Page 5 - SFHN October 2021 Issue

The Telehealth Tax Checklist Thank You:

Florida’s Hospital Workforce
Your telehealth tax billing software maintain
questions, answered documentation on where I saw a sign the other day more nurses seemed like
Healthcare practices your patient is located to that said, “Not all heroes an obvious choice, but
implementing telehealth ensure you allocate revenue wear capes,” and next to there are not enough can-
often focus their efforts on properly? those words were the outline didates out there. In fact,
the marketing, technology, • Are you using billing of a medical professional in a our survey showed more
security and logistics of codes consistently and surgical mask. It is so true, than 40 percent of our
providing healthcare serv- accurately for the telehealth but not just because of the hospitals reported taking
ices to their patients and services you perform? work our doctors, nurses, longer than 60 days to fill
occasionally overlook tax • Are you tracking and hospital staff have per- a nurse vacancy.
and state regulatory consid- patient outcomes to under- formed during the pandemic; It’s no wonder burnout
erations. The very nature stand at what point your it is because of the heroic is taking a hold of the
of telehealth, which allows BY JIM WHITE performance obligations work they perform every day, nurses and medical pro-
for patient care delivery have been fulfilled? whether we acknowledge it BY MARY MAYHEW fessionals in our hospi-
across state lines, requires a • Do you have one cen- or not! tals. High vacancy rates,
careful analysis of federal and state tax tralized, easy-to-use dashboard to aggre- Most days, people don’t typically think high turnover rates, the length of time it
compliance obligations. Fortunately, gate all data related to telehealth visits of the hospital or the more than 280,000 takes to fill a nurse opening; then add a
BDO has resources that can help. and outcomes? doctors, nurses, therapists, and support record number of people in the hospital
Whether you are the owner of a small • Have you addressed potential sales staff who work there until we need them. due to COVID-19. It’s a difficult time to
startup or the tax director of a large and use tax obligations of providing tele- Instead, we simply take comfort knowing be a medical professional.
healthcare enterprise, BDO’s telehealth health technology in various jurisdic- they are there. But will that always be the So, what can a Floridian do?
tax checklist highlights information that tions? case? Get vaccinated! One of the best ways
should be gathered and common issues • With employees in various states and Even prior to COVID-19, hospitals to thank a nurse or doctor is not to see
to consider when assessing telehealth local jurisdictions, have payroll tax and across Florida and the nation faced a them for something you can protect
Federal and state tax obligations. Using withholding obligations been addressed? workforce crisis. The 24/7 hospital envi- yourself against, like COVID-19.
your knowledge in conjunction with this ronment is demanding and difficult. In Thank them - not just on the days you
checklist will help identify gaps in your 3. After you’ve implemented tele- addition, there are many healthcare jobs need them, but whenever you encounter
telehealth tax planning regardless of the health: outside of the hospital setting that have one of these brave men and women in
stage of implementation. • Have you recently conducted a nexus contributed to the workforce shortages. your neighborhood, at church, or in the
review for your organization? Then COVID-19 hit, and a bad situation store. Thank the doctors, nurses, and
1. Before you implement telehealth: • Do you have a list of all states in got even worse. staff who stayed on the job and encour-
• If you are a tax-exempt healthcare which you may have generated revenue According to a study this spring by the age those in school seeking to enter this
provider, have you analyzed whether via telehealth visits? Florida Hospital Association, prior to the noble profession.
telehealth revenues could result in • Are you staying up to date on new most recent surge in COVID-19, eleven Lastly, remember that our hospitals are
Unrelated Business Income Tax? telehealth tax compliance rules as states percent of registered nurse (RN) posi- more than just buildings; they are about
• Have you properly assessed and look for ways to increase revenues? tions at our hospitals were vacant. That the people who deliver lifesaving care
addressed HIPAA, HITECH and other • Are you confident that you are accu- number may not sound significant, but a every day. Maybe your kind word of
security risks? rately recognizing revenue for your tele- single nurse may be responsible for the thanks or a friendly gesture will be the
• Do you have records detailing where health visits? care of 6–8 patients in a general care set- inspiration a doctor, nurse, or hospital
all your equipment and employees are • Have you received any tax notices or ting during their shift. Thus, having one staff member needs to hang on just a lit-
located? letters from either the IRS or any states? in ten nursing positions vacant results in tle longer.
• Where are your patients who will be • Have you complied with all state and 60–80 fewer patients that can be served Florida hospitals are responding to this
accessing telehealth services located? local tax obligations in each state in or extra shifts and even longer hours for shortage by increasing efforts to recruit
• Do you know where your providers which you are providing telehealth serv- those on duty to make sure every patient and retain their existing staff. They are
are licensed to practice? ices? receives the care they need. also focusing on making more nurses
• Are you up to date on state-level cor- Those extra shifts and hours add up available to serve as faculty, expanding
porate practice of medicine laws? Need more telehealth tax help? and eventually take their toll. Last year training slots, creating apprenticeships,
• Do you have the resources to address Please contact Jim White, Tax Partner one in four nurses in Florida left the and providing additional career ladders
telehealth tax compliance in-house? and BDO, National Healthcare Tax Leader, field, including one in three critical care for nurses who want to move to
• Are you working with an attorney at jrwhite@bdo.com. nurses. Again, a bad situation worsened advanced practices.
and tax advisor with telehealth expert- as hospitals responded to record hospi- It will take everyone working together
ise? talizations and the need for critical care to let our tremendously talented medical
• Have you conducted a state-by-state Contact: as intensive care units were close to max- professionals know that we respect their
analysis to determine where your compa- Alfredo Cepero, Managing Partner imum capacity. Hospitals that already work and how much they mean to your
ny should be registered to do business? 305-420-8006 / acepero@bdo.com faced a shortage of nurses were now los- hospital, to your family, and to our com-
ing experienced nurses who were just munities.
2. While you’re implementing tele- Angelo Pirozzi, Partner packing up and leaving altogether or left
health: 646-520-2870 / apirozzi@bdo.com to work for staffing agencies that provide Mary Mayhew is President and CEO of
• Does your practice management and
nurses in Florida or around the country. the Florida Hospital Association.
Something had to be done. Hiring

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