Page 5 - SOUTH FLORIDA HOSPITAL NEWS OCT 2021 ISSUE
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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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        South Florida Hospital News                                                              southfloridahospitalnews.com                                                          October 2021                            5
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