home Medical Equipment

•          Hospice

•          Intermediate Care Facilities for the Developmentally Disabled

•          Prescribed Pediatric Extended Care Center

•          Skilled Nursing Facilities

All schedules must be prepared in accordance with generally accepted accounting principles (GAAP). A Certified Public Accountant (CPA) must compile, examine, or apply agreed-upon procedures to prospective financial statements, including summaries of significant assumptions and accounting policies.

To establish AHCA proof of financial ability to operate each applicant can select the type of financial statement to be given to the Provider.  As mentioned above, the three choices are:

1.         Compile

2.         Agreed-upon procedures

3.         Examined

To establish AHCA proof of financial ability to operate and to learn more about your financial statement options

Before you select the level of service from the CPA, the following will serve as a brief analysis of each option.

1.         Compile – A compilation engagement is the lowest level of service that an accountant can perform on prospective financial presentations that is intended for third parties. Despite it being the lowest level of service, it is a very common deliverable provided by a CPA and often a cost effective solution for many companies, when required or accepted by third parties. Compilation procedures includes assembling, to the extent necessary, the prospective financial information based on the responsible party’s assumptions. Performing the required compilation procedures, including reading the prospective financial statements with their summaries of significant assumptions and accounting policies, and considering whether the prospective financial statements appear to be (1) presented in conformity with American Institute of Certified Public Accountants (AICPA) guidelines and (2) not obviously inappropriate. The compilation procedures are not performed for the purpose of providing any assurance on the presentation or on the underlying assumptions. The accountant may prepare the financial statements or then reads them when they are prepared by the Company’s management to make sure that they appear appropriate in form and content. Because the accountant does not perform any other procedures, the accountant does not obtain any assurance that the financial statements are free of material misstatement. A compilation report is issued by the CPA.

2.         Agreed-upon procedures – With an agreed-upon procedures engagement the accountant is engaged by a client to perform specific procedures and report findings. The accountant does not perform an examination or provide an opinion. Rather, the accountant reports only procedures and findings. In this type of an engagement, the accountant performs whatever procedures the users of the prospective statements specify. It is a flexible form of engagement; the procedures may be as extensive or cursory as the specified parties want, but should include more than a mere reading of the prospective financial statements. The service may be lower than a compilation, between a compilation and an examination, or as high as an examination.

3.         Examined – An examination engagement is a professional service that involves extensive corroborative procedures, resulting in the CPA’s expression of positive assurance about the presentation and the underlying assumptions. It is similar to an audit of historical financial statements and is the highest level of service that CPA’s can provide on prospective financial statements. The examination involves (a) evaluating the preparation of the prospective financial statements,(b) evaluating the support underlying the assumptions,(c) evaluating the presentation of the prospective financial statements for conformity with AICPA presentation guidelines, and (d) issuing an examination report.

Some additional insight factors to consider when choosing the levels of service

In an examination engagement an opinion is given by the CPA and it states that (i) the prospective financial statements are presented in conformity with AICPA guidelines and (ii) the assumptions provide a reasonable basis for the responsible party’s projection, the assumptions provide a reasonable basis for the responsible party’s projection given the hypothetical assumptions. Because an examination is an extensive service, it is more expensive to provide than the other two alternatives. Examinations are typically performed when the prospective presentation is associated with a decision involving a large amount of money or when a regulatory agency (such as a securities commission or health care authority) requires it.

Notwithstanding the statutory requirement for either a compilation, or agreed-upon procedures or examination to establish the AHCA proof of financial ability to operate, you may want to consult with your counsel and the health care authority before hiring the accountant to prepare the Florida AHCA Proof of Financial Ability application.

We can help you with …..

  • Due diligence on acquisitions of Home Health Agencies that are primarily Medicare based.
  • To provide the AHCA proof of financial ability to operate, we can assist you with the Florida AHCA Proof of Financial Ability application including assistance with compiled prospective(projected) financial statements that are required to be completed by a Certified Public Accountant for Home Health Agencies that are primarily Medicare based. We have developed specialized projection software that was customized to meet the AHCA requirement(s) for a Medicare based Home Health Agency that shows the monthly projected summary of revenue and expenses and the monthly projected cash flow statements for 24 months and the two annual balance sheets.
  • Setting up accounting systems with QuickBooks and related training after obtaining your license from the State of Florida.

We have prepared dozens of projections over the years in various industries and recently successfully assisted a Medicare based Home Health Agency  in completing and filing a AHCA proof of financial ability to operate (CHOW) and to attain a license from The Florida Agency for Healthcare Administration (AHCA) by completion of the  Proof of Financial Ability To Operate application, which included preparation of the projections, forms and schedules referred to above and communication with the AHCA reviewer.