Healthcare
Audit, tax, cost report, and advisory support for healthcare providers, built on roughly 20 years of work with facilities across about 35 states.
Overview
Pease Bell has served healthcare providers for about 20 years, and today our team works with roughly 600 facilities in about 35 states. Our clients range from long-term care and senior living operators to hospitals and outpatient practices, and they share a set of pressures that general business accountants often miss: reimbursement tied to government programs, cost reporting, lender and regulator reporting, and ownership structures that separate the operating business from the real estate. We bring audit, tax, and advisory work under one roof so those pieces are handled by people who know how they connect.
Much of our healthcare work centers on Medicare and Medicaid cost reports and on HUD Section 232 financed properties, where annual audited financial statements and lender reporting are part of keeping a loan in good standing. We also help owners with entity structure, transactions, and tax planning as their organizations grow or change hands. From our Cleveland, Ohio headquarters, we work with providers across the country, whether a client operates a single location or a multi-state portfolio.
How We Help Healthcare Providers
Financial Statement Audits
Audits and reviews of healthcare organizations’ financial statements for owners, boards, lenders, and regulators, including the patient revenue, third-party settlement, and estimate areas that receive close scrutiny.
Medicare and Medicaid Cost Reports
Preparation and review of Medicare and state Medicaid cost reports, with attention to cost allocation, statistics, and supporting documentation that holds up when the report is reviewed or audited.
HUD Section 232 Compliance
Annual audits and reporting support for facilities financed under HUD’s Section 232 program, coordinated with lender and HUD requirements so submissions are complete and consistent with your books.
Healthcare Tax Services
Federal and state tax compliance and planning for healthcare operators and their owners, including pass-through entities, multi-state filings, and the tax side of operating company and property company structures.
Transaction Advisory
Quality of earnings, tax diligence, and valuation support for buyers, sellers, and lenders involved in healthcare acquisitions, recapitalizations, and ownership changes, with findings presented in terms owners and lenders can act on.
Outsourced Accounting
Monthly accounting, close, and financial reporting support for providers that need experienced healthcare accounting help without building a larger internal finance team, including reporting by facility or location.
Explore Healthcare
Skilled Nursing & Long-Term Care
Cost reports, audits, and reimbursement strategy for operators across the continuum of care.
Learn more →Assisted Living
Audits, HUD 232 reporting support, entity structuring, and tax services for assisted living facilities, senior living communities, and CCRCs.
Learn more →Behavioral Health
Audits, cost reports, and Medicaid compliance for behavioral health and human services providers.
Learn more →Hospitals
Cost reports, audits, Form 990 support, and reimbursement analysis for community hospitals and critical access hospitals.
Learn more →Dental Practices
Tax planning, entity structure, acquisition support, and outsourced accounting for single-location practices, multi-location groups, and dental service organizations.
Learn more →Challenges We Help Healthcare Providers Address
- ✓Cost reports that must reconcile to audited financials and survive review
- ✓Reimbursement changes that shift margins and complicate revenue estimates
- ✓HUD and lender reporting requirements with little room for error
- ✓Ownership structures that separate operations from real estate
- ✓Acquisitions and ownership changes that require clean, defensible financial information
Featured Insights
Frequently Asked Questions
What accounting services do healthcare providers need?
Most healthcare providers need a financial statement audit or review, tax compliance and planning, and, if they participate in Medicare or Medicaid, cost report preparation. Providers with HUD-insured mortgages or outside lenders also have annual reporting obligations. Pease Bell handles audit, tax, cost reports, and advisory under one roof, which helps keep these deliverables consistent with each other.
Does Pease Bell prepare Medicare cost reports?
Yes. Cost report preparation is a core part of our healthcare practice. We prepare and review Medicare cost reports and state Medicaid cost reports for providers, working from your general ledger and statistical data. Because we also perform audits and tax work, we can help reconcile cost report figures to your financial statements and respond to questions from contractors or state agencies.
What is a HUD Section 232 loan?
Section 232 is a HUD program that insures mortgages for residential care facilities such as skilled nursing facilities and assisted living facilities. Borrowers take on ongoing reporting obligations, including annual audited financial statements. Pease Bell audits and supports HUD 232 financed facilities and coordinates with lenders so reporting is accurate and complete.
Do you work with healthcare providers outside Ohio?
Yes. Pease Bell is headquartered in Cleveland, Ohio, and our healthcare team works with roughly 600 facilities in about 35 states. Much of the work, including cost reports, audits, and tax filings, can be performed remotely with periodic on-site visits when an engagement requires them.
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