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Strategies to Manage Operations During COVID – 19
Finance Office Hours for Health Centers:
@NACHC
America’s Voice for Community Health CareThe National Association of Community Health Centers (NACHC) was founded in 1971 to promote efficient, high quality, comprehensive health care that is accessible, culturally and linguistically competent, community directed, and patient centered for all.
THE NACHCMISSION
@NACHC
Hear from the field
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Cashflow
Staffing and FFCRA
Let’s Hear from You
Resources
www.nachc.org
Agenda
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@NACHC
Jeffrey Allen, CPA – Partner, BKD, LLPDavid Fields, CPA – Partner, BKD, LLP
Cash Flow Issues –COVID 19
@NACHC
Cash Flow Projections
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Revenue Cycle
Grant Funding
Loans
Operational Issues
Time Value of Money
www.nachc.org
Discussion Topics
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Cash Flow Projections
• Days cash on hand assessment –operating funds vs. reserves
• Estimate cash inflows in the near term• Grant funds• 340B• Patient service revenue
• Assessment of cash outflows in the near term
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Revenue Cycle
No breakdowns from appointment scheduling to cash
receipt
Clean up patient accounts receivable
Medicaid opportunities
Telehealth Opportunity
MedicareState Medicaid
@NACHCwww.nachc.org
• Eligibility
• Amount of Payment
• Processing Time
• Repayment
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Medicare Accelerated/ Advance Payments
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Grant Funding
CHC supplemental funds• Coronavirus supplemental funding for health centers• CARES Act
Other grants
Grants management issues with supplemental funding
Loans
• Line of credit important• SBA Paycheck Protection Loans
• Forgivable under certain terms• Must have less than 500 employees• Work with bank on loan
• Other loans are available
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Operational Issues
• Staffing issues are key
• Vendor relationships are key
Redeploying staff
Special projects Rightsizing
Staffing for the
rebound
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Time Value of Money
• A dollar today is worth more than a dollar 5 years from now• Short‐term cash flow needs vs. long‐term borrowing• Monitor cash flow needs each week and project out expected needs for the next few weeks to help ensure that funds are not depleted
• The battle over priorities ‐ short‐term vs. long‐term during the crisis
Follow Us on Twitter
@NACHC @chccpa@DavidFieldsCPA
Things to ConsiderStaff Reductions/ Families First Coronavirus Response Act
@NACHC
• Intro – disclaimer• Decision to reduce staff – considerations• New legislation related to leave and sick pay
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@NACHC
Decision Points and Considerations
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Need to Reduce Staff
• Leave of Absence• Furlough
• Layoff• Termination
Consider for each:• SUTA implications• Benefit implications• Probability of return
• Reduced pay and hours
@NACHC
Families First Coronavirus Act HR 6201
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Current Staff Absence COVID‐19 Affected
COVID related absence –take care of others(Sec 4‐6)
COVID related absence – take care of themselves(Sec 1‐3)
• Enhanced FMLA• Wage
continuation @ 2/3rds
• Requires Paid Sick Leave – 80 hrs @ 100%
• All mandated wages subsidized by credit to employer FICA obligation
@NACHC
General Overview
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Timeline Review ‐ Families First Coronavirus Response Act
Extended FML ‐ Care for Children
Choose..or
Employee Sick Pay ‐ Direct Employee Illness/Quarantine
Required FML Pay, 2/3 rate, $10,000 max
Employer's Standard Benefits (PTO, Disability etc.)
Day 11 ‐ Maximum
Day 11 ‐ MaximumAvailable company provided time off benefits (typically 100% pay)
Emergency Sick Pay 2/3 rate, $2000 max
Emergency Sick Pay 100% rate, $5110 max
Day 1‐ 10
Day 1‐ 10
@NACHCwww.nachc.org | 20
@NACHCwww.nachc.org
• Please consider joining our “Noddlepod” COVID site which:
consolidates the broad range of information on COVID‐19 from many different sources (e.g., BPHC, CMS, NACHC) in a single location where you can quickly find info on a specific topic.
To access this site, email [email protected] or [email protected].
• Reduced Workflows and Staffing Guidance for Non‐Clinical Operations
https://cdn1.digitellinc.com/uploads/nachc/articles/f6261a7b3a88e14e6dfcd7c83880be28.pdf
• BKD Cashflow Video
https://players.brightcove.net/627943769001/default_default/index.html?videoId=6146359021001
• Medicare Accelerated and Advance Payments Program
https://www.cms.gov/files/document/Accelerated‐and‐Advanced‐Payments‐Fact‐Sheet.pdf
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Resources
@NACHC
ARE YOU LOOKING FOR RESOURCES?Please visit our website www.healthcenterinfo.org
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