Tackle Challenges in the Long-Term and Senior Living Markets
The long-term care and senior living markets have unique performance needs and challenges. As one of the top 10 public accounting and consulting firms in the United States, Crowe Horwath LLP has developed the depth and breadth of industry experience and expertise needed to understand the operating environment, critical issues, and unique culture of nursing homes and continuing care retirement communities (CCRCs).
Crowe is an active member and regular contributor to the Life Services Network (LSN) and the American Association of Homes and Services for the Aging (AAHSA), among others. We are committed to supporting national, state, and local healthcare organizations in furthering advances in patient care, and to providing thought leadership to members in the disciplines of revenue, operations, and risk management.
This industry involvement and experience help Crowe develop successful solutions for nursing home and CCRC clients, as demonstrated in this case study:
Nursing Home Acquisition Case Study
A 25-facility, 3,000-bed nursing home company was experiencing patient days declining by two percent, while net revenues and earnings before interest, taxes, depreciation, and amortization (EBITDA) from year one to year two were increasing slightly. At the same time, net accounts receivable had increased by $5 million in the same period, of which $4 million was related to accounts receivable older than 180 days.
This private equity company engaged Crowe to help assess the quality of the earnings and assets. Crowe’s transaction advisory experience, combined with a thorough understanding of business office operations in skilled nursing facilities, their revenue cycle processes and government reimbursements resulted in the current year net revenues (net of bad-debt expense) being overstated by approximately $3.5 million and accounts receivable being overstated by the same amount at the ending balance sheet date.
What Crowe’s clients from nursing homes and CCRCs say:
"We went through an extensive evaluation process before choosing Crowe as our accounting firm. I’ve never regretted the decision. From the beginning we were impressed with their experience in senior living and long-term care. As we’ve continued to work with them over the years, they bring new information and helpful insights to our business. They’re dependable, timely, and very efficient in their use of resources. Our final reports are done when we need them and they do an outstanding job of presenting audit and financial statements to our board. We have enormous trust and confidence in the work they do for us.”
-- Glenn Brichacek, President/CEO, The Admiral at the Lake
"I’ve worked with Crowe on financial audits and found them to be very, very diligent in adhering to schedules, which means we get the outcomes we expect. There are realistic expectations on both sides and I can count on excellent two-way communication. But what really shines in my mind is the review of financial statements they did for us in conjunction with a bond offering we made to reposition one of our facilities. In the past 17 years, I’ve done many bond offerings, and Crowe is the absolute best I’ve worked with. They were thorough and they stayed on top of it. Even our investment banking firm, working with them for the first time, was impressed.”
-- Michael Flynn, Chief Executive Officer, Smith Senior Living
"They are always willing to talk to us, answer questions, and address any concerns that come up. We know that they’ll be available to help when we need them. We’ve worked with Crowe for 12 years, and I don’t know any other firm I’d want to work with. When we added independent living apartments, they helped us organize the financing. They have close contact with my board. I trust them, and I know they’re going to do what’s best for us.”
-- Mary Haverstick, Administrator, Saint Anne Home and Retirement Community
"I’ve been through one successful audit with Crowe, and we’re starting our second. They’ve also helped us with issues that have come up, including reviewing our bond documents to determine our debt tolerance threshold as we enter the master planning phase of an expansion. They’re accessible, they respond quickly, and they ask questions to ensure they have a full and accurate understanding of our issues. They also work very well with our on-site staff. I’m very happy with our relationship with Crowe.”
-- Jonathan Cook, Executive Director, Marquette Manor