Skip to Main Content

GainInsight

Returned 925 results

Times of uncertainty often reveal where a business is most exposed—making exit planning an important time to address gaps with intention. By using assessments, risk profiling, and benchmarking, owners can prioritize the highest-impact issues and strengthen the metrics and controls needed for faster, better decisions that support business valuation.

AI medical scribes may ease documentation burden, but they also raise important questions about privacy, consent, and oversight. Learn what healthcare organizations should evaluate before adopting these tools in clinical practice. 

When most people think about water parks, they think about slides, lazy rivers, and summer crowds. What they do not always see is a highly complex operation that blends revenue generation, community service, workforce development, and long-term planning in a way that many public sector organizations can learn from.

Veterinary practices can miss key financial warnings. Find out about 12 common blind spots—from pricing and payroll to cash flow and planning—and see where stronger financial visibility can support healthier margins, better decisions, and long-term stability.

With uncertainty from shifting economic conditions, market volatility, and evolving tax policy, now may be a good time to use trust, gift, and estate strategies to transfer privately held business interests. Discounts for lack of control and marketability discounts may stretch exemptions.

With continued uncertainty in the business environment—shifting economic conditions, market volatility, and evolving tax policy—trust, gift, and estate strategies may help transfer privately held business interests. Noncontrolling interests may be discounted for lack of marketability when transferability is limited. 

Uncertainty can create planning opportunities. Learn how discounts for lack of control and discounts for lack of marketability work—and why applying them correctly (multiplicative, not additive) can help transfer more ownership while preserving gift and estate tax exemptions. 

The 2026 NAVIGATE Healthcare Leadership Summit highlighted the issues shaping healthcare today, from financial strain and regulatory change to payer audits and AI oversight. This article recaps the sessions and the key takeaways for industry leaders.

This article explores how Federally Qualified Health Centers can translate location- and service line-level reporting into budgets that reflect real operating conditions, support sustainability, and improve accountability.

CMS Administrator Dr. Mehmet Oz, in a letter to state Medicaid directors, issued new guidance mandating the creation of an off-cycle provider revalidation process to address fraud, waste, and abuse. Find out what providers need to know to navigate the changes.

State Medicaid agencies and Managed Care Organizations (MCOs) are facing growing pressure to better coordinate care across providers, vendors, and different state and federal agencies while reducing administrative complexity for members. Federal and state priorities—including greater focus on behavioral health integration, mental health parity, continuity of coverage, and proactive oversight—are also increasing expectations around coordination, accountability, and operational performance. 

Time and effort reporting is more than a routine administrative task—it’s a key control to ensure that payrolls charged to federally funded grants are allowable and properly supported. Because it is a high-risk area for grantees—and a frequent audit finding for HRSA grantees—strong documentation is critical to reducing compliance exposure and administrative burden. This article breaks down what time and effort reporting is, why the urgency has increased, and what health centers can do to strengthen practices and lower risks. 

Every organization experiences pain points from time to time: your costs may be too high, your cycle times too slow, your error rates are unacceptable, complaints are mounting. When things go wrong, it’s often the underlying processes and systems—not the people—that are at fault. To find a solution, organizations may turn to a consulting partner, like BerryDunn, for Business Process Improvement (BPI) services.

In this article, we discuss the types of BPI and related services like business process reengineering (BPR) you might consider, and how to decide which approach is right for your organization.

Defined contribution plan fiduciaries, especially those overseeing 401(k)s, face ongoing ERISA class actions. Plaintiffs now target routine practices, claiming they raise plan costs or shift expenses to participants. Plan sponsors, committees, and service providers are rechecking long‑standing practices to reduce risk. 

Community engagement is at the heart of what we do as parks and recreation professionals. When it works, it builds trust, strengthens programs, and leads to better, community-driven decisions. When it falls short, participation drops, projects lose momentum, and we risk hearing from the same voices over and over.  

When the federal government shut down for 43 days (October 1 – November 12, 2025), millions of families worried about losing access to WIC—the Special Supplemental Nutrition Program for Women, Infants, and Children. WIC provides healthy food and nutrition support to pregnant women, new moms, and children 5 years and younger. The shutdown exposed critical vulnerabilities in WIC funding. While states and USDA implemented emergency measures, the experience underscores the need for structural reforms and proactive planning. 

The 2026 National Money Laundering Risk Assessment provides a comprehensive look at the most significant illicit finance threats facing the US financial system. While the report spans the entire economy, several themes are particularly relevant for community banks, credit unions, and broker‑dealers. 

As states apply Medicaid work requirements, policymakers and stakeholders must look past top-line enrollment projections to grasp the full scope of the impact. Experience shows that work requirements introduce administrative complexity, enrollment volatility, and financial ripple effects across Medicaid programs, health insurers/managed care organizations (MCOs), providers, and employers. 

With the prevalence of workplace violence in the healthcare industry, it’s important—and required by law in some states—to have a workplace violence prevention program. Understanding the definition and types of workplace violence, regulations, plan elements, and other considerations is essential. 

As we previously wrote about, on February 20, 2026, the US Supreme Court invalidated tariffs imposed under the International Emergency Economic Powers Act (IEEPA).

Last week, the US Customs and Border Protection (CBP) announced a new process that allows importers to request refunds of those tariffs. We'll walk through how to actually claim refunds, what to expect from the process, and where complications can arise.

In today’s increasingly digital environment, cybersecurity has become a critical concern for nonprofit (NFP) organizations. While many NFPs operate with smaller teams and tight budgets, they still handle sensitive information—donor records, payment data, client demographics, and sometimes even health‑related or financial assistance files. Unfortunately, cybercriminals recognize this and often view NFPs as soft targets with valuable data. Because community trust is so important, a cybersecurity incident can create financial and reputational hurdles for an organization. The good news, however, is that strong cybersecurity foundations do not always require major capital investments. With strategic planning and a focus on essential controls, even the most resource‑constrained organizations can significantly reduce cyber risk. 

For many people, charitable giving is deeply personal, motivated less by tax considerations and more by values and a connection to a cause or organization.  While tax benefits are rarely the primary reason people give, understanding how charitable contributions may affect your taxes remains important. 

To foster broader adoption of the Community Bank Leverage Ratio framework and maintain strong capital standards for community banks, federal banking agencies revised the framework in a final rule issued on April 23, 2026. 

Effective October 1, 2025, the Health Resources and Services Administration (HRSA) expanded its delinquent audit process for Federally Qualified Healthcare Centers (FQHC) that have failed to complete their single audits and submit the corresponding reports within the designated time frame. If health centers fail to complete their single audits and submit the corresponding reports within the designated time frame, they may face additional actions. 

When CAD or RMS systems fall short, replacement often feels like the only option—but it isn’t always the right one. This article helps public safety and local government leaders step back, identify what’s really causing performance issues, and decide whether optimization or replacement is the smarter path forward. 

Commercial insurers publish detailed, machine‑readable files with negotiated rates for every provider, CPT code, and plan to comply with federal transparency requirements. The scale of the data makes it nearly impossible for providers to download and analyze, but payers with the right technology can. Are you leveraging this data to negotiate payer rates, or are you making decisions based on assumptions? 

A new federal executive order aimed at eliminating fraud, waste, and abuse signals a clear shift for healthcare and not-for-profit organizations that receive federal funds. While oversight of federal programs is nothing new, this order formalizes a cross-agency task force and raises expectations around documentation, internal controls, and accountability, particularly for organizations that participate in Medicaid, Medicare, and federal grant and assistance programs.

Workforce shortages, an aging staff, and rising patient demand threaten rural healthcare sustainability. This article is designed for rural health system leaders seeking practical ways to strengthen workforce stability and reduce constant operational strain

There has been a recent flurry of proposals surrounding payment stablecoin regulation. In March and April 2026, the Office of the Comptroller of the Currency (OCC) and Federal Deposit Insurance Corporation (FDIC) issued Notices of Proposed Rulemaking (NPR) to implement major provisions of the Guiding and Establishing National Innovation for US Stablecoins (GENIUS) Act. While this article focuses on the OCC and FDIC proposals, the US Department of the Treasury, the Financial Crimes Enforcement Network, and the Office of Foreign Assets Control have also issued recent proposals on implementing the GENIUS Act.

Maine’s new housing law changes how local zoning works—and raises the stakes for comprehensive planning. Learn what LD 1829 means for municipalities and how updated plans can help communities guide growth on their own terms. 

The FDIC's Quarterly Banking Profile for quarter four 2025 reports the performance for the 3,909 community banks evaluated.

On April 10, 2026, Maine’s governor signed into law the supplemental budget for the fiscal year. The supplemental budget includes several significant changes to the state’s income tax regime. The law updates Maine’s conformity to the Internal Revenue Code and outlines key provisions from which Maine tax law will decouple from federal treatment. The supplemental budget also introduces a 2% high-income tax surcharge and creates a Pass-Through Entity Tax (PTET) whereby electing flow-through businesses can pay income tax on behalf of their owners. 

In an environment of increasing comfort with ‘check the box’ agreements, consent can become a transactional exercise—an administrative checkpoint focused on signatures rather than comprehension. The emphasis shifts to ensuring paperwork is completed, rather than ensuring patients understand what is being proposed, what alternatives exist, what risks matter most to them, and whether they genuinely agree.

For tax years beginning January 1, 2026, additional changes under Internal Revenue Code §274(o) will further restrict meal deductibility under OBBBA, impacting how businesses classify, track, and deduct food-related expenses. 

Each year, more utility leaders realize they are playing catch-up in providing the online experience their customers expect.  And, each year, the bar gets higher. Easy self-service options, real-time updates, and responsive support have become the norm. As a result, today’s utility customers bring those same expectations to every interaction.

Most tax professionals know about amended returns. Fewer, however, use the superseded return strategically, and that's a missed opportunity. Here's the key distinction: an amended return supplements your original filing. A superseded return replaces it. Similar paperwork, completely different legal effect. The deciding factor is timing. 

Imagine a storm hits your community and there is widespread property, infrastructure, and facility damage; the emergency dispatch center goes dark, some facilities have power but most do not, powered computers show no network or internet connectivity, employee paychecks or vendor payments are delayed, and utility infrastructure asset information is not available. All because the technology supporting these mission essential functions failed.

Leadership in parks and recreation has always required a special kind of commitment. The work is public, people-centered, and often under-resourced. Many leaders in this field are deeply prepared, genuinely invested, and consistently reliable. 

By expanding Able Bodied Adults Without Dependents (ABAWD) requirements and tightening SNAP and Medicaid eligibility, the bill reshapes access to public assistance programs that help prevent people from falling deeper into homelessness. New compliance hurdles threaten food security for many unsheltered individuals who cannot realistically meet the documentation and work requirements. The OBBBA ABAWD expansion points to the need for a new statewide approach to unsheltered homelessness that better supports the safety and health of unsheltered families.  

Beginning with calendar year 2026, public housing agencies (PHAs) will be required to submit an annual Federal Financial Report (SF-425) for each operating subsidy grant. Reporting will continue annually until all funds are fully expended or returned to HUD. These changes reflect HUD’s increased focus on transparency, grant life cycle oversight, and compliance monitoring.

To quote George R. R. Martin, “Different roads sometimes lead to the same castle.” The same can be said for Schedule A. When it comes to qualifying as a public charity, the IRS offers more than one path forward. In Part I of this series, we explored the Schedule A Part II public support test—a common route for donor‑supported organizations. In this second installment, we turn to the Schedule A Part III test, an alternative approach designed for organizations that operate under a fee‑for‑service or program‑revenue model. While the tests are different, both can ultimately lead to the same destination: public charity status. 

This is the first in a two-part series that provides a detailed examination of Form 990, Schedule A, offering practical guidance to the many organizations responsible for its complete and accurate preparation. This article focuses on organizations that qualify under Part I, Line 7 – 509(a)(1) – and the steps required to substantiate this classification through the Part II public support test. 

Exclusion screening is one of those healthcare requirements that can feel routine—until it isn’t. An essential element of credentialing, it is the process of regularly checking whether individuals or entities that are connected to your organization appear on federal exclusion lists, created and maintained by US Department of Health & Human Services Office of the Inspector General (OIG) and the System for Award Management (SAM). Individuals or entities on the list may be prohibited from participating in federally funded healthcare programs. When a match is overlooked, the consequences can lead to financial, legal, operational, and reputational risk for an organization. 

Procurement is often described as “ground zero” for audit findings—and for good reason. In single audits and other compliance reviews, procurement files are one of the first places auditors look. Not because organizations are acting in bad faith, but because procurement is where documentation, judgment, and regulatory requirements collide. 

When a company is operating successfully and seeking liquidity—whether to fund growth or return value to shareholders—two primary pathways or “tracks” exist: the public market (IPO), and the private market (a sales transaction). 

The telehealth field is steadily changing as federal policymakers aim to keep patient access open while shaping long-term regulations. The Consolidated Appropriations Act of 2026 (H.R. 7148), signed into law on February 3, 2026, brought the biggest changes by extending major Medicare telehealth benefits for most services until December 31, 2027. Additionally, the US Department of Health and Human Services (HHS) updated its telehealth guidance, confirming these extensions and ensuring that Medicare beneficiaries in all regions continue to have broad access. 

Charitable organizations play a vital role in addressing social issues, supporting communities, and promoting public welfare. As part of their mission, these organizations often make direct charitable expenditures to fund projects, provide services, and support individuals in need. However, with the privilege of tax-exempt status comes the responsibility to ensure that funds are used appropriately and in compliance with regulatory requirements. One crucial aspect of this compliance is expenditure responsibility, a concept that ensures charitable resources are used for their intended purposes. 

The research and development (R&D) tax landscape is undergoing significant transformation in 2026. While some provisions restore previous benefits, others introduce heightened compliance requirements that demand immediate attention from businesses claiming R&D deductions and credits. 

On February 20, 2026, the US Supreme Court issued a ruling on Learning Resources, Inc. v. Trump, a case challenging President Trump’s authority to impose tariffs under the International Emergency Economic Powers Act (IEEPA). In a 6-3 vote, the US Supreme Court ruled that IEEPA does not permit the President to impose tariffs.

After years of advocacy from the Maine CPA community and business organizations, Governor Janet Mills' supplemental budget proposal includes a Pass-Through Entity Tax (PTET) for Maine, which would be effective for tax years beginning January 1, 2026. If enacted, partnerships and S corporations will finally have access to a federal tax planning strategy that businesses in 36 other states have been using for years. Maine has been late to the party, but the party has started!

The Governmental Accounting Standards Board (GASB) issued Statement No. 105, Subsequent Events to enhance the transparency, consistency, and value of financial reporting related to events that occur after the financial statement date, but before the financial statements are issued. The statement realigns existing guidance by clearly describing the subsequent events' time frame, distinguishing between recognized and non-recognized subsequent events, and providing specific disclosure requirements. 

In 2025, our team completed projects in seven states and kicked off new work in 17 states, partnering with communities ranging from fewer than 12,000 residents to more than one million. These projects reflect the core of what our Parks, Recreation, and Libraries team does: helping agencies improve operations, drive innovation, identify improvements based on community need, and strengthen their brand and image. 

Many software-as-a-service (SaaS) companies operate on a subscription-based model with large payments due up front. This article explores how these companies can manage the significant timing differences between financial reporting and IRS tax requirements. 

The accounting profession is undergoing one of the most significant transformations in its history. Advances in Artificial Intelligence (AI), automation, data analytics, and enhanced cloud-based platforms are reshaping not only how accounting work is performed, but also the value that CPAs deliver to their clients. The critical question is no longer whether technology is changing accounting—but whether your CPA is continuing to invest in education, innovation, and forward-thinking strategies to keep pace. This article outlines key questions you need to ask your CPA firm about AI and automation. 

Enacted as part of the One Big Beautiful Bill Act (OBBBA), the foreign entity of concern (FEOC) requirements are designed to reduce US reliance on certain foreign suppliers in the renewable energy sector. These rules bar projects with prohibited foreign entity (PFE) ties from claiming clean energy tax credits and take effect for projects initiated after December 31, 2025.

When CMS previewed its streamlined Medicaid Enterprise System (MES) templates at the Medicaid Enterprise Systems Conference (MESC) in August 2025, the message was clear: change is coming. And guess what? Change arrived with the start of the new year when CMS officially released eight new templates to standardize processes, improve oversight, and accelerate federal reviews. States and territories now have six months to adopt these templates, with full compliance required by July 1, 2026.

As we begin 2026, healthcare organizations have an opportunity to reset. Several years of sustained disruption have created a transformational moment for both operational and strategic realignment. Many organizations are transitioning from a period of reactive decision-making and are now better positioned to take a more intentional, proactive approach. As healthcare leaders, you’re beginning to see opportunities to restore margin, build resiliency, and boost strategic growth. 

As the construction industry faces mounting pressure to reduce its environmental footprint, artificial intelligence (AI) is emerging as a powerful driver of change. From optimizing material usage to monitoring energy consumption, AI is helping companies build smarter, greener, and more efficiently than ever. 

Bonus depreciation is officially back at 100%, and the rules for 2026 look very different from what many taxpayers had been planning for. After years of preparing for the gradual phase-down under the Tax Cuts and Jobs Act (TCJA), the One Big Beautiful Bill Act (OBBBA) of 2025—along with new IRS guidance in Notice 2026‑11—restores full expensing for most qualified property and sets a clearer long-term framework.

Does every audit feel like a rescue mission? Do you often feel like each year is the same as the last? You’re not alone. Many nonprofit and governmental agencies experience turbulence along the way and no audit is perfect. In this article, we’ll outline a strategic approach to help your audit journey progress to planned readiness. 

In a changing healthcare landscape, ensuring that all members of your organization—from administrative to clinical—meet federal eligibility requirements is imperative. Exclusion screening goes beyond regulatory compliance, protecting against costly penalties. Recent enforcement actions highlight the consequences of noncompliance. This article explores the essentials of exclusion screening, common mistakes, and practical insights to help your organization remain compliant. 

Across the United States, 2025 proved to be a pivotal year for nursing facilities (NFs). Fast-paced changes in the regulatory environment, significant shifts in payer mix, including growth of Medicare Advantage plans, and ongoing financial and workforce challenges, have reshaped the landscape. This article summarizes the most impactful trends and issues facing Skilled Nursing Facilities (SNF) and NFs in 2026, as well as strategies for providers to consider adapting. 

For many Critical Access Hospitals (CAHs), year-end Medicare settlements can be unpredictable—sometimes exceeding expectations, sometimes leaving an unexpected shortfall. These surprises often stem from a lack of proactive reimbursement modeling, and they can have real consequences for cash flow, operations, and long-term planning. The good news is that with the right tools and strategies, CAHs can anticipate settlements, make informed decisions, and protect both financial health and operational flexibility. 

Local governments are at a pivotal moment. As retirements accelerate and community needs shift, traditional hiring methods are no longer enough to build resilient, diverse teams. More than half of U.S. states, including the state of Washington, have adopted policies encouraging skills-based hiring, and in states with these policies, 22 out of 25 saw their share of job postings without degree requirements increase (National Governors Association, 2024). 

Launching a Constituent Relationship Management (CRM) initiative isn’t just a software upgrade, it’s a strategic shift in how your organization connects with constituents. Think of it like stepping onto the field for a high-stakes match: success requires preparation, agility, and a game plan that puts constituent experience at the center. 

Patient care is built on trust—and that trust can be compromised when financial relationships aren’t transparent. That’s why compliance laws like the Anti-Kickback Statute (AKS), the Sunshine Act, and the Open Payments Program (OPP) exist. They are designed to promote transparency in healthcare. This article breaks down the essentials and explores what the laws mean for healthcare organizations and clinicians. 

In small towns and rural communities, parks and recreation spaces are vital to quality of life. They’re where neighbors connect, children play, and local traditions thrive. Yet, developing a master plan for these spaces can feel overwhelming—especially with limited budgets and staff. The good news is that effective planning doesn’t have to be complicated or costly. With a right-sized approach, small communities can create practical, actionable master plans that reflect their unique needs and aspirations. 

The FDIC's Quarterly Banking Profile for quarter three 2025 reports the performance for the 3,953 community banks evaluated.

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our corporate board leadership series, BerryDunn Director of Executive Recruiting, Sarah Olson, shares key insights on leadership transitions, including identifying high-potential employees, offering internal leadership development, and prioritizing the development of a strategic succession plan. 

Rolling out new software isn’t just clicking “Install” and calling it a day. It’s more like planning a wedding. There’s the venue (servers), the guests (users), and yes, the unexpected costs that show up like distant relatives. In today’s digital-first world, implementing software is a strategic investment that can boost efficiency, strengthen compliance, and support long-term growth. However, the true cost goes beyond the sticker price on that shiny new platform. For nonprofits operating on limited budgets, careful planning is essential to avoiding hidden costs when making a technology upgrade. 

The affordable housing landscape in the United States is on the cusp of significant change with the introduction of the Renewing Opportunity in the American Dream (ROAD) to Housing Act of 2025. For nonprofit organizations operating in the affordable housing sector, this proposed legislation brings both new opportunities and important considerations. Here’s what you need to know. 

In healthcare, coding compliance isn’t just about accuracy—the true why behind it is to protect integrity, revenue, and trust. When hospitals and health systems need to develop an internal coding compliance audit plan, it’s important to focus on education, building a culture of accountability, and accuracy. Starting with the why will help staff understand the importance of proactive auditing. It’s far better to identify issues internally than to discover them during an external review. 

Site- and program-specific accounting can be a lifeline to Federally Qualified Health Centers (FQHCs) struggling with sustainability by providing a more granular look into operations. This approach allows an FQHC to gain key insights into the performance of its programs and sites and use those insights to make data-driven decisions to improve operations. To implement this method, an FQHC must set up its general ledger (GL), payroll, and Electronic Health Record (EHR) systems to report at the appropriate level of detail so that data flows cleanly into its accounting system. 

The FDIC has proposed raising several key regulatory thresholds, including those that determine which institutions must comply with Part 363’s audit and internal control requirements. The primary driver behind these proposed changes is the growth experienced by institutions since the original thresholds were set decades ago. While the changes are designed to ease compliance burdens for smaller institutions, they also come with a cautionary tale—they would reduce regulatory requirements, but not the risk. 

Liquidity is the lifeline of any nonprofit organization. Strong liquidity ensures uninterrupted programs, financial stability, and the flexibility to respond to unexpected challenges. This article shares practical steps to monitor and manage liquidity effectively, including setting clear policies, tracking cash flow, using key financial ratios, managing reserves, and leveraging technology. By following these best practices, organizations can maintain resilience, build trust with stakeholders, and stay focused on their mission—even during uncertain times.

The Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2025-08 in November 2025 to address stakeholder concerns regarding the accounting for acquired financial assets under current US GAAP. This update specifically amends the guidance for purchased loans, aiming to improve comparability, consistency, and decision usefulness in financial reporting. 

On November 5, 2025, the US Supreme Court heard arguments in Learning Resources, Inc. v. Trump, a case that challenges President Trump’s authority to impose tariffs under the International Emergency Economic Powers Act (IEEPA). If the Court finds the presidential power to impose tariffs unconstitutional, importers may be eligible for refunds of duties already paid and should act quickly. 

In a time when operational efficiency and sustainability are more critical than ever, small- and medium-sized manufacturers (SMMs) face a unique challenge—how to modernize without breaking the bank. Fortunately, the US Department of Energy (DOE) offers a solution through its Industrial Assessment Centers (IACs) Program—an initiative that combines expert guidance with financial support to help manufacturers thrive. 

For a physician beginning a new clinical role, an efficient onboarding process is crucial. A seamless onboarding experience signals to clinicians that the organization values their time, expertise, and contribution to the care continuum. In today’s environment, where every dollar and every patient interaction count, the financial impact of a well-executed onboarding strategy is considerable. 

As public health evolves and new challenges emerge, both new and seasoned professionals need guidance to navigate their careers effectively. Whether guiding fresh graduates or supporting experienced employees, mentoring is a vital step in the workforce lifecycle. It bridges the gaps from academic learning and onboarding through career transitions to professional growth and expertise, helping individuals move from passion to practice and thrive in their respective areas. 

Starting January 1, 2025, a new individual tax benefit allows taxpayers to deduct certain interest paid on loans for qualified passenger vehicle purchases. This deduction is available through the end of 2028 and presents both opportunities and compliance responsibilities for lenders. 

Beginning January 1, 2026, significant changes will affect catch-up contributions to retirement plans for high-earning individuals, sometimes referred to as ‘highly paid participants.’ The new rules specifically target plan participants whose prior-year compensation exceeds a set threshold and require that their catch-up contributions to 401(k), 403(b), and governmental 457(b) plans be made on a Roth (after-tax) basis. This article provides an overview of these new requirements, focusing on the affected plan participants, and discusses the pros and cons as well as key considerations for employers and affected individuals in advance of the transition deadline on December 31, 2025. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our corporate board leadership series, BerryDunn Financial Services Practice Group Senior Manager, Lindsay Francis, shares key insights on information security awareness and risk, including how to embed it in your organizational culture. 

For nonprofit organizations, every resource matters. Selecting the right Enterprise Resource Planning (ERP) system is no longer just a technology decision, it’s a strategic choice that impacts the entire organization. With so much at stake, it’s essential to approach ERP evaluation and implementation with careful planning and expert guidance. Follow these four steps for best practices to help you make informed decisions that support the mission and vision of your organization during the process. 

Local governments across the United States are facing a historic workforce transition. With nearly 38% of the local government workforce expected to retire within the next five years, the sector is confronting what experts have dubbed the “Silver Tsunami.” This wave of retirements, driven by an aging workforce and accelerated by post-pandemic burnout, is creating a perfect storm of staffing shortages, institutional knowledge loss, and increased pressure on remaining employees. 

Private foundations are vital players in the philanthropic landscape, channeling resources toward charitable, educational, and scientific causes. However, to maintain their tax-exempt status and avoid excise taxes, these organizations must comply with strict IRS rules—particularly those governing qualifying distributions. In the second installment of our trilogy, we will follow the McQueen Family Foundation to determine their qualifying distributions. As a non-operating foundation, this is a crucial step in their annual compliance requirements. 

Construction companies face distinct challenges that make them uniquely vulnerable to fraud. Multiple job sites, a mobile workforce, complex billing arrangements, and layers of subcontractors all increase the risks of misreporting, theft or even errors and require specific oversight. The good news? By understanding the three most common risks, owners can take practical steps to protect both their business and their bottom line. 

When utilities launch a Customer Information System (CIS) project, it can feel like game day—high stakes, fast decisions, and a lot riding on the outcome. Just like championship teams, successful CIS projects require vision, leadership, adaptability, and a playbook built for tough calls and last-minute pivots. 

No one likes to be caught off guard, especially when it comes to an audit. Being “audit ready” isn’t about checking a box; it’s about building confidence, protecting your reputation, and making sure your team can carry out its daily responsibilities with minimal disruption. It’s also important to know when to seek help. 

Today’s healthcare leaders are navigating a perfect storm of workforce shortages, financial strain, regulatory uncertainty, and more, creating unprecedented pressure across the industry. Meanwhile, leaders are being asked to innovate, improve operational efficiencies, and deliver exceptional care—all while remaining compliant and financially viable. Developing a strategy is key. 

In a move that has sparked widespread attention across higher education, the US Department of Education (ED) recently placed Harvard University on Heightened Cash Monitoring (HCM) status. This designation is typically reserved for institutions facing serious financial or administrative challenges. While Harvard’s inclusion may come as a surprise, the decision underscores the importance of understanding the HCM framework and its implications for colleges and universities nationwide. 

Assuring access to behavioral health services in rural communities remains one of the most persistent and critical challenges that state governments face today. Research shows that nearly 18% of large rural areas and over 40% of small or isolated rural areas are at least 30 minutes away from any mental health care facility. In comparison, fewer than 10% of urban areas face this issue. According to Rural Health Information Hub, over 70% of rural counties lack a psychiatrist, and many have no psychologists or licensed counselors. Rural communities often struggle to access behavioral health services, which can harm community well-being, economic stability, and family life. 

Your compliance policies should be living documents that guide daily activities for many staff members. To be effective, they must be clear, concise, and appropriately specific. How do your policies stack up? 

The FDIC's Quarterly Banking Profile for quarter two 2025 reports the performance for the 3,982 community banks evaluated.

When it comes to Medicare reimbursement, the hospital Area Wage Index (AWI) may be one of the most important and often overlooked factors influencing your bottom line. This article breaks down how the wage index is calculated and offers practical strategies to help hospitals avoid common pitfalls, support audit readiness, and take full advantage of this critical reimbursement mechanism.  

In an era defined by rapid technological advancement and constant innovation, one truth remains unchanged: the success of any organization depends on its people. Employee engagement is not a nice-to-have—it’s a strategic imperative. BerryDunn’s Valuable Organizational Insights on Culture and Engagement (VOICE) assessment provides leaders with a research-backed, actionable framework for understanding and improving engagement. Unlike traditional surveys, VOICE translates insights into impact quickly, equipping organizations with tailored recommendations and tools that drive meaningful change within weeks.

The US Department of Health and Human Services (HHS) has revised its federal grant policy, introducing stricter oversight into budget adjustments. Effective October 1, 2025, the new rule lowers the allowable rebudgeting threshold from 25% to 10% and is expected to significantly reduce reallocation flexibility while increasing the administrative workload and compliance risks for health centers and other HHS grantees. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our corporate board leadership series, BerryDunn Director of Learning & Development, Shawn Tuttle, shares key insights on developing talent within an organization, including the importance of experiential learning, artificial intelligence, employee retention, and the role of managers. 

A financial institution’s core banking system, or core processing system, is an essential software that provides the backbone for day-to-day operations and transaction processing. Accounting for the costs of these systems can be tricky because of the complexities often involved in these contracts.

The Minimum Investment Return (MIR) is a critical component for all private foundations. It is a standardized calculation based primarily on the value of the foundation’s investment (i.e., non-charitable use) assets to ensure that endowments are put to charitable use rather than accumulating excessive wealth with little to no public benefit. By adhering to IRS guidelines and maintaining diligent records, foundations not only avoid costly penalties but also contribute meaningfully to the communities and causes they support. 

On March 25, 2025, President Trump issued an executive order regarding federal tax payments and refunds. Effective September 30, 2025, the US Secretary of the Treasury will discontinue the issuance of paper checks for tax refunds. Additionally, “as soon as practicable,” all payments to the federal government must be made electronically. This change could have a significant impact on taxpayers, especially those who do not have a US bank account. 

In today’s digital age, residents expect the same level of service from their local government as they do from private companies—fast, transparent, and personalized. For municipalities striving to meet these expectations, a constituent relationship management (CRM) system can be a game-changer. 

Organizations across industries are constantly seeking ways to enhance efficiency, streamline operations, and maximize value. However, outdated processes, unnecessary complexity, and organizational inertia can hinder progress, slowing innovation and impacting productivity. The good news? Businesses and institutions can adopt proven methods to become more agile, responsive, and effective—with the right mindset and leadership. 

On July 18, 2025, the US took a historic step in digital finance when President Donald Trump signed the GENIUS Act into law. This legislation introduces the first comprehensive federal framework for payment stablecoins, aiming to balance innovation with consumer protection and financial stability while strengthening the US dollar’s global dominance. 

In recent years, the public health workforce has faced unprecedented challenges—from responding to the COVID-19 pandemic to addressing the impact of social determinants of health on communities. These pressures have led to poorer quality of care, reduced access to services, diminished preparedness, and a decline in public trust in the public health system. As political tensions deepen and workplace stress intensifies, public health employees are reporting increased mental health concerns, including burnout and moral injury. 

ESOPs are an attractive employee benefit, giving employees ownership interest in the company through shares of stock and an appealing exit strategy for founders. However, accounting for ESOP transactions can be confusing and cause frustrations for accountants. Understanding the basics of accounting for ESOP transactions is essential to avoiding inaccurate financial statements and ensuring compliance with US Generally Accepted Accounting Principles. 

Most healthcare organizations conduct internal or external Evaluation and Management (E/M) audits on a monthly, quarterly, or annual basis to stay ahead of compliance risks and optimize reimbursement. While these audits can be stressful, given their association with risk, penalties, and payer scrutiny, when executed effectively, they can uncover significant opportunities within a practice.  

Artificial Intelligence (AI) is no longer a futuristic concept reserved for research labs or tech giants in Silicon Valley. Today, AI is becoming a practical and powerful tool for local governments across the country—helping to boost efficiency, reduce costs, and elevate the quality of public services. 

The National Recreation and Parks Association’s (NRPA) Conference is just around the corner, and the annual conference can really be overwhelming, especially for first-year attendees," shares Rich Neumann, manager with BerryDunn's Parks, Recreation, and Libraries team. "Here you have direct access to the brightest minds in our industry exploring the hottest trends in parks and recreation." With the conference approaching (September 16-19 in Orlando), our team of consultants and former practitioners shares their proven strategies for navigating this landmark event. 

Changes are brewing in the healthcare industry due to far-reaching federal reforms. With the One Big Beautiful Bill Act (OBBBA) now signed into law—alongside Executive Orders (EO), judicial rulings, and other federal actions—providers are facing a wave of new requirements and opportunities. This article highlights some of the changes affecting the industry and offers a comprehensive, downloadable summary for a closer look at key impacts.

In its newly released PIH Notice 2025-14, HUD lays out clear guidance for Public Housing Agencies on how to properly manage, report, and safeguard Operating Funds—especially when using centralized accounts like PayMaster or Revolving Fund Accounts. 

In today’s governmental accounting space, transparency isn’t just a best practice; it’s expected. Internal and external users rely on financial statements not just for numbers, but for a clear and concise picture of how a government is managing its assets and planning for the future. GASB 104 raises the bar on how governments disclose capital assets, and it warrants attention. 

Reflections from the MESC 2025 conference. 

A new Executive Order issued by President Donald Trump on August 7, 2025, brings major changes to how federal agencies handle discretionary grants. Titled "Improving Oversight of Federal Grantmaking," the changes in this Order introduce more political oversight, tighter controls on how funds are used, and new compliance rules that will directly affect organizations receiving federal funding. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our board leadership series, BerryDunn's Learning Consultant, Michelle Holloway, shares insights on learning and development, including designing effective training deliverables, aligning courses with an organization’s goals, and getting buy-in from leadership. 

The One Big Beautiful Bill Act (OBBBA) introduces sweeping reforms to federal student aid programs, reshaping the financial landscape for higher education institutions and their students. From changes in loan borrowing limits and repayment structures to Pell Grant eligibility and institutional accountability, the OBBBA signals a new era of fiscal discipline and transparency in postsecondary education.

One of the most overlooked yet critical aspects of a successful system replacement for justice and public safety information systems is the planning and documentation of interfaces and integrations.

For many hospitals and health systems implementing Electronic Health Record (EHR) systems, the "go-live" milestone is less of a celebration and more of a stumbling point—even when the implementation seemed like a triumph. Why does this happen? The truth is, go-live is just one of many milestones on the long ascent of your EHR journey.

The Public Company Accounting Oversight Board has released its 2024 Annual Report on the Interim Inspection Program for audits of broker-dealers, outlining persistent deficiencies in broker-dealer audits and attestation engagements. For management and audit committees, the report offers crucial insights into audit risks, regulatory expectations, and areas where stronger oversight is needed. 

The Centers for Medicare & Medicaid Services (CMS) issued the final rule for the PPS for SNFs for FY 2026 which was published in the Federal Register on August 4, 2025; the regulations in this rule are effective October 1, 2025. 

As financial institutions continue to navigate evolving regulatory landscapes, the recently enacted OBBBA legislation introduces a noteworthy incentive aimed at supporting rural and agricultural development. Effective July 4, 2025, the bill provides a 25% federal income tax exemption on interest income earned from qualifying rural or agricultural real estate loans.  

Executive Order (EO) 14221, released on February 25, 2025, directed the Secretaries of Labor, Health and Human Services (HHS), and the Treasury to implement changes to improve implementation and increase enforcement of the hospital price transparency (HPT) rule. Here we offer practical guidance for HPT compliance. 

Capital campaigns can be game changers for nonprofits, enabling bold investments in infrastructure, programs, and long-term growth. Whether you're building a new facility, expanding services, or upgrading technology, a capital campaign aligns fundraising with your strategic vision. 

The FDIC's Quarterly Banking Profile for quarter one 2025 reports the performance for the 4,022 community banks evaluated.

Healthcare organizations are currently facing growing financial challenges and experiencing high staff turnover. Recruiting a compliance officer may prove challenging due to the unavailability of experienced professionals or concerns about salary and fringe expenses. Depending on a healthcare organization’s fiscal health, consideration might be given to downsizing the compliance department. This article offers guidance to healthcare administrators as they ponder several compliance-related what-if scenarios.

CMS recently extended the deadline for the mandatory SNF provider enrollment off-cycle revalidation to January 1, 2026.  

July is National Parks and Recreation Month, and it’s the perfect time to celebrate the people who transform everyday spaces into places of joy, connection, and belonging. To highlight this year’s theme, ‘Build together, play together,’ members of BerryDunn’s Parks, Recreation, and Libraries team share stories of projects that helped communities thrive—and the personal ways they embrace play in their own lives. 

Signed into law by President Trump on July 4, 2025, the One Big Beautiful Bill Act (OBBBA) marks a significant step forward in addressing America’s growing need for affordable housing. With the demand for low-cost units far outpacing supply nationwide, the legislation offers targeted solutions aimed at making development more feasible and sustainable.

On July 4, 2025, the One Big Beautiful Bill Act (OBBBA) was signed into law. This article summarizes relevant key provisions that impact tax-exempt organizations. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our board leadership series, BerryDunn HR Generalist Maddie Stevens, shares insights on onboarding, engaging, and fostering connections for new employees, as well as leveraging generational gaps in the workforce.  

On July 1, 2025, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) transitioned from cost report-based to claim-based Medicare reimbursement for influenza, pneumococcal, COVID-19, and Hepatitis B vaccines. This important policy change enables real-time payment, improving cash flow and making vaccine administration more financially viable for health centers and clinics. 

Tariffs remain a significant cost factor for US importers and exporters. Understanding and leveraging trade programs is more critical than ever. One underutilized but highly valuable strategic tool is duty drawback. 

Artificial intelligence applications in healthcare have become ubiquitous and pervasive, and their adoption is accelerating. A recent American Medical Association survey disclosed physicians’ confidence in AI’s advantage for patient care is on the rise and their enthusiasm for its use is increasing. 

The "Big Beautiful Bill" introduces a new savings vehicle for American families called the Trump Account. This novel provision has largely been overshadowed by other headline items including the SALT cap—and perhaps understandably so. This article will explain what these accounts are, how they would work, and their tax implications, so that if the legislation passes, you can be informed on whether they fit into your family's financial future.

BerryDunn's Valuable Organizational Insights on Culture and Engagement (VOICE) assessment offers an evidence-based approach to measuring and enhancing employee engagement, helping leaders identify ways to cultivate a motivated, committed, and high-performing workforce. 

Newly appointed to lead BerryDunn’s Healthcare Practice Group, Lisa Trundy-Whitten is closely attuned to the healthcare industry. From challenges faced by healthcare organizations to the solutions BerryDunn’s experts can provide, Lisa shares her vision for the team as she takes the helm, as well as thoughtful insights for today’s healthcare leaders. 

As artificial intelligence (AI) becomes increasingly woven into nonprofit operations, boards are stepping into a new and critical role. Traditionally focused on mission oversight and fiscal responsibility, today's boards must also shape how AI is introduced, governed, and aligned with the organization’s values. Below are the seven most important actions a board can take to ensure responsible and strategic AI implementation. 

For healthcare finance professionals, Artificial Intelligence (AI) has become a strategic imperative. With a strong implementation strategy, AI can be implemented to prevent and manage denials, reducing the financial and administrative pressures on an organization. 

The debate and negotiations over tax reform are taking shape in the United States Congress. The United States Senate is reviewing the ‘One Big Beautiful Bill Act’ (OBBBA) passed by the US House of Representatives in late May. The House-passed legislation contains meaningful tax reforms with potentially significant impact to businesses and individuals.

Credit, purchase, and debit cards each offer convenience for small-dollar purchases, but carry varying levels of risk. Strong internal controls are essential to prevent fraud, misuse, and compliance violations.

Nonprofit leaders must assess the risks and strategically position their organizations to adapt to changing funding landscapes. This article outlines key steps to help your organization proactively evaluate funding vulnerabilities, mitigate risks, and plan for sustainable operations. 

CAPRA accreditation is more than a “stamp of approval” for parks and recreation agencies. It is the foundation of a well-run parks and recreation department, offering proof that an agency is operating at the highest standards. In a competitive municipal environment where funding is tight and priorities shift, accreditation gives departments the credibility they need to advocate for resources and drive innovation. 

In the complex world of international trade, businesses are constantly seeking ways to optimize their supply chains and reduce costs. One often-overlooked strategy that can yield significant savings is the use of first sale declarations.  

Federally Qualified Health Centers (FQHCs) face a perfect storm—level grant funding, shrinking 340B drug pricing savings, and rising expenses. Staying sustainable requires identifying ways to maximize operations and revenue while controlling costs. That’s where site- and program-specific accounting become essential. 

The proposed “One Big Beautiful Bill Act” includes several provisions that would directly impact tax-exempt organizations. BerryDunn’s experts provide a breakdown of how the bill could affect nonprofits.

The proposed $880 billion cuts to Medicaid, along with recently imposed tariffs and funding freezes, have placed healthcare organizations directly in the crosshairs of federal funding reductions. The result is an unprecedented threat that would profoundly affect the financial stability of organizations providing care.

The US Department of Health and Human Services Office of Inspector General has been actively enforcing healthcare compliance and fraud prevention in 2025. Are you ready? 

When it’s time to change auditors, it’s important to find a firm that feels like a long-term partner. Start by asking the right questions up front. 

With default federal student loan collections now resumed by the Department of Education, higher education institutions and other effected nonprofits need a strategy to ensure compliance. 

After an intense overnight session, the US House of Representatives narrowly passed the "One Big Beautiful Bill Act" with a 215-214 vote, marking a significant milestone in fiscal policy reform. The bill, which now heads to the Senate for further consideration, proposes extensive tax changes alongside broader regulatory shifts. While House Republicans and the current administration champion the bill as a legislative victory, Democratic opposition remains strong, and modifications are expected before it reaches the president’s desk.

Public health agencies have a powerful opportunity to inspire the next generation of professionals to join the governmental workforce. To build a pipeline of committed talent, agencies must take proactive steps—establishing dynamic mentorship programs, creating hands-on internship opportunities, and sharing compelling success stories that highlight the profound impact and fulfillment of serving in public health.

The Supporting Affordability and Fairness with Every Bet (SAFE) Act is a proposed federal legislation aimed at establishing minimum standards for sports betting across the United States. The SAFE Bet Act aims to help ensure minimum standards at in place throughout the United States for responsible gambling, protection of consumers, and maintaining the integrity of sports betting.

In today's globalized economy, businesses face an ever-changing landscape of tariffs, trade policies, and international supply chain challenges. For companies navigating these complexities, foreign trade zones (FTZs) present a strategic opportunity to reduce costs, improve logistical efficiency, and enhance overall competitiveness. 

As hospitals strive to balance their budgets and sustain primary care, there are options for hospitals to take that could ease financial burdens while preserving provider presence in the communities they serve. This article explores actionable models and strategies to reimagine primary care delivery in a way that benefits both patients and hospital systems.

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. As the challenges facing companies grow increasingly complex, from disruptive technological trends to shifting societal expectations, the board's role has never been more critical. 

Nonprofit audit committees play a pivotal role in maintaining transparency and accountability. Their responsibilities include financial oversight, compliance, reporting guidelines, risk management, external audits, internal audits, and ethical standards. Have you ever wondered what kinds of questions the audit committee should be asking of management and each other? Consider the following list of sample questions as a starting place.

How often does a new category of lending open up for the banking industry? This could happen if Congress ends federal tax exemptions for interest earned on municipal (“muni”) bonds. While a final decision has not yet been made, Congress is debating this option as they decide how to handle expiring provisions of the 2017 Tax Cuts and Jobs Act.

Employee retention is crucial in construction, where turnover can delay projects, increase training costs, and reduce efficiency. Statistics show that turnover in construction is approximately 21.4%, and with the industry facing an estimated labor shortage of 430,000 workers as of 2023, retaining skilled workers is vital. Here, we’ll look at proven strategies, backed by industry data and case studies, that small to medium-sized construction companies can use to reduce turnover and improve employee satisfaction.

Digital accessibility is more than a legal requirement—it’s about ensuring everyone can access public services, regardless of ability. As government agencies increasingly move services online, compliance with accessibility standards like the ADA’s Web Content Accessibility Guidelines (WCAG), EAA regulations, and Section 508 is essential. 

As new regulations take shape and tariff frameworks continue to change, importers must assess their compliance strategies with heightened scrutiny. One of the most critical components of this evaluation is transfer pricing. 

How does your nursing facility’s financial health stack up against industry peers? Benchmarking can provide you with the clear, relevant comparisons that are essential to measuring and optimizing your facility’s performance.

The construction industry presents some unique accounting and financial reporting requirements when it comes to construction work-in-progress (WIP) schedules. To keep a solid pulse on contract financial status and results, it is important that these schedules are accurate and up to date.

The FDIC's Quarterly Banking Profile for Q4 2024 reports positive performance for the 4,046 community banks evaluated.

On March 28, 2025, the FDIC issued a Financial Institution Letter (FIL), which rescinds its prior notification requirement for financial institutions engaging in crypto-related activities, as established in FIL-16-2022. 

In late 2024, the Centers for Medicare and Medicaid Services (CMS) launched a sweeping off-cycle mandate requiring all skilled nursing facilities (SNFs) in the United States to revalidate their Medicare provider enrollment record. Facilities of all types–including for-profit and not-for-profit–are affected.

To address evolving threats and regulatory challenges, OCR has issued proposed modifications to the Security Rule, introducing stricter security controls, mandatory encryption requirements, and a shift away from “addressable” implementation specifications. While these changes aim to improve data security, they also introduce new compliance burdens that could be challenging for many regulated entities. 

For foster teens, the path to adulthood is uniquely challenging. As thousands of young adults age out of the foster care system each year, many child welfare agencies are searching for ways to better support them through this transition. According to Dr. Elizabeth Wynter, child welfare advocate and author of Follow the Love: Permanent Connections Scaffolding, the key is to build strong youth-adult partnerships. In a recent episode of BerryDunn’s Fresh Perspectives in Social Work podcast, Dr. Wynter and I discussed the need for a “connection scaffold” and offered insights on improving outcomes for foster youth. Here are five take-aways from our conversation.

In today's data-driven world, the ability to share information between Medicaid and Public Health Agencies (PHAs) is crucial for efficiently using limited resources to serve both individual patient and population health goals and priorities. Often, states already have the needed technology, but they don’t have the partnerships or workforce infrastructure to leverage existing investments across different agencies.

Public health is at a crossroads. With the lessons learned from COVID-19 and a workforce on the brink of burnout, now is the time for transformative action. By reimagining operations, infrastructure, and health equity, we can shape a system that’s responsive to future challenges.

Most nonprofits rely on federal and state government funds to fulfill their missions. With a federal funding freeze in the headlines, many clients are asking us how they can best prepare for a freeze and protect their organizations if funding is cut. Here are three steps you can take today to stay ahead. 

If your organization is in the process of a large-scale project, such as replacing or implementing an electronic health record (EHR) system in the near future, success will depend on having a sound communication plan in effect before, during, and after the implementation. Fortunately, effective communication is not a difficult task to achieve. Based on our experience helping local governments implement EHR other systems nationwide, our team has developed five simple communication steps for successful implementations. 

The end of 4Q 2024 marks the start of a new year. In the Valuation Group, the end of the calendar year brings us to one of our busiest times of year: “ESOP season.” During the first few months of the year, we perform annual valuations for 30+ ESOP clients.

For manufacturers in New England, the global trade environment has always played a significant role in shaping supply chain strategies and cost structures. With the current tariff landscape marked by rapid changes and adjustments due to ongoing trade negotiations and economic strategies, businesses must be ready to quickly reevaluate their pricing models and material cost standards to maintain profitability. 

As the new year begins, your organization may be starting to plan for your next fundraising event. In addition to raising money for the organization, fundraising events are a wonderful way to build relationships within the community, raise awareness for a cause, and provide a meaningful experience to donors. Beyond the excitement and benefits of these events, there are important Form 990 reporting and compliance requirements that you must consider. Below are the most frequently asked questions we receive from our clients. We hope this helps you avoid some common pitfalls around fundraising events.

Rapid advancements in artificial intelligence (AI), robotics, quantum computing, and augmented reality will redefine how society functions by 2035

The market approach is one of three different ways to estimate the value of a company. In its simplest form, the market approach is fairly straightforward. Below is a very basic model for how a valuation could be applied:

Like many male-dominated industries, construction workplaces are often aligned with traditional masculine values such as self-reliance and stoicism, which can encourage resistance to traditional well-being approaches. 

The Financial Accounting Standards Board (FASB) has recently issued two significant Accounting Standards Updates (ASUs): ASU No. 2023-07 and ASU No. 2024-03. These updates aim to enhance the transparency and usefulness of financial disclosures for public business entities (PBEs) and are only applicable to PBEs.

Is your nonprofit using a break-even bottom line as your ultimate budget goal? If so, you may be missing out on opportunities to strategically further your mission. By looking at your budget using a statement of financial position perspective, rather than just a profit and loss perspective, you can gain a more complete financial picture of your organization.

As organizations navigate the complexities ahead in 2025, economic uncertainty presents both challenges and opportunities. Organizations must strategically address financial stability, donor engagement, federal compliance requirements, and workforce management to sustain their missions. This article dives into five critical finance trends and explores how nonprofits can effectively adapt.

The housing industry is subject to ongoing regulatory changes that are critical to their operations. Recently, we shared changes impacting compliance for multifamily housing, but that's just one example; all facets of the industry are subject to ongoing changes to compliance.

The FDIC's Quarterly Banking Profile for Q3 2024 reports positive performance for the 4,082 community banks evaluated.

Effective January 1, 2025, qualifying businesses in all Maine jurisdictions will be eligible for a generous, refundable credit while simultaneously investing in their business.

What Medicaid agencies and Medicaid-participating managed care organizations need to know about best practices for adhering to federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Requirements.

The Centers for Medicare & Medicaid Services (CMS) issued the final rule for the PPS for SNFs for FY 2025 which was published in the Federal Register on August 6, 2024, the regulations in this rule are effective October 1, 2024.

On November 6, 2024, members of the BerryDunn financial services team joined bankers and board members throughout the state of Maine at the annual Maine Bankers Association FDIC Directors’ College in Augusta, Maine. Here are our key takeaways from the event:

The election created a sense of anxiety and uncertainty among many people for a variety of reasons. One such concern was around how the election would affect business value.

The revenue cycle is an intricate system involving interdependent functions. Like an ecosystem, each component plays an important role. To optimize your revenue cycle, it helps to understand these four components of the ecosystem and the roles they play.

In this guide, we’ll explore the key benefits of the REAP Grant, explain who should consider applying, and highlight the important tax implications to help you make informed decisions about whether this program is right for your business.

This article explores the current trends in banking fraud, highlighting traditional schemes, emerging threats, and effective preventive measures.

These 7 success factors address the essential aspects of an economic development strategy––a roadmap for your community to encourage economic growth, create jobs, and improve the quality of life.

On July 25, 2024, the Public Company Accounting Oversight Board (PCAOB) issued its 2023 Annual Report on the Interim Inspection Program Related to Audits of Brokers and Dealers. The PCAOB can essentially be considered “the auditor of the auditor” and thus performs various inspections of audit firms that conduct broker-dealer audits on an annual basis.

The COVID-19 pandemic taught our public health systems a number of critical lessons about how we should engage, communicate, partner, and share data with other agencies and our communities. It also reinforced the importance of applying an intentional health equity lens to the system to better support vulnerable communities in times of crisis.  

The implementation of Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 606, Revenue from Contracts with Customers, which has been in effect since 2018 for broker-dealers, has had a profound impact on financial reporting across various industries. For broker-dealers, the adoption of this standard has introduced new challenges and considerations in recognizing revenue accurately and in accordance with the principles outlined in ASC 606.  

Your parks and recreation master plan was created with the goals and values of your community at its core. It’s part of what makes your community a great place to live, work, and play. It’s also a living document, designed to meet both current and future community needs—and to evolve as those needs change.

We often see broker-dealers receive 12b-1 fees in the course of ordinary business. With these fees, we often see the broker-dealer acting as a pass-through, retaining these fees on its balance sheet until the ultimate payee requests such funds, typically for payment or reimbursement of expenses that are permissible to be paid from 12b-1 fees, as outlined in the distribution agreement. These fees can often be substantial and result in significant receivables on the broker-dealer’s balance sheet.

Enterprise Resource Planning (ERP) systems provide a shared platform for people in your organization to work together––and the benefits can be game-changing. 

The SECURE Acts made several changes to 401(k) and 403(b) plan requirements. Among those changes is a change to the permissible minimum service requirements.

One of the key strategies to making the patient check-in process a good experience for patients, while also gathering the most important information for billing, is to have clear scripts for your patient access staff. 

In April 2024, the Governmental Accounting Standards Board (GASB) issued GASB Statement No. 103, Financial Reporting Model Improvements.

A more popular addition to Medicaid Enterprise System Conference (MESC) discussions this year was AI, and attendees expressed both fear and excitement over its potential to tactically support the enterprise.

If it’s been a while since your nonprofit organization last conducted a review of its governing documents and policies, worry not, you’re not alone! This article will highlight a few of the most critical documents applicable to nonprofits to ensure you remain in compliance and good standing.

How should a business owner, management team, or investor estimate the value of its company? There are a variety of methods available in the world of business valuation. Let’s discuss the pros and cons of using a common financial metric in the assessment of a business’s value: Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA).

If there’s one thing that was clear at the recent Medicaid Enterprise Systems Conference (MESC) in Louisville, it is that CMS is focused on meaningful enterprise planning, meaningful outcome definitions, and meaningful data from State Medicaid Agencies (SMAs) to illustrate trends throughout every phase of the IT life cycle and the benefit to Medicaid beneficiaries.

Although summertime is a generally slower time for the valuation team, we’ve seen a notable increase in M&A activity. Transactional activity often follows interest rate trends. We’ve seen activity pick up significantly in the last nine months under the current stable interest rate environment. As rates drop, more deals are sure to follow.

Nursing facilities need to be aware of a wide range of potential data uses for payer-based reporting (PBR) data and have comprehensive internal data review procedures to help ensure the public use file reflects accurate reporting and facility is prepared for an audit.   

For larger educational institutions that can receive hundreds of such disclosable donations in a given year, the Schedule B reporting onus can become downright brutal. However, there is a special rule available for Schedule B reporting that could greatly reduce that requirement. Fundraising and Development departments rejoice!

To help public health state agencies target budget and fiscal management training needs for their workforce, a comprehensive assessment can be utilized to examine four domains of administrative management activities with a focus on financial management.

At first glance, the healthcare patient check-in process seems straightforward. But when examined through the lens of your revenue cycle and patient experience, it’s one of the most important interactions for your team to get right.

Non-profit financial statements include a wealth of important knowledge but can often be overwhelming. When sharing your financial statements with your board of directors or other stakeholders, it can be useful to simplify your statements so the key information stands out and unimportant information doesn’t cause confusion.

Parks and recreation agencies, like any public-serving organization, have an obligation to equally serve all members of their communities. But knowing that something must be done is not the same thing as knowing how to approach it. As heard in a recent episode of the “Let’s Talk Parks with BerryDunn” podcast, host Becky Dunlap spoke with Meredith Tekin, President of the International Board of Credentialing and Continuing Education Standards (IBCCES), and Lane Gram, Manager for Parks and Recreation in Gilbert, Arizona, about how the town is undertaking the endeavor of making their parks and facilities accessible and enjoyable for all.

In February 2024, the American Association of State Highway and Transportation Officials (AASHTO) released a 2024 Edition of the Uniform Audit & Accounting (A&A) Guide, which supersedes the 2016 edition. The guide is a tool for architectural and engineering (A/E) firms calculating and reporting overhead rates to state transportation departments (DOTs), and to guide state DOT auditors and public accounting firms in performing audits of A/E firms’ indirect cost schedules.  

The United States Department of Housing and Urban Development (HUD) signed the Housing Opportunity through Modernization Act (HOTMA) into law on July 29, 2016. For multifamily housing owners, HOTMA went into effect on January 1, 2024, and owners are expected to be fully compliant by January 1, 2025.

To stay competitive in the recruitment and retention of employees, employers need to stay abreast of the current well-being trends—the ones that have the potential to move the needle in creating a thriving, healthy workforce.

The Centers for Medicare and Medicaid Services (CMS) has temporarily paused the Program for Comparative Billing Reports (CBRs) and Evaluating Payment Patterns Electronic Report (PEPPERs). During this pause, which is expected to end in the fall of 2024, CMS will be improving and updating the program.

In November 2023, the US Department of Labor’s Employee Benefits Security Administration (EBSA) issued its fourth assessment of the quality of audit work performed by independent qualified public accountants. Here are our five key takeaways.

Did you receive an Employee Retention Credit (ERC) that you now believe you were ineligible for? Since the ERC was announced, many ineligible claims have been filed, due to a variety of reasons, including companies working with ERC vendors that either did not understand the complexities or were not providing the due diligence necessary to ensure that the applications were complete and accurate.

Early-stage startups must often contemplate the most practical way to raise capital for their business. If traditional debt and equity methods are not available, different avenues to raising capital must be considered. Here are four alternatives to traditional debt and equity transactions:

The Corporate Transparency Act (CTA) was enacted into law by Congress on January 1, 2021, as part of the National Defense Authorization Act. The CTA mandates that every foreign or domestic entity registered to do business in the United States disclose Beneficial Ownership Information (BOI) beginning in 2024.

On December 20, 2023, the National Credit Union Administration (NCUA) issued a technical correction with the calculation of the Current Expected Credit Loss (CECL) transition amount.

A SOC report can be an invaluable tool in helping you gain confidence about your service providers.

With the rapid growth of Medicare Advantage (MA) plans in the last several years, many hospitals are struggling to effectively manage the financial and operational challenges of these plans, including:

  • Increased denials of Medicare Advantage claims
  • Confusion between Medicare, supplemental Medicare plans, and Medicare Advantage (Part C) plans, and what each cover
  • Extra burden of “shadow billing” inpatient claims and leaving potential reimbursement off the table if not done correctly
  • Compliance risk, including the risk of Medicare fraud

Derivatives can be used to hedge against a company’s exposure to a particular risk, whether that be the purchase price of materials or equipment, the selling price of a product a company has already purchased the materials to produce, or a variable rate of interest on debt.   

Staff turnover can present a number of challenges for independent schools. When staff turnover in your business office occurs, there are serious matters related to financial risk that you should consider.  

Owners of rental property who receive assistance from the US Department of Housing and Urban Development (HUD) through debt financing or tenant rent subsidies for affordable housing are subject to specific reporting and compliance requirements. It’s important to know and understand these requirements in order to be ready for audits, maintain compliance, and continue to receive funding. Here are three of the most complex requirements that anyone receiving funding from HUD needs to be aware of and have a process in place to help ensure compliance.  

In the realm of gaming and sports betting, maintaining proper security, privacy, and operational integrity are crucial in providing assurance to all parties involved. In such a heavily regulated industry, it is essential that sportsbook providers have the resources and professional advice needed for obtaining and maintaining compliance.

As we put a bow on another Medicaid Enterprise Systems Conference (MESC), I want to express my thanks to the New England States Consortium Systems Organization (NESCSO), the State of Colorado, and the City of Denver for hosting a fantastic event.

We’ve all heard stories about organizations spending thousands on software projects that take longer than expected to implement and exceed original budgets. One of the reasons this occurs is that organizations often don’t realize that purchasing a large, commercial off-the-shelf (COTS) system is a significant undertaking.

The Centers for Medicare and Medicaid Services (CMS) issued the Final Rule for the PPS for SNFs for FY 2024, which was published in the Federal Register on August 7, 2023. The regulations in this rule are effective October 1, 2023, except certain amendments, which are effective January 1, 2024. 

There’s a good chance that your organization is being forced to do more with less under the strain of budget constraints and competing initiatives. It’s a matter of survival. 

Executive compensation, bonuses, and other cost structure items, such as rent, are often contentious issues in business valuations, as business valuations are often valued by reference to the income they produce. If the business being valued pays its employees an above-market rate, for example, its income will be depressed. Accordingly, if no adjustments are made, the value of the business will also be diminished.

Across all industries, organizations are struggling to attract and retain the employees needed to provide services to their communities. From local governments to retail outlets to…well, just about everyone.

In the latest episode of the Let’s Talk Parks with BerryDunn podcast, we discussed the topic of retaining all-star employees as it relates to Parks and Recreation Departments who are struggling to maintain community services due to staffing levels. The conversation with my colleagues Nikki Ginger and Barbara Heller and our guests Nicole Falceto and Fernando Avellanet from the Loudoun County (Virginia) Parks, Recreation and Community Services Department uncovered tangible and actionable strategies that any type of organization can use to start the process of improving their organizational culture to better retain staff.

Organizational change is hard. And necessary. And manageable.

You know your organization needs to change – to develop a better culture, to enhance efficiencies, or to improve outcomes. But where do you start?

In our most recent episodes of the Fresh Perspectives in Social Work Podcast, I had a conversation about this subject with organizational development experts Megan Clough, Manager with the State Government Practice Group at BerryDunn, and Jennifer Kerr, Director of Organizational Effectiveness at American Public Human Services Association (APHSA).

At BerryDunn, our healthcare consulting teams have worked with hundreds of organizations as they’ve transitioned to new enterprise systems such as Electronic Health Records (EHR) systems and Enterprise Resource Planning (ERP) systems. Based on our experience, there are 10 key areas to focus on in order to have a successful conversion.   

It can be challenging and stressful to plan for technology initiatives, especially those that involve and impact every area of your organization. 

Do you have a CEO succession plan? If not, you need to create one now.

This article is the first in a series to help employee benefit plan fiduciaries better understand their responsibilities and manage the risks of non-compliance with ERISA requirements.

Follow these six steps to help your senior living organization improve cash flow, decrease days in accounts receivable, and reduce write offs. 

As we find ourselves in a fast-moving, strong business growth environment, there is no better time to consider the controls needed to enhance your IT security as you implement new, high-demand technology and software to allow your organization to thrive and grow. Here are five risks you need to take care of if you want to build or maintain strong IT security.

In light of the recent cyberattacks in higher education across the US, more and more institutions are finding themselves no longer immune to these activities. Security by obscurity is no longer an effective approach—all institutions are potential targets. Colleges and universities must take action to ensure processes and documentation are in place to prepare for and respond appropriately to a potential cybersecurity incident.

This is the second blog post in the blog series: “Procuring Agile vs. Non-Agile Service”. Read the first blog. This blog post demonstrates the differences in Stage 1: Plan Project in the five stages of procuring agile vs. non-agile services.

Measuring performance of Medicaid Enterprise Systems (MES) is emerging as the next logical step in modularizing Medicaid programs. As CMS continues to refine and implement outcomes-based modular certification, it is critical that states adapt to this next step in order to continue to meet CMS funding requirements.

On June 18, 2019, the State of Maine enacted Legislative Document 1819, House Paper 1296, An Act to Harmonize State Income Tax Law and the Centralized Partnership Audit Rules of the Federal Internal Revenue Code of 1986

Planning and development service fees are, for many municipalities, often discussed but rarely changed. There are a number of reasons you might need to consider or defend your fee structure―complaints from developers, rising costs of operation, and changes in code or process are just a few.

Patient Driven Payment Model (PDPM) implementation is less than three months away. Is your facility ready for admissions under PDPM? The way you think about admissions and the admission process will change under PDPM.

Proposed House bill brings state income tax standards to the digital age

On June 3, 2019, the US House of Representatives introduced H.R. 3063, also known as the Business Activity Tax Simplification Act of 2019, which seeks to modernize tax laws for the sale of personal property, and clarify physical presence standards for state income tax nexus as it applies to services and intangible goods. But before we can catch up on today, we need to go back in time—great Scott!

As the Project Management Body of Knowledge® (PMBOK®) explains, organizations fall along a structure and reporting spectrum. On one end of this spectrum are functional organizations, in which people report to their functional managers. (For example, Finance staff report to a Finance director.) On the other end of this spectrum are projectized organizations, in which people report to a project manager. Toward the middle of the spectrum lie hybrid—or matrix—organizations, in which reporting lines are fairly complex; e.g., people may report to both functional managers and project managers. 

As your organization works to modernize and improve your Medicaid Enterprise System (MES), are you using independent verification and validation (IV&V) to your advantage? Does your relationship with your IV&V provider help you identify high-risk project areas early, or provide you with an objective view of the progress and quality of your MES modernization initiative? Maybe your experience hasn’t shown you the benefits of IV&V. 

The IRS announced plans to conduct examinations of the universal availability requirements for 403(b) plans (Plans) this summer. Noncompliance with these requirements results in operational errors for Plans―ultimately requiring correction. Plan sponsors should review their Plans for proper inclusion and exclusion of employees. Such review can help you avoid costly penalties if the IRS does conduct an examination and uncovers an issue with the Plan’s implementation of universal availability.

Best practices for financial institution contracts with technology providers

As the financial services sector moves in an increasingly digital direction, you cannot overstate the need for robust and relevant information security programs. Financial institutions place more reliance than ever on third-party technology vendors to support core aspects of their business, and in turn place more reliance on those vendors to meet the industry’s high standards for information security. These include those in the Gramm-Leach-Bliley Act, Sarbanes Oxley 404, and regulations established by the Federal Financial Institutions Examination Council (FFIEC).

What is the difference in how government organizations procure agile vs. non-agile information technology (IT) services?

Focus on the people: How higher ed institutions can successfully make an ERP system change

The enterprise resource planning (ERP) system is the heart of an institution’s business, maintaining all aspects of day-to-day operations, from student registration to staff payroll. Many institutions have used the same ERP systems for decades and face challenges to meet the changing demands of staff and students. As new ERP vendors enter the marketplace with new features and functionality, institutions are considering a change. Some things to consider.

LIBOR is leaving—is your financial institution ready to make the most of it?

In July 2017, the UK’s Financial Conduct Authority announced the phasing out of the London Interbank Offered Rate, commonly known as LIBOR, by the end of 20211. With less than two years to go, US federal regulators are urging financial institutions to start assessing their LIBOR exposure and planning their transition. Here we offer some general impacts of the phasing out, specific actions your institution can take to prepare, and, finally, some background on how we got here (see Background at right).

Who has the time or resources to keep tabs on everything that everyone in an organization does? No one. Therefore, you naturally need to trust (at least on a certain level) the actions and motives of various personnel. At the top of your “trust level” are privileged users—such as system and network administrators and developers—who keep vital systems, applications, and hardware up and running.

Law enforcement, courts, prosecutors, and corrections personnel provide many complex, seemingly limitless services. Seemingly is the key word here, for in reality these personnel provide a set number of incredibly important services.

“The world is one big data problem,” says MIT scientist and visionary Andrew McAfee.

That’s a daunting (though hardly surprising) quote for many in data-rich sectors, including higher education. Yet blaming data is like blaming air for a malfunctioning wind turbine. Data is a valuable asset that can make your institution move.

Best Practices for Educating Your Financial Institution’s Board of Directors on Cybersecurity

According to Cybersecurity Ventures, cybercrime will account for $6 trillion annually by 2021—that’s more than the global trade of all major illegal drugs combined.  Data breaches and other information security events adversely impact organizations through significant losses in revenue, erosion of customer trust, substantial remediation costs, increased insurance premiums, and more.

Not-for-profit board members need to wear many hats for the organization they serve. Every board member begins their term with a different set of skills, often chosen specifically for those unique abilities. As board members, we often assist the organization in raising money and as such, it is important for all members of the board to be fluent in the language of fundraising. Here are some basic definitions you need to know, and the differences between them

Writing a Request for Proposal (RFP) for a new software system can be complex, time-consuming, and—let’s face it—frustrating, especially if you don’t often write RFPs. The process seems dogged by endless questions, such as:

On October 1, 2019, the Medicare Skilled Nursing Facility (SNF) payment system will transition from RUGS-IV to the Patient Driven Payment Model. This payment model is a major change from the way SNFs are currently reimbursed.

Of all the changes that came with the sweeping Tax Cuts and Jobs Act (TCJA) in late 2017, none has prompted as big a response from our clients as the changes TCJA makes to the qualified parking deduction.

In auditing, the concept of professional skepticism is ubiquitous. Just as a Jedi in Star Wars is constantly trying to hone his understanding of the “force”, an auditor is constantly crafting his or her ability to apply professional skepticism. 

As a new year is upon us, many people think about “out with the old and in with the new”. For those of us who think about technology, and in particular, blockchain technology, the new year brings with it the realization that blockchain is here to stay (at least in some form).

A capital campaign is a big undertaking. During the planning stage of a capital campaign you need to not only focus on your donor outreach strategy, but also on outreach materials. 

The existing case mix classification group, Resource Utilization Group IV (RUG- IV) will be replaced with a new case mix model, the Patient Driven Payment Model (PDPM). CMS has indicated factors leading to the change in the payment system include over utilization of therapy and incentives for longer lengths of stay.

Good fundraising and good accounting do not always seamlessly align. While they all feed the same mission, fundraisers work to meet revenue goals while accountants focus on recording transactions in compliance with accounting standards. 

Your government agency just signed the contract to purchase and implement a shiny new commercial off-the-shelf (COTS) software to replace your aging legacy software. The project plan and schedule are set; the vendor is ready to begin configuration and customization tasks; and your team is eager to start the implementation process.

A common pitfall for inbound sellers is applying the same concepts used to adopt “no tax” positions made for federal income tax purposes to determinations concerning sales and use tax compliance. Although similar conceptually, separate analyses are required for each determination.

All teams experience losing streaks, and all franchise dynasties lose some luster. Nevertheless, the game must go on. 

As 2018 is about to come to a close, organizations with fiscal year ends after December 15, 2018, are poised to start implementing the new not-for-profit reporting standard. Here are three areas to address before the close of the fiscal year to set your organization up for a smooth and successful transition, and keep in compliance:

It’s that time of year. Kids have gone back to school, the leaves are changing color, the air is getting crisp and… year-end tax planning strategies are front of mind! 

Reading through the 133-page exposure draft for the Proposed Statement on Auditing Standards (SAS) Forming an Opinion and Reporting on Financial Statements of Employee Benefit Plans Subject to ERISA, issued back in April 2017, and then comparing it to the final 100+ page standard approved in September 2018, may not sound like a fun way to spend a Sunday morning sipping a coffee (or three), but I disagree.

I leaned out of my expansive corner office (think: cubicle) and asked my coworker Andrew about an interesting topic I had been thinking about. “Hey Andrew, do you know what BATNA stands for?” I asked. 

State governments regularly negotiate contracts with vendors. Unfortunately, these negotiations are often prolonged, which can have major downstream effects on projects, procurements, and implementations—including skewed timelines, delayed milestones, and increased costs. 

With the wind down of the Federal Perkins Loan Program and announcement that the Federal Capital Contribution (FCC) (the federal funds contributed to the loan program over time) will begin to be repaid, higher education institutions must now decide how to handle these outstanding loans.

Reflecting on this year's National Academy for State Health Policy (NASHP) Conference in Jacksonville, Florida, I am amazed by all the recent healthcare innovations, which are resulting in policies with real and positive effects on health outcomes.

Modernization means different things to different people—especially in the context of state government. For some, it is the cause of a messy chain reaction that ends (at best) in frustration and inefficiency. For others, it is the beneficial effect of a thoughtful and well-planned series of steps. 

Truly effective preventive health interventions require starting early, as evidenced by the large body of research and the growing federal focus on the role of Medicaid in addressing Social Determinants of Health (SDoH) and Adverse Childhood Experiences (ACEs).

Do you want to receive top dollar for your business? Do you want to make your business irresistible to a potential buyer? Looking for a stress-free retirement? If you find yourself answering “yes” to these questions, it’s time to take steps to create a transferable business.

Last week, in addition to The Eagles Greatest Hits (1971-1975) album becoming the highest selling album of all time, overtaking Michael Jackson’s Thriller, the IRS issued Notice 2018-67—its first formal guidance on Internal Revenue Code Section 512(a)(6).

Artificial Intelligence, or AI, is no longer the exclusive tool of well-funded government entities and defense contractors, let alone a plot device in science fiction film and literature. Instead, AI is becoming as ubiquitous as the personal computer. 

The world of professional sports is rife with instability and insecurity. Star athletes leave or become injured; coaching staff make bad calls or public statements. The ultimate strength of a sports team is its ability to rebound. The same holds true for other groups and businesses.

As I head home from a fabulous week at the 2018 Medicaid Enterprise Systems Conference (MESC), I am reflecting on my biggest takeaways. Do we have the information we need to effectively move into the next 12 months of work in the Medicaid space? My initial reaction is YES!

Here we go again! With the 2018 Medicaid Enterprise System Conference (MESC) underway, we have another Medicaid Enterprise Certification Toolkit (MECT) Release. On July 31, 2018, the Centers for Medicare and Medicaid Services (CMS) issued the MECT Version 2.3.

Although there is no legal requirement to have a formal shareholder agreement, it’s a good idea for any company with more than one shareholder to have one, as it reduces the potential for conflict between shareholders, helping the company run smoothly and profitably. 

Is your state Medicaid agency considering a Centers for Medicare and Medicaid Services (CMS) Section 1115 Waiver to fight the opioid epidemic in your state? States want the waiver because it provides flexibility to test different approaches to finance and deliver Medicaid services.

All business owners need to consider a business valuation, ideally updated annually. A current business valuation is important for your company’s financial health as it can:

Are you struggling to improve business outcomes through modifications to your software solutions? If so, then you have no doubt tried — or are trying — traditional software implementation approaches. Yet, these methods can overwhelm staff, require strong project management, and consume countless hours (and dollars).

By now, you know all about the new corporate tax rate — a flat rate of 21% vs. the previous top tax rate of 35% — arguably the most publicized change of the recently passed Tax Cuts and Jobs Act (TCJA).

Any sports team can pull off a random great play. Only the best sports teams, though, can pull off great plays consistently — and over time. The secret to this lies in the ability of the coaching staff to manage the team on a day-to-day basis, while also continually selling their vision to the team’s ownership.

For over four years the business community has been discussing the impact Accounting Standards Codification (ASC) 606, Revenue from Contracts with Customers, will have on financial reporting. As you evaluate the impact this standard will have on a manufacturers’ financial reporting practices, there are certain provisions of ASC 606 you should consider.

The late science fiction writer (and college professor) Isaac Asimov once said: “I do not fear computers. I fear the lack of them.” Had Asimov worked in higher ed IT management, he might have added: “but above all else, I fear the lack of computer staff.”

When an organization wants to select and implement a new software solution, the following process typically occurs:

People are naturally resistant to change. Employees facing organizational change that will impact day-to-day operations are no exception, and they can feel threatened or fearful of what that change will bring. Even more challenging are multiyear initiatives where the project’s completion is years away.

Cost increases and labor issues have contributed to the rise of outsourcing as an option for senior living and health care providers.  While outsourcing of all types is a growing trend — from the C-suite to food service, it is a decision that should be considered carefully, as lack of planning could result in significant long-lasting financial, public relations and personnel losses. 

The day-to-day work of providing government services involves collecting, using, and storing large amounts of data. The data that government agencies accumulate is a critical asset — it holds answers about which programs perform best, which interventions are most effective, and how to improve service delivery. 

A professional sports team is an ever-changing entity. To have a general perspective on the team’s fluctuating strengths and weaknesses, a good coach needs to trust and empower their staff to discover the details. Chapter 5 in BerryDunn’s Cybersecurity Playbook for Management looks at how discovery can help managers understand their organization’s ever-changing IT environment. 

While new software applications help you speed up processes and operations, deciding which ones will work best for your organization can quickly evolve into analysis paralysis, as there are so many considerations.

Over the course of its day-to-day operations, every organization acquires, stores, and transmits Protected Health Information (PHI), including names, email addresses, phone numbers, account numbers, and social security numbers.

With the rise of artificial intelligence, most malware programs are starting to think together. Fortinet recently released a report that highlights some terms we need to start paying attention to:

Just as sports teams need to bring in outside resources — a new starting pitcher, for example, or a free agent QB — in order to get better and win more games, most organizations need to bring in outside resources to win the cybersecurity game.

The first time a student walks into a business class, they may expect to learn a lot about numbers. What they might not realize is they are walking into a foreign language class! 

As a leader in a higher education institution, you'll be familiar with this paradox: Every solution can lead to more problems, and every answer can lead to more questions. It’s like navigating an endless maze. When it comes to mobile apps, the same holds true. 

The recent Tax Cuts and Jobs Act includes many sweeping tax law changes, some of which left taxpayers scrambling at the end of 2017 to maximize tax saving opportunities. While the dust settles on tax reform at the federal level, the whirlwind at the state level is just beginning, with many unanswered questions.

It may be hard to believe some seasons, but every professional sports team currently has the necessary resources — talent, plays, and equipment — to win. The challenge is to identify and leverage them for maximum benefit.

Large-scale projects require extensive planning, quick decision-making, thoughtful problem-solving, and above all else, resourcefulness. One way to be resourceful? 

Did you know that there was more than a 40% increase (from $4.3 billion to $6.0 billion) in civil penalties assessed by the IRS regarding employment tax, for the 2016 fiscal year?

Texting has become a simple, convenient, and entrenched component of our everyday lives. We use it with family, friends, coworkers—and clients. My wife and I text to coordinate day care pickup and drop off of our kids every day.

We know, both from our experience as external auditors (all of us) and years of experience working in private sector firms (many of us), that changing audit firms can be a painful process. NOTE: if you’re a current BerryDunn client, feel free to stop reading here.

It’s one thing for coaching staff to see the need for a new quarterback or pitcher. Selecting and onboarding this talent is a whole new ballgame. Various questions have to be answered before moving forward: 

Private-sector pundits love to drone on about drones! Also known as Unmanned Aircraft Systems (UASs), drones are dramatically altering processes and increasing opportunities in the for-profit world. 

Success is slippery and can be evasive, even on the simplest of projects. Grasping it grows harder during lengthier and more complex undertakings, such as enterprise-wide technology projects—and requires incorporating a variety of short- and long-term strategies. 

When it comes to IT security, more than one CEO running a small organization has told me they have really good people taking care of “all that.” These CEOs choose to believe their people perform good practices. 

A penalty letter doesn’t mean the IRS is correct, but it’s important you know what to do to avoid paying an erroneous penalty. 

Most of us have been (or should have been) instructed to avoid using clichés in our writing. These overstated phrases and expressions add little value, and often only increase sentence length. We should also avoid clichés in our thinking, for what we think can often influence how we act.

In a previous blog post, “Six Steps to Gain Speed on Collections”, we discussed the importance of regular reviews of long-term care facility financial performance indicators and benchmarks, and suggestions to speed up collections. 

Is your organization a service provider that hosts or supports sensitive customer data, (e.g., personal health information (PHI), personally identifiable information (PII))? 

The relationship between people, processes, and technology is as elemental as earth—and older than civilization. From the first sharpened rock to the Internet of Things, the three have been crucially intertwined and interdependent. 

For professional baseball players who get paid millions to swing a bat, going through a slump is daunting. The mere thought of a slump conjures up frustration, anxiety and humiliation, and in extreme cases, the possibility of job loss.

After working with state health policy for seven years and Medicaid for 16, I had the opportunity for the first time to attend the 30th Annual National Association of State Health Policy (NASHP) Conference on October 23–25, 2017. Here are my top three takeaways.

Of course, we’re all suffering from “data breach fatigue.” But some breach announcements carry considerably more risk to the victim than others. For example, if I had received a letter saying a credit card of mine had been compromised, the end result would be simple:

The Merriam-Webster Dictionary defines leadership as having the capacity to lead. Though modest in theory, the concept of leadership permeates all industries and is a building block for every organization’s success. 

As more state and local government workers enter retirement, state and local agencies are becoming more dependent on millennial workers — the largest and most educated generation of workers in American history. But there is a serious gap between supply and demand.

Have you ever had a project derail at the last minute, or discovered that a project’s return on investment did not meet projections? These types of issues happen in the final stages of a project, often as a result of incorrect or incomplete stakeholder identification.

The MESC “B’more for healthcare innovation” is now behind us. This annual Medicaid conference is a great marker of time, and we remember each by location: St. Louis, Des Moines, Denver, Charleston… and now, Baltimore. 

Here’s a challenge for you: Can you identify the number one predictor of project success? According to Prosci, the leading change-management research organization, the answer is the project sponsor.

A year ago, CMS released the Medicaid Enterprise Certification Toolkit (MECT) 2.1: a new Medicaid Management Information Systems (MMIS) Certification approach that aligns milestone reviews with the systems development life cycle (SDLC) to provide feedback at key points throughout design, development, and implementation (DDI).

Today’s senior living providers must ensure that their mission and vision for the future are built on a healthy financial plan and structure. Here are some things you should know to build just that.

While GASB has been talking about split-interest agreements for a long time (the proposal first released in June of 2015, with GASB Statement No. 81, Irrevocable Split-Interest Agreements released in March of 2016), time is quickly running out for a well-planned implementation.

Because we’ve been through this process many times, we’ve learned a few lessons and determined some best practices. Here are some tips to help you promote a positive post go-live experience.

Some days, social media seems nothing more than a blur of easily forgettable memes. Yet certain memes keep reappearing to the point where we have no choice but to remember them. 

Four steps to take if you get an ACA Tax Penalty Notice from the IRS. It’s been almost a year since the IRS filing deadline for 2015 Forms 1094-C and 1095-C. Most expected the IRS to issue employer penalty notices related to the 2015 calendar year in late 2016.

We all know them. In fact, you might be one of them — people who worry the words “go live” will lead to job loss (theirs). This feeling is not entirely irrational. 

Recently the Governmental Accounting Standards Board (GASB) finished its Governmental Accounting Research System (GARS), a full codification of governmental accounting standards.

We humans have a complex attitude toward change. In one sense, we like finding it. For instance: “Now I can buy something from the vending machine!” In reality, we try to avoid change as much as possible. Why? 

RANSOMWARE UPDATE: It happened again. Another ransomware attack hit very large corporations around the globe. Much like WannaCry, a worm spread through entire networks, and locked out encryption data and systems.

On June 16th the FASB issued the final standard for credit losses. We’ve analyzed the new standard and pulled together some key items you’ll need to know:

As the technology we use for work and at home becomes increasingly intertwined, security issues that affect one also affect the other and we must address security risks at both levels.

In July 2016, we wrote about how the booming microbrewery scene in Maine is shaking up the three-tier system of alcohol distribution, which dates back to the 1930s.

As we begin the second year of Uniform Guidance, here’s what we’ve learned from year one, and some strategies you can use to approach various challenges, all told from a runner's point of view.

During my lunch in sunny Florida while traveling for business, enjoying a nice reprieve from another cold Maine winter, I checked my social media account.

When last we blogged about the Financial Accounting Standards Board’s (FASB) new “current expected credit losses” (CECL) model for estimating an allowance for loan and lease losses (ALLL), we reviewed the process for developing reasonable and supportable forecasts for use in establishing the ALLL. 

Government projects conducted in challenging conditions require trust, collaboration, communication, and project management acumen to succeed. Here are five recommendations for project success.

Recently, federal banking regulators released an interagency financial institution letter on CECL, in the form of a Q&A. Read it here

NEW IRS proposed guidance is welcome news and provides not-for-profit employers with more flexibility than originally expected.

Electronic accessibility in every aspect of modern life has increased ten-fold, but government — and courts in particular — has been slow to follow.

When it comes to offering non-qualified deferred compensation to executives of not-for-profit organizations, there aren’t many options.

People love the idea of being able to conveniently charge their phones without a cable or having to hunt for a plug. Free charging stations are popping up everywhere.

By now, pretty much everyone in the banking industry has heard plenty of talk about CECL – the forthcoming “Current Expected Credit Loss” model of accounting for an institution’s allowance for loan losses (ALL).

Financial fraud by the numbers. In a June 2016 Gallup poll, 72 percent of respondents said they had “very little” or only “some” confidence in banks.

By now you have heard that the Financial Accounting Standards Board’s (FASB) answer to the criticism the incurred-loss model for accounting for the allowance for loan and lease losses faced during the financial crisis has been released in its final form. 

Many of my hospital clients have an increased incidence of providing temporary housing for locums, temps and some employees and, as a result, have questions regarding the proper tax reporting to these individuals.   

With the implementation of GASB 72 now in full force, GASB organizations are hard at work drafting their new fair value disclosures. The addition of a fair value hierarchy table in the footnotes will add a bit more thickness to a likely already hefty financial package. 

There is plenty of media coverage of Maine’s, and specifically Portland’s, burgeoning microbrew scene. It’s good economic development and complements the already established “foodie” scene Portland is renowned for.

Online banking? Check. Online shopping? You bet. Online permit application submittal? What? Actually, yes. As Americans are becoming more and more accustomed to performing everyday functions online, local governments are evolving and keeping up with the times. This online evolution is coming in the form of implementing modern enterprise applications with electronic workflow and a public-facing portal that allows residents to apply for permits, submit documentation, pay for, and collaborate with local government staff to perform a variety of processes.

Why it can happen to you and how to protect yourself. We’ve all seen the headlines. Stories about not-for-profit fraud have been popping up in the news, and the statistics confirm what you might have suspected: fraud in the not-for-profit sector is on the rise.

Read this if you are a business owner or an advisor to business owners.

In times of uncertainty, exit planning can be a strong reason to focus on the opportunity in front of you. Instead of waiting for conditions to improve, business owners are often best served by staying active, involved, and focusing their efforts on improving their business. Consider what opportunities you can take advantage of and be ready to succeed when the climate improves.

Assessing risks and strengthening operations

In periods of uncertainty, the landscape shifts—revealing weaknesses, threats, and hidden hazards. How these challenges are navigated can shape long-term outcomes. Will this moment be used to identify, assess, and address these risks? 

It is important to view challenging times in the context of a larger, long-term perspective. It presents the perfect opportunity to focus on building resiliency, redundancy, and strength. Unsettled times allow business owners to discover and understand: 

  • What broke first and why? 
  • How can you shore it up for better operations in the days ahead?
  • What weak spots you didn’t know about are now apparent?
  • How can you address those weaknesses?
  • How can you leverage existing resources differently to chart a path forward?

Models of priority: The progress of a business

There are various stages or hierarchies of priority in thinking about the progress of a business. Each priority model features bases and pinnacles. The pinnacles of each model are realized in a long-term setting, after the remaining bases have been solidified. While continued development of a clear vision for your business is paramount, dynamic shifts in the landscape call for reassessment of the bases. In the long-term, self-fulfillment manifests from properly executed strategy, but in the near- and mid-term, these various frameworks force strategic planning back to assess and address the base components.  

The bases of each model should serve as safe havens for reversion. When facing uncertainty and failure, have you made your base strong enough to redirect your efforts into an actionable plan for the long-term? 

Action Planning Pyramid and Value Maturity Index

Action Planning
Five Stages of Value Maturity

The Value Maturity Index, broken into five stages, is a stepwise assessment of active exit and business strategy. Inherent in the value acceleration framework are the concepts of resiliency, redundancy, disaster recovery, and actionable planning. 

While we may have been fully entrenched in the build phase, setbacks due to dynamic changes in the landscape force us back to protect mode—the assessment and methodical shoring up of weaker points of the operation to protect against future downside risks.

Though this stepwise progression is linear in nature, flexibility and adaptability are paramount in changing course to address the needs of your current state. 

When we look at action planning, parallels can be drawn to the various models. Certainly, we are focused on continuing sales, marketing, and customer relationships, but it becomes a question of reversion to meeting the basic needs and serving a client’s pain points rather than beginning ground-breaking efforts.  

An uncertain climate forces us to the base, where the focus is on solidifying any exposed areas that have emerged, and likely compounded, by the current challenges. Concerns related to management, metrics, core values, and priorities are the bases in need of coverage. 

Maslow’s Hierarchy of Needs
 

Maslow's Hierarchy of Needs

Maslow’s Hierarchy of Needs1 is a well-known motivational theory in psychology that comprises a five-tiered model of human needs, whereby each successive tier must be fulfilled (beginning at the base) before rising to the next tier. It can be used to view similar information from a psychological perspective.

Value acceleration and creating successful outcomes are largely tied to a clear long-term vision. We typically reside in the self-actualization level of the hierarchy of needs when undertaking the high-level view of the framework.

In periods of uncertainty, the emphasis is on adaptability, so there will be less concern with the top levels. Those levels remain available but are not the pressing issue of the moment. If we think about shoring up bases (the protect stage) when viewing this psychological model, our focus is on the “basic needs” level. That is, keeping people (i.e., self, family, and employees) safe and remaining connected for immediate continuity.

McKinsey & Company Event Horizons

McKinsey & Company Event Horizons

Many others in related fields view uncertain times in similar terms. In the McKinsey & Company Events Horizon view2:

  • Resolve addresses those immediate hurdles and challenges a business is currently facing.
  • Resilience focuses on near-term items to be addressed once the initial base is covered. 
  • Return views the mid-term horizon in understanding how to return to scale by focusing on understanding metrics and increasing the frequency of measurements for informed decision-making. 
  • Reimagination and reform typically go hand in hand, but without covering bases of needs, crafting a dynamic shift in operations to incorporate new environments may be counterproductive. 

Once these bases have been clearly assessed and addressed, the path forward may appear dramatically different. This is when creative solutions to enhance opportunity should begin to take shape. Examples may include newly emerged revenue streams and opportunities, fully integrated systems and dashboards to capture timely decision-making data points, or strategic pivots in your business model to improve navigation in changing environments. 

Discover and control in uncertain times

Consider what the period of uncertainty has revealed and ask yourself: 

  • What existing challenges became more apparent?  
  • How can these areas be addressed? 
  • Is this the time to make large investments in the company or the right investments? 

Taking stock of your company’s future through the incorporation of lessons learned will bolster value in the long-term by de-risking and developing new opportunities, methods, work, shifts in productivity, and shifts in mentality. That approach also brings lots of questions: 

  • If there are no early warning signs, why not?  
  • What should your indicators be?  
  • What metrics are crucial in identifying the pulse of your current situation?  
  • What is your business reliant on?  
  • How can you build information and indicators for rapid shifts in decision-making?  
  • How strong are your current controls and how integrated are your management and information systems? 

To answer these questions, you need to quantify and develop metrics that will aid in the early identification of future challenges, thus increasing your responsiveness with data-driven decision mechanisms. Having your fingers on the pulse of your company and understanding the impact of each input on your strategy will focus your attention on the information that matters most. This allows you to understand, position, and adapt to changes in your business and community environment in a proactive and agile manner. Measurements, forecasts, and dashboards should provide you with regular, valid, and relevant information you can use to take informed action in decision-making. 

The importance of look-backs

Historical look-backs during various points of time will allow you to key in on pivotal data indicators and inflection points. When looking at this from an operational view, industry and economic factors impacting your company can serve as corroborating pieces of evidence to further support data metrics analyzed.

  • It's best practice to regularly study and update development, pipeline, and reliance metrics for feedback and information discovery with data integrated throughout your operations. This helps avoid lag time in reporting on stale information towards real-time actionable data points.  
  • Each metric is specific to your business and can be directly mapped back to increases in shareholder value. Understanding these business value drivers will focus your attention and intention on improving in the right areas, while avoiding distracting and less impactful pain points. 
  • Instead of focusing on precision, build in flexibility and adaptability with scenario- and sensitivity-based criteria to understand changes, implications, and reliance of each input. Understanding these relationships in a broader scheme aids you in quick, impactful decision-making, guiding you toward enhanced value. 

Remaining resilient in challenging times 

This approach allows an opportunity to fully assess the known and unknown problem areas, weaknesses, perils, and hazards your business may be facing. From that base, you can begin to address these issues to scale effectively with lower overall risk when activity picks up. 

Management metrics, core values, and priorities drive resilience for long-term continuity by shoring up the foundation to build for the future. Assembling evidence in troubled times provides an opportunity to capitalize on and fulfill core values. Documenting these decisions and improvements memorializes your decision-making and impact on value enhancement, and serves as a playbook for future events. 

What you make of difficult periods through identification, assessment, and addressing newly emerged risk areas provides the opportunity to increase success as the climate rebounds.

Key takeaways

  • Stay active during uncertainty: Improve the business now rather than waiting for conditions to recover. 
  • Identify and mitigate newly exposed risks: Examine what broke first, what weak spots surfaced, and how to shore up operations. 
  • Reinforce the “base” of the business: Prioritize management practices, core values, metrics, controls, and near-term continuity. 
  • Measure what matters more often: Build timely dashboards, forecasts, and early-warning indicators to support faster, data-driven decisions. 
  • Document lessons learned and improvements: Create a repeatable playbook that reduces future downside risk and supports long-term value. 

BerryDunn can help 

Our credentialed business valuation specialists bring clarity to the complexities of valuation while adhering to strict development and reporting standards. Through our assessments, risk profiling, and benchmarking analyses, we help business owners discover the largest gaps across the company, prioritize the most impactful problem areas to address, and implement changes to enhance business value through continuous improvement. We render an independent, objective opinion of your company’s value in a reporting format tailored to meet your needs. If you have questions about your unique situation, or would like more information, please contact the business valuation consulting team.

1Maslow’s Hierarchy of Needs, Saul McLeod, updated March 20, 2020. SimplyPsychology. www.simplypsychology.org/maslow.html.
2Beyond coronavirus: The path to the next normal, Kevin Sneader and Shubham Singhal, McKinsey & Company, March 23, 2020.  www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/beyond-coronavirus-the-path-to-the-next-normal. COVID-19: Briefing note, March 30, 2020, Our latest perspectives on the coronavirus pandemic. Matt Craven, Mihir Mysore, Shubham Singhal, Sven Smit, and Matt Wilson. McKinsey & Company. www.mckinsey.com/business-functions/risk/our-insights/covid-19-implications-for-business.

Article
Value acceleration in times of uncertainty

Who this article applies to: Healthcare compliance officers, administrators, clinical leaders, information officers, clinicians, and quality and risk managers at hospitals, health systems, ambulatory care facilities, and medical practices.

AI-based medical scribes have rapidly progressed from novel ambient listening tools used by tech-savvy clinicians to formally integrated applications in both ambulatory and hospital practice settings. Designed to listen to clinician‑patient conversations and generate draft clinical notes for review before they become part of the medical record, these tools promise to relieve clinician burnout by reducing the documentation burden and after‑hours charting. For healthcare organizations facing clinical workforce shortages and rising administrative pressure, the appeal is obvious.

How AI scribes work—and why it matters for compliance 

Most AI medical scribe platforms combine speech recognition, natural language processing, and generative AI to produce the clinical encounter note. Often integrated with the clinician’s electronic health record platform, audio recordings or transcripts are temporarily stored outside the electronic health record before the finalized note is returned for clinician review and sign‑off. The underlying technology may handle Protected Health Information (PHI) at multiple points along the informational data path.

This information architecture is important from a compliance perspective. Audio recordings and transcripts are electronic PHI, even if retained briefly. As a result, AI scribe vendors are considered business associates under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), requiring AI scribe vendor compliance with the HIPAA Privacy, Security, and Breach Notification Rules. There is no such thing as a “HIPAA‑certified” AI product—compliance depends on how the tool is deployed, governed, and monitored by the healthcare organization. 

Privacy, consent, and risk for AI scribe use 

A key risk area for AI scribes is patient consent. Because these tools record live patient-clinician conversations to generate clinical notes, in addition to HIPAA compliance obligations, their use may be governed by individual state audio‑recording and all‑party consent laws. Some states have one-party consent laws, while others (such as Connecticut) have two-party consent requirements, which require every participant in the conversation to give consent before recording begins.  

Consent cannot be assumed, implied, or retroactively documented by AI‑generated notes alone. Recent legal actions against healthcare organizations in multiple two-party consent states have alleged deployment of ambient listening tools without adequately notifying patients or obtaining valid consent for recording and downstream data use. Regulators and plaintiffs alike are scrutinizing whether patients were meaningfully informed that conversations were being recorded, how long recordings were retained, where data was stored, and whether patients had a genuine opportunity to opt out. Transparency and documentation around consent are rapidly becoming baseline expectations. 

Oversight and regulation are evolving 

At the federal level, most AI scribe tools are not currently regulated as medical devices. However, regulators are paying close attention to how AI influences clinical workflows and documentation. Recent FDA guidance on AI‑enabled health technologies emphasizes life-cycle governance, transparency, cybersecurity, and post‑market monitoring. AI systems have the same obligations that apply when humans access PHI—including minimum necessary standards, access controls, audit logs, and risk analysis.  

For healthcare organizations, this means enforcement risk is not theoretical. HIPAA applies fully to AI systems today, and state attorneys general and private litigants are increasingly willing to test the boundaries of consent, disclosure, and data governance in court. 

Practical guidance for AI medical scribe adoption and use 

When introduced within a strong governance framework, AI medical scribes can deliver demonstrable clinical and operational value. Organizations adopting these tools can reduce compliance risks by focusing on a few core principles: 

  • Organizational self-audit: Know what tools may already be in use and restrict ad-hoc clinician use without organizational vetting and oversight. 
  • Develop organizational governance policies for AI tool adoption and use:
    • Tool evaluation, selection, and approval
    • Data retention and deletion
    • Explicit clinician responsibility for review and sign-off of AI-generated notes 
  • Vendor due diligence and contracting: Confirm how data is captured, stored, retained, and deleted. Require the vendor to provide evidence supporting compliance with applicable HIPAA provisions and execute a Business Associate Agreement (BAA). 
  • Transparent patient communication: Clearly explain when AI documentation is used, what is recorded, and what choices patients have.
  • Affirmative consent workflows: Build consent processes and documentation that stand on their own, separate from AI-generated statements. 
  • Clinician accountability: Reinforce clinician responsibility for reviewing, correcting, and approving all AI‑generated documentation. 
  • Oversight: Perform ongoing monitoring, audits, and periodic reassessment of AI-based scribe tools.

Ensuring responsible use of AI medical scribes 

AI medical scribes can improve efficiency, reduce burnout, and support high‑quality documentation. When deployed carelessly, these tools can erode patient trust and expose organizations to regulatory, legal, and reputational risk. 

Compliance, privacy, and operations leaders play a critical role in ensuring that innovation enhances care delivery without compromising the standards that patients and regulators expect and demand. 

Key takeaways

  • Understand that AI medical scribes may handle PHI at multiple points along the informational data path. 
  • Recognize that audio recordings and transcripts are electronic PHI, even if retained briefly. 
  • Confirm that AI scribe vendors function as business associates under HIPAA and execute a Business Associate Agreement. 
  • Build consent processes and documentation that stand on their own, separate from AI-generated statements. 
  • Reinforce clinician responsibility for reviewing, correcting, and approving all AI-generated documentation. 

BerryDunn can help 

Our healthcare compliance team can help. We incorporate deep, hands-on knowledge with industry best practices to help your organization manage compliance and revenue integrity risks. Learn more about our healthcare compliance consulting team and services.    

Article
AI medical scribes: Eavesdropping, recording, and risk

When most people think about water parks, they think about slides, lazy rivers, and summer crowds. What they do not always see is a highly complex operation that blends revenue generation, community service, workforce development, and long-term planning in a way that many public sector organizations can learn from.

Water World, operated by the Hyland Hills Park and Recreation District, is a standout example. With more than 70 acres, 50 attractions, and roughly 500,000 visitors over an 85-day season, it operates at a scale that rivals private-sector attractions. But the more interesting story is not just its size. It is how that scale supports a broader mission.

Listen to the Let's Talk Parks podcast with guests from Hyland Hills Park and Recreation District. 

A different model for funding public services

At its core, Water World exists because of a funding challenge. In the late 1970s, the district needed a way to support programs that were not self-sustaining without raising taxes. The solution was to build a revenue-generating amenity that could subsidize the rest of the system. That model still holds today. Revenue from Water World and other enterprise operations helps fund community offerings like youth sports, parks, and senior programs, while keeping the local tax burden low.

This is a useful reframing for many public organizations. Instead of viewing amenities solely as cost centers, there is an opportunity to think about how select offerings can generate revenue that sustains the broader mission. Not every agency can or should build a large water park, but the mindset applies broadly. Strategic investments that attract regional audiences can create funding streams that benefit local residents.

Scale changes operations, but not fundamentals

Running a facility like Water World requires significant operational complexity. Behind the scenes, there are teams managing water quality, maintenance, safety protocols, and guest flow across dozens of attractions.

And yet, one of the most important takeaways is that the core challenges are the same as those faced by smaller facilities. Water quality, safety, staffing, and maintenance are universal. The difference is scale. In some ways, scale provides advantages. Larger operations can support specialized staff and dedicated teams. Smaller facilities often rely on fewer individuals wearing multiple hats.

For leaders in smaller communities, this is an important reminder. While your resources may be different, the fundamentals are not. Clear processes, strong training, and consistent attention to the guest experience matter just as much at a single pool as they do at a 70-acre park.

Staffing is a strategy, not just a seasonal task

Hiring nearly 1,000 seasonal employees each year, including around 300 lifeguards, is no small task. Water World begins planning in the fall, opens applications around February, and relies heavily on returning staff and word of mouth to fill roles quickly.

What stands out is the emphasis on employee experience. Many staff members are in their first jobs, and leadership treats that responsibility seriously. Investments in compensation, engagement programs, and leadership development have led to stronger retention and better performance.

This is a shift many organizations are still making. Instead of viewing seasonal or entry-level roles as transactional, successful organizations are treating them as foundational experiences. When employees feel supported and engaged, they stay longer, perform better, and contribute to a stronger overall experience.

Marketing works best when the experience delivers

Water World markets year-round, even though it operates for just a few months each year. Strategies include digital campaigns, media relations, email marketing, and local partnerships. But one of the most effective tactics is also one of the simplest: capturing authentic guest experiences. Interns are often sent into the park to create organic social content that reflects real guest reactions.

This aligns with a broader truth. Marketing can drive awareness, but it cannot compensate for a weak experience. As one leader noted, if the product does not deliver, people will not come back. For organizations with limited marketing budgets, this is encouraging. Authentic, experience-driven content is often more effective than polished campaigns. The key is to create something worth talking about.

Continuous reinvestment keeps experiences relevant

One of the more difficult aspects of managing a long-standing attraction is deciding when to update or replace existing features. Water World refers to this process as “reimagination.” Decisions are based on a combination of guest feedback, usage patterns, maintenance needs, and overall experience quality. Even when an attraction has strong sentimental value, it may no longer meet current expectations.

These decisions are not easy. Leaders recognize the emotional connection guests have with legacy attractions, and they often provide opportunities for closure, such as farewell events or final visits. The lesson here is that maintaining relevance requires ongoing investment. Whether it is updating a facility, refining a program, or improving an experience, organizations need to balance nostalgia with evolving expectations.

Safety and preparedness cannot be static

Safety has always been a priority in aquatics, but expectations have evolved. Water World has expanded its approach to include comprehensive emergency action planning, cross-agency collaboration, and large-scale drills involving multiple jurisdictions. This level of preparation reflects a broader shift. Public-facing organizations must be ready for a wide range of scenarios, many of which were not top of mind a decade ago.

For smaller agencies, the takeaway is not to replicate large-scale drills, but to build relationships. Engaging local law enforcement and first responders, sharing facility knowledge, and developing clear protocols can significantly improve readiness.

The real impact is human, not operational

It is easy to focus on metrics such as attendance, revenue, or staffing. But the most meaningful outcomes are harder to quantify. Water World is the largest youth employer in its county, giving thousands of young people their first job experience. Former employees return with their own families. Longtime guests maintain decades-long relationships with the park.

These connections are what turn a facility into a community asset. They are also what justify the effort, investment, and complexity required to operate at this scale. 

At its best, parks and recreation work is about creating places where people connect, grow, and create memories. Water World shows what that can look like when those goals are paired with strong strategy and execution.

Key takeaways

Not every organization will operate a water park. But many can apply the underlying principles:

  • Think strategically about revenue-generating services that support your mission

  • Focus on fundamentals, regardless of scale

  • Treat staffing as a long-term investment

  • Let the customer experience drive your marketing

  • Continuously reinvest in relevance

  • Build strong safety and community partnerships

Innovative strategies for parks, recreation, and libraries

BerryDunn's consultants work with you to improve operations, drive innovation, identify improvements to services based on community need, and elevate your brand and image―all from the perspective of our team’s combined 100 years of hands-on experience. We provide practical park solutions, recreation expertise, and library consulting. Learn more about our team and services.

Article
What water parks can teach us about running sustainable, high-impact community services

Veterinary practice owners can miss important financial warning signs even when revenue is growing. This article explains 12 common blind spots, including weak cash flow visibility, outdated pricing, missed charges, labor inefficiencies, and limited long-term planning. Without financial visibility, practices risk lower profitability, greater stress, and diminished long-term value and resilience.

Who this applies to: Veterinary practice owners, managers, and financial directors.

What is a financial blind spot?  

Financial blind spots are operational areas where practice owners: 

  • Lack visibility into the true financial health of the business 
  • Make decisions without the full financial picture 
  • Focus on activity rather than profitability 

These gaps affect more than the bottom line—they can impact profitability, cash flow, business value, and owner stress. 

Why does financial visibility matter to veterinary practices? 

Financial visibility is crucial to the success of a business. While busy teams, growing revenue, and strong client demand might give the appearance of success, many owners are still asking questions that indicate poor visibility: 

  • “We’re busier than ever. Where is the money going?” 
  • “Why does cash feel tight despite revenue being up?” 
  • “I don’t fully understand my financials. What am I missing?” 

Financial visibility gaps and their impact on veterinary practices
 

1. Busy doesn’t always translate to profitability: Common signs for this problem are revenue growth with shrinking margins, longer staff hours with little financial improvement, and growth creating complexity rather than more profit. Activity does not equal profitability. 

2. Profitable on paper while stressed in reality: Profitability on paper can mask cash flow problems, causing stress for veterinary practice owners. This stress often leads to cautious or anxious behaviors that affect decision-making and growth.  

3. Limited financial visibility: Many businesses limit financial reviews to quarterly, tax season, or in response to a problem. Often, the books and records have not been prepared in a clean, consistent fashion that allows for proper analysis and comparisons. Without a regular review of accurate records, owners cannot spot trends early, adjust pricing or costs, and make informed decisions for growth. Monthly reviews are critical. 

4. Pricing that hasn’t kept pace: Don’t underestimate the impact of inflation, rising labor costs, technology expenses, and operational complexity. The result can be eroding margins and declining profits regardless of strong demand. 

5. Revenue leakage through missed charges and excessive discounting: Missed charges often occur during rushed checkouts, handoffs, or emergency cases in veterinary clinics. Leakage lowers staff value, contributes to burnout, and causes financial losses. Addressing leakage requires awareness and disciplined processes—not aggressive price increases. 

6. Revenue mix distortions: Non-core revenue streams can distort financial benchmarks if not separated from core medical income. Segmenting revenue properly reveals true performance trends and reduces confusion in benchmarking. Clarity in revenue mix is necessary for making good strategic decisions. 

7. Misaligned compensation structures: Compensation structures can unintentionally create challenges. For example, problems can occur if pay is not aligned with productivity, incentives reward activity instead of profitability, and ownership compensation is unclear—all of which make growth harder to sustain and adversely affect profitability.

8. Labor growth without clarity on productivity: Increasing staff without improving productivity can reduce overall profitability and operational efficiency. Normalized overtime and full schedules can mask inefficiencies and reveal financial gaps during growth. Careful financial review is essential to align staffing growth with sustainable and value-enhancing results. 

9. Inventory as a hidden cash trap: Overstocking and expiration can lead to drained cash and increased cost of goods sold in veterinary practices. Simultaneous complaints of stockouts and excess supplies highlight poor inventory management systems. When inventory is mismanaged, it ties up working capital, impacting cash flow and profitability. Maintaining awareness of inventory dynamics helps to identify when operational controls require improvement.

10. Don’t ignore the balance sheet: Many practice owners focus on income statements, neglecting balance sheets, which are crucial to financial health. Liquidity, leverage, and equity growth are vital indicators of business resilience and exit readiness. Ignoring the balance sheet limits strategic options and weakens negotiating power during business transitions.

11. Owner draws and hidden value erosion: When an owner treats the business like a personal ATM, it reduces business equity and limits strategic options. If personal lifestyle growth surpasses business earnings, long-term business value declines. Identifying value erosion early helps to preserve business options during expansion and sale. 

12. Lack of long-term financial planning: Many businesses plan for next month or next quarter instead of intentionally building the business over time. It’s important to step back to consider a long-term growth strategy, owner succession, business valuation, and exit planning. 

Key takeaways

  • Make financial visibility a priority. 
  • Pay attention to profitability, not just revenue. 
  • Be strategic with pricing. 
  • Ensure compensation structures are aligned. 
  • Focus on long-term planning. 

BerryDunn can help 

Do you need help understanding the financial story behind your practice? The veterinary world is uniquely complex. As a veterinary accounting and financial management consulting firm, our proactive approach to client service, ability to anticipate potential problems and tax burdens, use of cutting-edge technology, and focus on industry trends clearly demonstrates our commitment to providing the best quality services for our clients, without geographic limitation. Helping a practice grow and succeed is one of our fundamental strengths. Learn more about our team and services. 

Article
12 financial blind spots veterinary practices should avoid

Read this if you are a business owner or an advisor to business owners.

This article is part one of a three-part series. 

With continued uncertainty in the business environment—driven by shifting economic conditions, market volatility, and evolving tax policy—now may be a good time to utilize trust, gift, and estate strategies in the transfer of privately held business interests. Periods of uncertainty can create an opportunity to free up considerable portions of lifetime gift and estate tax exemption amounts through transfers, particularly as uncertainty and increased risk serve to reduce business valuations.  

An element to consider is the ability to transfer noncontrolling interests in a business. These interests are potentially subject to Discounts for Lack of Control (DLOC) and lack of marketability. This may further reduce the overall value transferred through a given strategy, potentially offloading a larger percentage of ownership in a business while retaining large portions of the gift and estate lifetime exemption. For the first part of this series, we’ll focus on the DLOC.

What is discount for lack of control?

In the context of a hypothetical willing buyer and willing seller, the buyer may place a greater value on an ownership interest with the ability to make changes at their discretion, compared to an alternative ownership interest lacking control. Simply put, buyers like to be in control, and they will pay less for the investment if the interest lacks these characteristics.  

When valuing noncontrolling business interests, there is an inherent discount to full value recognized to reflect the fact that the subject interest does not hold a controlling position. As a result of this discount, the value of a noncontrolling interest in a company will differ from the pro-rata value per share of the entire company. DLOCs alone commonly reduce the value of the transferred interest by 5% to 15%. 

All else being equal, a noncontrolling ownership position is less desirable (valuable) than a controlling position. This is because of the majority owner’s right to control any or all of the following activities:

  • Managing the assets or selecting agents for this purpose 
  • Controlling major business decisions, asset allocation choices, setting salary levels, admitting new investors, acquiring assets, selling the company, and declaring/paying distributions

Market-based evidence of proxies for DLOCs can be found within the following subscription-based databases, including but not limited to: 

  • Control premium studies published in the Mergerstat® Review series by FactSet Mergerstat/Business Valuation Resources
  • Closed-end fund data
  • The Partnership Profiles, Inc. Minority Interest Database and Executive Summary Report on Re-Sale Discounts for applicable entity types

In addition to these resources, to fully assess the degree of discount applicable to a subject interest, consider company-specific factors when estimating the DLOC. The degree of control for a subject interest may be impacted by relevant state statutes and the governing documents of the subject company. These factors are analyzed in conjunction with the current operational and financial policies established and implemented in practice by management to establish a comprehensive view on the applicable degree of discount.

Hypothetical business owners are knowledgeable of the facts and circumstances surrounding a business interest. They take a close look at what they are buying before they make an offer. Like most owners, they prefer to be in control and are generally unwilling to pay the pro-rata value for a minority interest in a business that lacks control. To assess an appropriate discount for lack of control, consider resources such as those referred to above, then ensure the selected discounts are appropriate based on the factors specific to the company and interest being valued. 

Key takeaways

  • Use periods of uncertainty to consider trust, gift, and estate strategies for transferring privately held business interests. 
  • Recognize that noncontrolling interests may qualify for discounts for lack of control, reducing reported transfer value. 
  • Define a DLOC as the price reduction buyers apply when an ownership stake cannot influence decisions or change operations. 
  • Expect DLOCs alone to commonly reduce transferred-interest value by 5%–15%, making minority value differ from pro‑rata value. 
  • Support a DLOC with market evidence (control premium studies, closed-end fund data, minority interest databases) and company-specific factors (state statutes, governing documents, operating policies). 

BerryDunn can help 

BerryDunn’s credentialed business valuation specialists bring clarity to the complexities of valuation while adhering to strict development and reporting standards. We render an independent, objective opinion of your company’s value in a reporting format tailored to meet your needs. If you have questions about your unique situation, or would like more information, please contact the business valuation consulting team

Article
Discounts for lack of control in business valuations