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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. 

The AKS: Why free isn’t always free  

Imagine this: A medical device company offers a clinician an all-expenses-paid trip to a conference in Maui. Sounds great, right? Under AKS, it could be a felony. 

What the AKS says 

According to the AKS, it’s illegal to offer, solicit, or receive anything of value to influence referrals for services covered by federal healthcare programs. 

Real-world example: 

A physician accepts lavish dinners from a pharmaceutical representative and then prescribes that company’s drug more often. That’s a red flag under AKS. 

The penalties for convictions under the AKS are up to $100,000 per violation, 10 years in prison, and exclusion from Medicare/Medicaid. 

The Sunshine Act and OPP: Shining a light on industry relationships 

The Sunshine Act, enacted in 2010 as part of the Affordable Care Act, created the Open Payments Program (OPP) to make financial relationships between healthcare providers and the industry more transparent. 

How the Sunshine Act and OPP work 

Manufacturers of drugs, devices, and biologics report payments or transfers of value to physicians and teaching hospitals. CMS publishes OPP data annually, and anyone can look it up.  

Real-world example: 

A clinician attends a dinner sponsored by a medical device manufacturing company. That $150 meal? It’s reported and will appear in the Open Payments database for anyone to see. 

In 2024, CMS reported $13.18 billion in disclosed payments made to clinicians and hospitals, including general payments, research payments, and ownership or investment interests. Patients, journalists, and regulators review this data—so accuracy and transparency are critical. California now requires physicians to inform new patients about reviewing provider data in the OPP.

Key dates for the Sunshine Act and OPP: 

  • Data is collected year-round and submitted annually between February 1 and March 31. 
  • Covered recipients can review and dispute reported data between April 1 and May 30. 
  • Data for the preceding year is published by June 30 and then made publicly available. 

Practical tips for healthcare organizations:

  • Develop organizational policies: Many hospitals and healthcare organizations have ethical guidelines and policies surrounding the acceptance of gifts and other remuneration. 
  • Educate your team: Share basics with new staff as part of orientation and provide education regarding organizational policies, reporting limits, and how to review and dispute Open Payments data. 
  • Review annually: Ensure compliance by reviewing data reported under your institution yearly. 

Practical tips for clinicians:

  • Familiarize yourself with policies: Know your organization's ethics guidelines and gifts policies. 
  • Learn how to review data reported under your name:
    • Check your OPP profile: Review your Open Payments data annually between April 1 and May 15 to ensure accuracy and dispute any reported data, if necessary.  
    • Ask before you accept: If it feels like a reward, ask yourself, Would I do this if there were no gift involved? If unsure, consult your organization’s compliance department.

Why transparency matters 

Compliance isn’t about saying no to everything—it’s about making informed decisions that protect patients and your reputation. A “gift horse” might look appealing, but if it compromises trust and reputation, it’s not worth the ride. 

BerryDunn can help 

Our healthcare compliance team incorporates deep, hands-on knowledge with industry best practices to help your organization manage compliance and revenue integrity risks. Learn more about BerryDunn’s team and services.   

Additional resources on healthcare transparency laws 

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Navigating the Anti-Kickback Statute, Sunshine Act, and Open Payments Program

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. 

Learn from real-world success 

Across the country, small communities are proving that right-sized planning works. The most successful efforts share common traits: 

  • A clear, shared vision. 
  • Strong community engagement. 
  • Practical, phased implementation. 

These communities don’t try to do everything at once. Instead, they focus on what matters most, build momentum with early successes, and adapt as they go. 

Let’s break it down: 

1. Build a shared vision for your community, with your community

A compelling vision is the foundation of any master plan. This vision should capture the hopes and dreams of the community, not just the preferences of a few. 

To build this vision: 

  • Learn about your community's demographics, existing facilities, and unique character. 
  • Engage residents, staff, and local leaders in open conversations. 
  • Host visioning workshops to gather ideas and priorities. 
  • Draft a vision statement and set strategic, measurable goals. 
  • Validate your vision with the community to ensure broad support. 

2. Take stock: inventory and level of service 

Understanding what you have is just as important as knowing what you want. Conduct a thorough inventory of parks, trails, and amenities, and analyze how well they serve the community. 

Key steps include: 

  • Mapping all facilities and amenities. 
  • Assessing access and quality using level of service (LOS) analysis. 
  • Identifying underserved neighborhoods or groups. 
  • Visualizing gaps and opportunities for improvement. 

3. Engage the community creatively 

Community engagement is the heart of right-sized planning. Small communities may lack big budgets, but they have strong relationships and local knowledge. 

Effective engagement strategies: 

  • Meet people where they are—at markets, festivals, or parks. 
  • Use pop-up booths and intercept surveys for informal feedback. 
  • Form advisory groups representing diverse interests. 
  • Leverage existing community events to reach more residents. 
  • Use digital tools like online surveys and interactive maps for broader input. 
  • A mixed-method approach ensures everyone has a voice, from youth to seniors. 

4. Conduct a needs assessment 

A thoughtful needs assessment combines data with lived experience. This process uncovers what’s working, what’s missing, and what could be improved. 

Best practices: 

  • Collect quantitative data (surveys, usage stats, demographics). 
  • Gather qualitative insights (focus groups, interviews). 
  • Pay special attention to underserved groups. 
  • Compare current offerings with community desires to identify clear priorities. 

5. Prioritize and implement your master plan strategically 

Not every idea can be implemented at once. Prioritization ensures resources are used effectively and progress is visible. 

How to prioritize: 

  • Focus on actionable, high-impact projects rather than long wish lists. 
  • Break large projects into manageable phases. 
  • Match available resources—funding, staff, partnerships—to your goals. 
  • Collaborate with local schools, nonprofits, and neighboring communities. 

A helpful tool is the urgency-versus-feasibility matrix: 

Top priority High urgency, high feasibility (quick wins with big impact) 
Strategic challenges High urgency, low feasibility (important but harder to implement) 
Opportunistic projects Low urgency, high feasibility (easy to do, not urgent) 
Low priority Low urgency, low feasibility (not urgent, hard to do) 

Here's an example of how an urgency/feasibility matrix may look:

Right-sized planning empowers small communities to create parks and recreation master plans that are practical, inclusive, and achievable. By clarifying your purpose, building a shared vision, assessing needs, and prioritizing action, even the smallest community can create parks and recreation spaces that enrich lives for generations to come. 

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. 

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Right-sized planning: practical steps for small community parks and recreation master plans

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

Note: Graphs are for all FDIC-insured institutions unless the graph indicates it is only for FDIC-insured community banks. 

Financial Performance 

  • Quarterly net income rose by $756.9 million (9.9%) from the previous quarter to $8.4 billion, with 63.9% of community banks reporting an increase. 

  • Pretax return on assets increased to 1.46%, up 13 basis points quarter over quarter and 25 basis points year over year. 

  • Net interest margin rose to 3.73%, up 10 basis points from the prior quarter and 37 basis points year over year.

Costs and Efficiency 

  • Noninterest expense increased by $303 million (1.7%) from the previous quarter and has increased 7.9% year over year. 

  • Provision expenses decreased by 0.5% quarter over quarter and have increased 33.1% year over year, signaling growing concern over potential credit losses. 

  • Efficiency ratio declined to 60.28%, down 2.59% basis points from the prior quarter, indicating better cost control relative to revenue. 

Loan and Deposit Trends 

  • Loan and lease balances increased by $24.4 billion (1.3%) quarter over quarter and 5.2% year over year, led by nonfarm nonresidential CRE and 1–4 family residential loans. 

  • Domestic deposits rose 1.6% quarter over quarter and 5.1% year over year, with stronger growth in noninterest-bearing than interest-bearing accounts. 

  • Nearly 70% (69.5%) of community banks reported loan growth, and 60% reported deposit growth during the quarter. 

Asset Quality 

  • Past-due and nonaccrual loans (PDNA) decreased one basis point to 1.26%. 

  • Net charge-off ratio increased four basis points from the prior quarter to 0.23%, rising above the pre-pandemic average of 0.15%. 

  • Reserve coverage ratio continued to decline to 157.1%, indicating that allowance growth lagged increases in noncurrent loan balances. 

Capital and Structural Stability

  • Capital ratios improved modestly across the board: CBLR rose to 14.27%, and the leverage capital ratio remained at 11%. 

  • Unrealized losses on securities fell by $7.8 billion (18.8%) from the prior quarter to $33.6 billion total. 

  • Community bank count declined by 26 during the quarter due to mergers and transitions. 

Conclusion and Outlook 

The third quarter of 2025 reflected steady progress for community banks, with net income rising nearly 10% from the prior quarter and more than six in 10 institutions reporting stronger earnings. Net interest margin continued its upward trajectory, climbing 37 basis points year over year, while pretax return on assets also improved. At the same time, efficiency gains were evident as the ratio declined, signaling better cost management relative to revenue. However, rising noninterest expenses and elevated provision costs underscore ongoing concerns about credit quality. Although past-due and nonaccrual loans edged lower, net charge-offs increased above pre-pandemic averages, and reserve coverage ratios continued to weaken, suggesting that allowance growth will continue to rise for the foreseeable future. 

As we move deeper into the final stretch of 2025, community banks must remain attentive to both economic and regulatory developments. Recent federal tax changes allowing deductions for vehicle loan interest could stimulate consumer lending activity, particularly in auto finance, but may also introduce new competitive pressures and portfolio concentration risks. In this article, we provide further information on the impacts of the change in taxes on vehicle loan interest. Meanwhile, the issuance of ASU 2025-08 introduces updated accounting guidance that will affect recognition and measurement practices for acquisitive institutions, requiring banks to reassess reporting processes and internal controls related to the accounting for acquired loans. Further discussion of this change can be found in this article. Speaking of internal controls, the FDIC recently issued a final rule raising several key thresholds, including those that determine which institutions must comply with Part 363’s audit and internal control requirements. The final rule notably raises the asset threshold requiring an independent attestation of internal control effectiveness over financial reporting from $1 billion to $5 billion. To learn more, including a summary of the other threshold changes, read this article. Coupled with the active merger and acquisition market—evidenced by the decline in community bank count—these shifts highlight the importance of adaptability. With credit risk likely to continue to rise and regulatory changes on the horizon, community banks face a complex environment where resilience and proactive risk management will be critical. 

BerryDunn has a Federal Impacts page, where we frequently post updates related to the federal landscape. Check out this page for timely information that may impact your institution or your institution’s borrowers. We wish you the best of holidays and, as always, your BerryDunn team is here to help.

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FDIC Issues its Third Quarter 2025 Quarterly Banking Profile

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.  

This series is designed to empower board members with the insights and tools necessary to navigate change with confidence. Our experts, each a leader in their respective fields, will share real-world examples, practical frameworks, and actionable advice in a Q&A format, as well as lessons learned from their personal and professional journeys.   

Succession planning and developing future leaders

For the latest installment of our 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. 

Q. What do you consider the most critical elements of a successful succession planning strategy for leadership roles? 

A. There are several elements to succession planning, and the first one is clarity—being clear about how you want people to perform in your organization. You want to be consistent when eyeing possible internal candidates for leadership roles, and you want to make sure that you are developing them for future success.

Once you identify a potential successor for a leadership role, you want to make sure that you look at the skills they have today that they will need to take on that next-level role. You want to make sure you have the training, coaching, and mentoring in place to allow that person to grow into the role. The employee also needs to have a clear understanding of where the organization is going because if we just look at people to take over roles as of today, as opposed to the future, then you are not going to have the skill set that will allow the organization to grow.   

Finally, you must plan. It takes thoughtful discussions, and often it requires outside consultants to assist and keep you on track. It's easy to get caught up in the day-to-day of the organization and think that this is just going to happen without any pre-planning. But that's not true. It requires a solid plan to get you where you want to be. 

Q. In your experience, what are the biggest challenges companies face when preparing for leadership transitions, and how can they be mitigated?  

A. Planning. Leaders might know they want to grow the organization, but they don't always have the road map to get there, and succession planning for that growth is a key element. You need to sit down and be willing to talk openly about what this is going to look like from a transition standpoint. As an example, let’s consider an organization that unexpectedly loses its longtime CEO and has no succession plan in place. Not having someone marked to take over such a critical role is a huge disruption. As a result, they find themselves unable to make decisions that should have been addressed long ago. This puts the organization in a difficult position, and it will take time to move forward because no prior planning or consideration was done. It’s exactly the kind of scenario an organization should avoid—major transitions need intentional, proactive planning. 

Q. How do you assess and prepare internal candidates for C-suite readiness while maintaining confidentiality and minimizing disruption?  

A. It’s a struggle because not everyone is suited to take on that next-level role. Sometimes people reach a ceiling, but they may think that they can do more. Organizations must be clear about expectations, development, and skill sets—both current skills and gaps. If you are looking at an internal candidate for a potential leadership position in the future, you have to understand where they need to grow and tailor a growth plan for them through stretch assignments and training. You must be transparent about what you're doing. If someone is thinking that they're going to be taking on a leadership role, but they really don't have the skill set to do so, you need to be open to having conversations with them about those gaps. This includes sharing how they match up against others, without naming names, and making sure they understand what they must do to get to that next-level role, and whether they are even capable of it. You have to be realistic with them. These are difficult conversations, which is why most people avoid them. If you're not honest up front, it can cause angst and resentment down the road. 

Q. How do you identify and develop high-potential employees for future leadership roles without creating perceptions of favoritism or exclusivity?  

A. You need to be transparent and upfront about their capabilities, as well as where they need to grow and if they need training. Giving them a stretch assignment and analyzing their reaction can tell you a lot. If they really struggle with the assignment, you can have that conversation. You can explain that you are looking at everyone's capabilities, and this project didn't go as expected, which tells us that you're not ready yet. Here, you can offer the employee feedback on what they need to do to reach the leadership level. 

Q. In your experience, how can organizations balance the need for external executive hires with the development of internal talent pipelines?  

A. You need to really go back to your awareness of people's capabilities. If you don’t have anybody in the organization that can fill the vacant leadership role, and if you’ve never made a succession plan, then you need to view it from a recruiting standpoint. What’s the pipeline out there for talent for C-suite positions? Leaders in an organization can start by networking with others in the industry, with an eye for potential talent for the future.   

You need to always look towards that future vision, making sure that you're networking early and often. You've got to think deeply about whether you've done your succession planning. If there is no one that you're seeing who you can tap to take on that role, no matter how much development you do with them, it’s time to look externally.  

Q. What role does mentorship or coaching play in effective succession planning, and how do you structure those programs for impact?  

A. Coaching and mentoring play a significant role in most employees’ development. How do you help them become their best selves and advance their careers? Growth can’t rely solely on external training or earning additional degrees. It also comes from observing and modeling the behaviors of others—whether leaders or colleagues who have done the work before. You can’t overlook the skills, knowledge, experience, and education people already bring to the table. 

It’s especially frustrating when a long-term employee leaves and, when asked about their replacement, you discover that little to no effort was made to capture that person’s organizational knowledge. Too often, their expertise wasn’t transferred to anyone else. When they walk out the door, their institutional knowledge disappears with them. While starting fresh isn’t always a negative, in many cases, it forces the organization back to square one, requiring more time and effort. With proper foresight, that knowledge could have been captured, documented, and shared to make the transition seamless. 

Q. What strategies do you use to ensure succession plans reflect the organization’s long-term strategic goals and evolving leadership competencies?  

A. There needs to be alignment with your strategic plan. If you haven't executed a strategic plan, you need to make sure that you create one so you grow in the right direction. You want to make sure that the right people have the right skill sets for that growth. Succession planning should link directly to the organization's mission. Vision and strategic priorities can't be separated. Watch for methods used to anticipate future leadership needs, including emerging skills, leadership styles, and industry trends. You want to know where other organizations in your industry are headed and what tools they are using. What people are they tapping into? What new services are they offering? Make sure that your development program is solid and that it contributes to finding strong leaders in your organization. Have a robust mentoring program and training opportunities, and make sure that you're identifying those high-potential employees and have a conversation with them about the future. This is important because you don’t want a high-potential employee to leave thinking there is no future growth for them at the organization.  

Also, look for ongoing evaluation methods of talent reviews, performance metrics, and feedback loops that are going to ensure that your succession plan remains relevant over time. You're always going to be looking at that plan and updating it. Adaptability is also important. You have to stay relevant, making sure that you're changing over time to fit the needs of the organization today and in the future. 

Q. How do you measure the effectiveness of succession planning efforts in terms of leadership readiness, retention, and organizational resilience? 

A. It's important to track the number of key positions with at least one successor identified. You need to very succinctly look at each position and determine who your high-potential employees are for that role. Evaluate those successors through performance reviews and feedback loops, doing assessments and simulation exercises, such as what-if scenarios. Examine how often an internal candidate is successfully promoted to a leadership role compared to filling it with an outside candidate. From a talent management perspective, you want to keep a healthy balance between the two.  

Measure retention and consider your turnover rate, as well as what is causing it. What needs to be adjusted? Make sure that you know where all your employees stand, that your high performers know they're high performers, and that you're having conversations with them to let them know how valuable they are.  

The resiliency of an organization is another big piece. It’s essential to make sure that the organization can adapt to unexpected changes caused by departures or role transitions. You don’t want a change to cause a panic situation; you want to be prepared for the unexpected. 

Q. Looking ahead, how do you see succession planning evolving in response to changing workforce demographics and leadership expectations?  

A. Succession planning is becoming more strategic and forward-looking. Organizations are increasingly recognizing that failing to plan creates significant challenges. They must prioritize diversity, skills, and potential—not just tenure. A shorter-tenured employee can still be a high-potential performer who brings valuable perspectives. In fact, the two-year employee may be a stronger leadership successor than someone with 30 years in the organization, depending on their broader experience and background. Length of service alone shouldn’t be the determining factor. The workforce itself is shifting: the population is aging, and fewer young workers are entering the pipeline. Organizations must stay laser-focused on what this means for their future and for their industry as a whole. 

It’s also essential to be clear about your organization’s values, especially at the board level. Boards can’t sit passively and assume the organization will take care of everything—they need to ask thoughtful, informed questions to ensure long-term stability, success, and readiness. The more intentional the planning, the stronger the organization becomes. Boards should be accountable for understanding and overseeing the organization’s critical processes. 

About Sarah

As Director of Executive Recruiting, Sarah partners with clients to create high-impact leadership teams that support an organization’s mission and culture. Drawing from more than two decades of recruiting experience and a large network of professionals, she has the knowledge and resources to help connect clients with the best talent for their specific needs. Learn more about Sarah. 

BerryDunn partners with organizations to create work environments where business success and personal growth coexist and where people are confident knowing their workplace positively contributes to their well-being. We take a comprehensive approach to our workforce and well-being work, considering how business needs, organizational capacity, and the employee experience work together to drive your business forward. That’s why we initiate each executive search by learning our client’s values—allowing us to find a candidate who shares those values while also meeting technical qualifications. Once we understand a client’s culture and business demands, we go beyond the pool of “available” executives and turn to our deep resource network to find the ideal candidate. Learn more about our executive recruiting team and services. 

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Corporate board leadership: Core principles in strategic C-suite succession planning

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. 

What are software implementation costs? 

Software implementation costs include all expenses tied to integrating a new system into your organization’s operations. Whether it’s internally developed software, purchased solutions, or a cloud-based platform like SaaS, these costs vary based on complexity, company size, and scope.  

Where do hidden system implementation costs hide? 

Here’s the short answer—everywhere. The long answer? They lurk in: 

  • Licensing and subscriptions: These are the more obvious places where costs can surface.

  • Customization and configuration: "Out of the box” rarely fits perfectly, which often means additional work. 

  • Integration with existing systems: Getting your new system to work with your existing systems can be challenging. 

  • Data migration: Moving years of data is complicated and time-consuming. 

  • Training and change management: Much time and effort go into getting users up and running on the new system. 

  • Testing and post-launch support: Planning and getting support can sometimes lead to additional costs based on what you uncover. 

These costs stretch across phases—planning, development, testing, deployment, and post-launch support. If you’re not tracking them, your budget might feel like a magician’s hat: costs keep popping out of nowhere. 

Accounting for these hidden costs 

Here’s where the rules come in. According to Financial Accounting Standards Board (FASB) guidance (ASC 350-40, Accounting for Internal-Use Software), you need to separate costs that can be capitalized from those that must be expensed

  • Capitalize: Development-phase costs like coding, testing, installation, and direct labor. These go on the balance sheet and get amortized over the software’s useful life. 

  • Expense: Early-stage activities (e.g., feasibility studies, vendor selection), post-implementation efforts (e.g., training, maintenance), and general overhead. These hit your bottom line immediately. 

Materiality can also be considered. Smaller costs may be expensed for simplicity. 

Why hidden software implementation costs matter to nonprofits 

Software implementation costs aren’t just accounting trivia; they’re the difference between a smooth upgrade and a budget wedding. In today’s digital-first world, knowing which costs to capitalize and which to expense isn’t just good practice; it’s essential for keeping your financials clean and your auditors happy. Think of it like planning a wedding: some items are lasting investments—like the photography and rings (capitalized), while others are one-day details, like flowers or catering (expensed). When in doubt, lean on the pros—your accounting team and trusty guidance like ASC 350-40. Treat these costs like the strategic investment they are and your balance sheet will be better for it. 

BerryDunn can help 

The right system can help your organization increase efficiencies, reduce risk, and make informed, data-driven decisions. Implementing a new system is a critical decision with significant business impacts. BerryDunn’s team can provide assessment, system evaluation, and implementation services for ERP systems for nonprofits, such as financial and student information systems, and can expertly guide you through the process. Learn more about our services and team.  

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Hidden software implementation costs: What nonprofits need to know