Key financial metrics for manufacturers

Editor's note: read this if you are a CFO, controller, accountant, or business manager.

We auditors can be annoying, especially when we send multiple follow-up emails after being in the field for consecutive days. Over the years, we have worked with our clients to create best practices you can use to prepare for our arrival on site for year-end work. Time and time again these have proven to reduce follow-up requests and can help you and your organization get back to your day-to-day operations quickly. 

1. Reconcile early and often to save time.
   Performing reconciliations to the general ledger for an entire year's worth of activity is a very time consuming process. Reconciling accounts on a monthly or quarterly basis will help identify potential variances or issues that need to be investigated; these potential variances and issues could be an underlying problem within the general ledger or control system that, if not addressed early, will require more time and resources at year-end. Accounts with significant activity (cash, accounts receivable, investments, fixed assets, accounts payable and accrued expenses and debt), should be reconciled on a monthly basis. Accounts with less activity (prepaids, other assets, accrued expenses, other liabilities and equity) can be reconciled on a different schedule.
2. Scan the trial balance to avoid surprises.
   As auditors, one of the first procedures we perform is to scan the trial balance for year-over-year anomalies. This allows us to identify any significant irregularities that require immediate follow up. Does the year-over-year change make sense? Should this account be a debit balance or a credit balance? Are there any accounts with exactly the same balance as the prior year and should they have the same balance? By performing this task and answering these questions prior to year-end fieldwork, you will be able to reduce our follow up by providing explanations ahead of time or by making correcting entries in advance, if necessary. 
3. Provide support to be proactive.
   On an annual basis, your organization may go through changes that will require you to provide us documented contractual support.  Such events may include new or a refinancing of debt, large fixed asset additions, new construction, renovations, or changes in ownership structure.  Gathering and providing the documentation for these events prior to fieldwork will help reduce auditor inquiries and will allow us to gain an understanding of the details of the transaction in advance of performing substantive audit procedures. 
4. Utilize the schedule request to stay organized.
   Each member of your team should have a clear understanding of their role in preparing for year-end. Creating columns on the schedule request for responsibility, completion date and reviewer assigned will help maintain organization and help ensure all items are addressed and available prior to arrival of the audit team. 
5. Be available to maximize efficiency. 
   It is important for key members of the team to be available during the scheduled time of the engagement.  Minimizing commitments outside of the audit engagement during on site fieldwork and having all year-end schedules prepared prior to our arrival will allow us to work more efficiently and effectively and help reduce follow up after fieldwork has been completed. 

Careful consideration and performance of these tasks will help your organization better prepare for the year-end audit engagement, reduce lingering auditor inquiries, and ultimately reduce the time your internal resources spend on the annual audit process. See you soon. 

As CMS and other agencies release resources to help senior living and long-term care organizations navigate the rapidly changing landscape, we will add important links and information to this blog post:

• CMS Accelerated and Advanced Payments Fact Sheet
• CMS Flexibilities to Fight COVID-19 for Long-Term Care Facilities
• CARES Act Provider Relief Fund
• Additional Allocations of CARES Act Provider Relief Fund
• State resources:
  • Maine
    • Rate Add-On for COVID-19 Related Costs
      • Nursing Facilities
      • ICF/MRs
      • PNMI (Appendix C)
      • PNMI (Appendix F)
    • Temporary Rate Increase Guidance
    • Extraordinary Circumstance Allowance for COVID-19 Related Costs
  • New Hampshire
    • COVID-19 Relief Fund Application
    • Long-Term Care Stabilization Program Guidance and FAQs
  • Massachusetts
    • Supplemental Payment to Nursing Facilities
    • Standard Payment to COVID-19 Nursing Facilities
  • Vermont
    • Temporary Medicaid Long-Term Care Facilities Rate Restructure
  • Virginia
    • Supplemental Payment to Nursing Facilities
• FASB and GASB News: Postponement of the Lease Accounting Standards

We are here to help
Please contact the BerryDunn senior living team if you have any questions, or would like to discuss your specific situation.

CARES Act update:

As anticipated, the House of Representatives approved the CARES Act on March 27, 2020, and the President has signed the measure. The provisions highlighted in our prior summary remain intact in the final measure. 

So…how are the emergency relief funds in the legislation accessed by healthcare providers?

• Public Health & Social Services Emergency Fund (PHSSEF): The guidance on how hospitals will access the $100 billion in PHSSEF funds to offset “COVID-19 related expenses and lost revenue” is expected to be released shortly. Keep an eye on this space for further updates as information becomes available.
• Medicare Advanced Lump Sum or Periodic Interim Payments: Application is made through the Fiscal Intermediary (FI). It should be noted that healthcare organizations do not qualify if they are in bankruptcy, under active medical review or program integrity investigation, or have outstanding, delinquent Medicare overpayments.
• SBA Paycheck Protection Program (PPP): This application process begins with your local lender. Do not hesitate—contact your lender immediately as it is anticipated that application volume will be tremendous. For more specifics on this program compiled by BerryDunn experts, visit our blog.

We will continue to provide updates as more information becomes available. In the meantime, please feel free to contact the hospital consulting team. Despite the current circumstances we remain available to support your needs. 

On March 25, 2020 the US Senate unanimously approved the $2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act (The “Act”). The White House has signaled that it will sign the measure as approved by the Senate. 

Major provisions of the proposed legislation include:

• $100 billion for hospital “COVID-19 related expenses and lost revenue”
• $275 million for rural hospitals, telehealth, poison control centers, and HIV/AIDS programs
• $250 million for hospital capacity expansion and response
• $150 million for modifications of existing hospital, nursing home, and “domiciliary facilities” undertaken as part of COVID-19 response

The CARES Act also includes the following targeted relief and payment modifications under the Medicare and Medicaid programs:

• The Medicare 2% sequester will be suspended from May 1, 2020 through December 31, 2020. 
• “Through the duration of the COVID-19 emergency period”, the Act will increase by 20% hospital payments for the treatment of patients admitted with COVID-19. The add-on applies to hospitals paid through the Inpatient Prospective Payment System.
• $4 billion in scheduled cuts to Medicaid Disproportionate Share Hospital payments will be further delayed from May 22, 2020 to November 30, 2020.
• Certain hospitals, including those designated as rural or frontier, have the option to request up to a six month advanced lump sum or periodic interim payments from Medicare. The payments will:
  1. Be based upon net payments represented by unbilled discharges or unpaid bills,
  2. Equal up to 100% of prior period payments, 125% for Critical Access Hospitals
  3. In terms of paying down the “no interest loans”, hospitals will be given a four month grace period to begin making payments and at least 12 months to fully liquidate the obligation.

Non-financing provisions contained in the Act that will impact hospital operations include:

• Providing acute care hospitals the option to transfer patients out of their facilities and into alternative care settings to "prioritize resources needed to treat COVID-19 cases." That flexibility will come through the waiver of the Inpatient Rehabilitation Facility (IRF) three-hour rule, which requires patients to need at least three hours of intensive rehabilitation at least five days per week to be admitted to an IRF.
• Allowing Long-Term Care Hospitals (LTCH) to maintain their designation even if more than 50% of their cases are less intensive and would temporarily pause LTCH site-neutral payments.
• Suspending scheduled Medicare payment cuts for durable medical equipment during the length of the COVID-19 emergency period, to help patients transition from hospital to home.
• Disallow Medicare beneficiary cost-sharing payments for any COVID-19 vaccine.
• Ensuring that uninsured individuals could receive free COVID-19 tests "and related service" through any state Medicaid program that elects to enroll them.

Other emergency-period provisions that directly affect other entities but have implications for hospitals:

• Affording $150 billion to states, territories, and tribal governments to cover their costs for responding to the coronavirus public health emergency.
• Physician assistants, nurse practitioners, and other professionals will be allowed to order home health services for Medicare beneficiaries, to increase "beneficiary access to care in the safety of their home."
• Requiring HHS to clarify guidance encouraging the use of telecommunications systems, including remote patient monitoring, for home health services.
• Allowing qualified providers to use telehealth technologies to fulfill the hospice face-to-face recertification requirement.
• Eliminating the requirement that a nephrologist conduct some of the required periodic evaluations of a home-dialysis patient face-to-face.
• Allowing federally qualified health centers and rural health clinics to serve as a distant site for telehealth consultations.
• Eliminating the telehealth requirement that physicians or other professionals have treated a patient in the past three years.
• Allowing high-deductible health plans with a health savings account (HSA) to cover telehealth services before a patient reaches the deductible.
• Allowing patients to use HSA and flexible spending accounts to buy over-the-counter medical products without a prescription.

For more information
If you have questions or need more information about your specific situation, please contact the hospital consulting team. We’re here to help. 
 

Over the last few weeks, CMS and the President have enacted legislation and released guidance to assist the senior living industry in coping with the impact of COVID-19. We recognize the elderly residents of our country are the most vulnerable population and your days are filled caring for your population’s needs and health. Our senior living professionals have written this article to highlight new regulations impacting the industry and offer practical tips for guarding your facility's financial health through the COVID-19 outbreak.

Amidst rapid hourly changes in contending with the coronavirus and its far-reaching impacts, the way you run your facility has changed. Along with this change comes an increase in expenditures. To ensure that your facility is getting much needed financial relief and being properly reimbursed for the full impact of COVID-19, we recommend tracking your expenditures related to the coronavirus. Expenditures related to COVID-19 go beyond the cost of additional Personal Protective Equipment (PPE), they will likely include additional direct care staffing, along with housekeeping, dietary and laundry staffing, and supplies needed to maintain the heightened level of hygiene required to combat the spread of COVID-19 in your facility.

CMS issues waiver of 3-Day Stay and Spell of Illness
On March 14, Centers for Medicare and Medicaid Services (CMS) issued two waivers to aid skilled nursing facilities in addressing the national COVID-19 outbreak. CMS is waiving both the 3-Day Stay and Spell of Illness requirements. Read the COVID-19 Emergency Declaration.

Key provisions to consider with regard to 3-midnight qualifying stay requirement:

• The exception applies to traditional Medicare coverage only (Medicare Advantage plans may or may not follow this exception);
• It is in effect as of March 1, 2020, and will only be in effect while public health emergency is declared;
• Applies only to beneficiaries affected by the emergency or who experience dislocations;
• Providers have to document medical necessity and clinical reasons for not meeting 3-midnight requirement, understanding that the intent of this provision is to free up hospital beds and reduce potential risk of exposure to the patient;
• Providers are to use condition code “DR” on the claims. 

Read additional AHCA clarifications and guidance regarding the waivers of 3-Day Stay and Spell of Illness requirements.

MDS completion and submission waivers
CMS is waiving 42 CFR 483.20 to provide relief to SNFs on the timeframe requirements for Minimum Data Set (MDS) assessments and transmissions. CMS has yet to issue technical guidance on how to implement.

On March 22, 2020, CMS announced temporary administrative burden relief related to Quality Reporting which includes certain SNF-specific changes:

• Quality Reporting Program (QRP) April/May deadline for 10/1/19 - 12/31/19 data submission is optional for those facilities that have not yet submitted data;
• Facilities do not need to submit 1/1/20 - 6/30/20 data for purposes of compliance with QRP;
• CMS will not use any data for the first 2 quarters of 2020, 1/1/20 - 6/30/20, in its calculations;
• Claims for 1/1/20 - 6/30/20 will be excluded from calculation of all-cause readmission measures that result in value-based purchasing adjustments.

Read the full CMS press release.

Families First Coronavirus Response Act (FFCRA)
On March 18, 2020, the President signed into law, H.R. 6201, the Families First Coronavirus Response Act. The legislation eliminates patient cost-sharing for COVID-19 testing and related services, establishes an emergency paid leave program, and expands unemployment and nutrition assistance. Moreover, the bill provides a temporary 6.2% increase in Federal Medical Assistance Percentages (FMAP) for each calendar quarter occurring during an emergency period.

FMAP is the federal portion of funds for state Medicaid programs. With this temporary increase states can use the increased federal funds for any portion of the state Medicaid program. Due to significant increases in unemployment from business closures, the increase may be used to provide Medicaid coverage for the newly unemployed and uninsured. This would result in less funding for provider rate increases to cover COVID-19 related costs. However, on March 21, 2020, the federal government also announced that it is considering a special enrollment period for Affordable Care Act Health Insurance Exchange coverage. A special enrollment period would offer lower cost coverage to individuals with reduced incomes and could influence how the FMAP increase will be used, possibly resulting in more being allocated to covering provider rates. As of today, it is still unclear how states will use the increased funds.

A table released by AHCA on March 14, 2020, provides estimates of the increase in Federal Medicaid funding from FMAP assuming the increase is in effect January through December 2020. 

There are two provisions of the FFCRA that deal with paid leave provisions for employees. BerryDunn's employee benefits consultants provide insight and clarity on the paid leave provisions for employees.

Prioritization of survey activities
CMS released guidance prioritizing and suspending most federal and state survey agency (SSA) surveys, and delaying revisit surveys, for the next three weeks beginning on March 20, 2020, for all nursing homes. Standard surveys and non-Immediate Jeopardy (IJ) related onsite surveys will be suspended for three weeks. Complaints and facility-reported incidents that are considered at the IJ level will be conducted during this time. Facilities are encouraged to use the CDC developed COVID-19 Focused Survey for Nursing Homes. Get additional CMS guidance. 

Coronavirus Aid, Relief, and Economic Security (CARES) Act
On March 25, 2020, the US Senate unanimously approved the $2 trillion CARES Act (The “Act”). It is anticipated that the House of Representatives will vote on the Act today, March 27, 2020. The White House has signaled that it will sign the measure as approved by the Senate. 

Major provisions of the proposed legislation include:

• The Medicare 2% sequester will be temporarily suspended starting in late May 2020. 
• $150 million for modifications of existing hospital, nursing home, and “domiciliary facilities” undertaken as part of COVID-19 response.
• $65 million for housing for the elderly and people with disabilities for rental assistance, service coordinators and support services for the more than 114,000 affordable households for the elderly, and more than 30,000 affordable households for low-income people with disabilities.
• $2.8 million to provide staff treating veterans living at Armed Forces Retirement Homes with the personal protective equipment they need. The funding provides this and other necessary equipment and staffing support to help minimize the spread of the coronavirus among residents.
• $955 million for the Administration for Community Living to support nutrition programs, home- and community-based services, support for family caregivers, and expand oversight and protections for seniors and individuals with disabilities.
• $200 million for the Centers for Medicare & Medicaid Services to assist nursing homes with infection control and support states’ efforts to prevent the spread of the coronavirus in nursing homes.

Practical tips for monitoring and maintaining your organization’s financial health 
As we navigate these next few months, facilities will face challenges to maintain the health and safety of their residents and staff as well as the financial health of the organization. Some things you should be doing now:

• Calculate your working capital and cash position weekly or bi-weekly.
• Perform cash flow projections for the next few months. Be sure the timing of your cash receipts will cover payroll and supplies expenditures each week. 
• Contact your lenders to obtain or increase available working capital lines of credit.
• Ascertain if you can release any investment balances if needed.

We are here to help
Please contact the BerryDunn senior living team if you have any questions, or would like to discuss your specific situation.

Editor’s note: Read this if you are a Chief Executive Officer, Chief Financial Officer, Chief Risk Officer, Chief Information Officer, or Controller.

Last month, the Office of the Comptroller of the Currency (OCC) issued its Semiannual Risk Perspective for Fall 2019. The report addresses key issues facing banks and focuses on those that pose threats to their safety and soundness. According to the report:

• Bank financial performance is strong due to a favorable credit environment and the longest economic expansion in U.S. history.
• Capital levels have reached historical highs.
• Return on equity was above its 2006 pre-crisis level for the first time at 12.7%.
• Net income grew 8.22% from the same period a year ago; however, net interest income grew only 4%, as loan growth is below historical averages and an increasing number of banks are facing a flat or declining net interest margin.
• There is continued weakness in residential and commercial real estate loan growth.
• Delinquent and nonperforming loans remain below their long-term averages.

Banks can thrive even with economic uncertainty

While these trends indicate that 2019 was by and large an excellent year, banks cannot afford to be complacent, as 2019 also saw increasing risks to the industry. For instance, in 2019 there was much discussion of the future cessation of the London InterBank Offer Rate (LIBOR). The OCC has indicated it will increase its regulatory oversight regarding the anticipated cessation, to ensure banks assess their exposure to LIBOR and are appropriately planning their transition from the widely used benchmark rate. The Financial Accounting Standards Board (FASB) is also working on a project to address accounting issues that could arise from the transition from LIBOR.

And, although 2019 continued the longest economic expansion in US history, economic uncertainty exists due to, in part, the US-China trade conflict and ongoing Brexit discussions. This economic uncertainty has caused volatility in the interest rate environment. Aside from the yield curve inverting in 2019, banks also saw the Federal Funds target rate increase 25 basis points prior to decreasing 50 basis points. Given the typically asset-sensitive nature of banks’ balance sheets, the current interest rate environment will also put pressure on net interest margins. The current volatility of interest rates has caused the OCC to conclude interest rate risk is currently at heightened levels. 

Net interest income continues to be the most significant driver of net revenues for community banks, comprising nearly 80% of net revenues. With a difficult interest rate environment and lackluster loan growth in residential and commercial real estate, banks may face a difficult path ahead. Banks should tread cautiously, especially if this uncertainty persists. Asset-liability management will need be a significant focus (more than usual) as banks try to position themselves to not only maintain profitability through this uncertainty, but also come out stronger than before. Specifically, if lower rates persist, asset growth will need be a priority over deposit growth to maintain profitability at lower net interest margins. If loan growth continues to wane, this will prove to be difficult.

Innovations to compete with new lending sources

Adding to the list of threats to performance is the increasing amount of alternative financial resources available to borrowers. Banks have traditionally been the only source of credit for borrowers. However, technology has rapidly changed that landscape. Person-to-person (P2P) lending (also known as crowd lending, or social lending), allows people to borrow funds directly from another person, cutting out traditional lending sources (banks). Additionally, blockchain technology, if the hype is accurate, has the potential to eliminate the need of a financial intermediary altogether. 

Banks are adapting to this competition and to customers looking for more convenience and alternative services by offering new, unique services that differentiate themselves from others and provide added value to the customer. Banks have delivered through remote deposit, ATMs, and interactive teller machines (ITMs). Banks will need to continue to adopt innovative services to remain competitive. 

For instance, banks could offer video conferencing services, in which customers could have a live conversation with a bank representative through their smartphone. This convenience would allow a customer to conduct a transaction, such as apply for a loan, from the convenience of their home, while still maintaining human interaction throughout the transaction. Such a service would help banks compete with digital channels offered by non-banks, such as Quicken Loans, which is now the largest mortgage originator in the United States.

Strategies to protect against technological risks

These services all require the use of existing and new technologies, which have caused banks to hold more personally identifiable information (PII) digitally across an increasing number of digital platforms. As noted by the OCC, this digital exposure has created persistent cybersecurity risks for banks. Adopting a robust cybersecurity framework is no longer an option. 

Banks should bring cybersecurity to the forefront of their strategic planning. Any strategic plan must consider cybersecurity implications, as a single disaster can be detrimental to a bank’s reputation. And, given this rapidly changing environment, the cybersecurity conversation must be ongoing through relevant bank committees and the board of directors.

Furthermore, these technological solutions require partnerships with businesses that banks would not traditionally partner with. Financial technology (fintech) companies don’t just pose as a competitor to traditional banks. Many fintech companies are offering their technological solutions to traditional banks. However, outsourcing technological solutions to fintech companies and other businesses does not relieve a bank from performing its own due diligence and ensuring those companies meet the bank’s standards. 

Banks should evaluate potential vendors to ensure they comply with the bank’s vendor management policy. Since environments are constantly changing, this evaluation should be ongoing. Many vendors now provide System and Organization Controls (SOC) reports which detail the control environment at the vendor and involve independent third-party testing of those controls that exist at the vendor. SOC reports can provide a useful starting point for evaluating a vendor’s ongoing compliance with the bank’s vendor management policy. However, it is not a substitute for ongoing communication with a vendor.

There is no doubt 2019 was a successful year for banks. But past performance is not a guarantee of future success. Banks face many challenges, risks, and uncertainties, of which only a few have been outlined above. The current landscape may be challenging but it is also filled with opportunity. Banks should consider expanding their services, adopting new technologies, and partnering with other companies to leverage their strengths. Doing so should help position themselves for an exciting decade ahead.

If you have specific concerns about challenges facing your institution, please contact the team. 

Editor’s note: Read this if your organization is an entity with significant lease transactions with terms greater than a year.  

Updated: June 2020

The new Accounting Standards Codification Topic 842 (ASC 842) lease accounting standard is actually not that new. The Financial Accounting Standards Board (FASB) first released the standard in 2016 but, due to a series of delays, it hasn’t been required yet. Even with delays, some organizations have already started to implement ASC 842. They include:

1. Public business entities
2. Not-for-profits that have issued or are conduit bond obligors for securities traded, listed, or quoted on an exchange or an over the-counter market

All other entities will start implementing for fiscal years starting after December 15, 2021 and internal periods within fiscal years beginning after December 15, 2022 (January 1 for calendar reporting periods).

Here’s a quick rundown of the lease classifications and how they’ll impact your financial statements.  

Classifying leases

Under the new standards, leases fall into one of two classifications: finance leases and operating leases. This classification makes all the difference in how leases are reported in the financial statements. 

Finance lease

A finance lease essentially treats an asset as if it were purchased by the lessee and financed with funds from the lessor. This prevents companies from hiding financial obligations that are basically liabilities. ASC 842 requires leases to be classified as finance leases if they meet any of the following five criteria:

1. The lease transfers ownership of the underlying asset to the lessee by the end of the lease term.
2. The lease grants the lessee an option to purchase the underlying asset that the lessee is reasonably certain to exercise.
3. The lease term is for the major part of the remaining economic life of the underlying asset. However, if the commencement date falls at or near the end of the economic life of the underlying asset, this criterion shall not be used for purposes of classifying the lease.
4. The present value of the sum of the lease payments and any residual value guaranteed by the lessee that is not already reflected in the lease payments in accordance with paragraph 842-10-30-5(f) equals or exceeds substantially all of the fair value of the underlying asset.
5. The underlying asset is of such a specialized nature that it is expected to have no alternative use to the lessor at the end of the lease term.

As you can see from the five criteria, finance leases are just purchase arrangements financed over time. ASC 842 is designed to reflect that and improve transparency for investors and other stakeholders.  

Operating lease

Any lease not meeting any of the above criteria is classified as an operating lease. 

No more off-book leases

One of the problems ASC 842 seeks to solve is “off-book” operating leases that show up only as notes on the balance sheet and cloud the debt ratios of companies. Under the new standards, both operating and finance leases will be reported on the balance sheet. The only exceptions are certain leases with terms of 12 months of less. 

Recording finance vs. operating leases

With both operating and finance leases reported on the balance sheet, what’s the difference between the two? The major difference is the way they are recorded on the income statement:

• Interest and amortization are recorded separately on the income statement for finance leases.
• Operating leases will report a single line item based on the lease payment. 
• Principal repayments for finance lease are classified as financing activities.
• Payments on operating leases are classified as operating activities.

Next Steps 

Make sure you start by implementing for fiscal years starting after December 15, 2021 and internal periods within fiscal years beginning after December 15, 2022. If you have questions about finance or operating leases, or need help with the new standard, please don’t hesitate to contact the team. 

Download our lease classification infographic for a comparison of finance and operating leases under ASC 842.