Walters & Associates CPAs

10/22/2026

Most home health and hospice agencies work with several partners: a bookkeeper for the books, a biller for claims, a specialist for the cost report, maybe a planner for the owner's own finances.

Each one sees a slice of the business. None of them sees the whole thing.

That gap tends to show up at the worst times: during a sale, during an audit, during a CAP year that is not going the way anyone expected.

In practice, that can mean a month-end close that waits on the slowest vendor, a cost report that does not match the general ledger, and a buyer’s review that surfaces differences the owner did not know existed.

Walters & Associates, CPAs works across accounting, tax planning, Medicare and Medicaid cost reporting, and hospice CAP accounting, so the team preparing one number can see the others.

Billing runs through our sister company, Walters Billing Solutions, and owners can work with our affiliated RIA, Walters Strategic Advisors, on their personal finances.

If your agency’s financial picture lives across several vendors, ask how long it would take to produce one reconciled view.

The answer shows what the gap costs.

See how our outsourced accounting works: https://waltersaccounting.com/services/outsourced-accounting-services/

10/19/2026

The CAP year that closed on September 30 and the one that opened on October 1 both need attention now.

The year that closed is a filing. The self-determined CAP report is due by February 28 and can be submitted as early as December 31.

The data comes from the Provider Statistical & Reimbursement (PS&R) Report.

Pulling it as soon as it is available gives the agency the most time to plan for any liability.

The year that opened is a monitoring job. The CAP amount for FY 2027 is $36,174.75 per beneficiary, and exposure starts building with the first admission.

Clean claims do not keep a hospice under the CAP. Payments measured against the number of beneficiaries do.

Walters & Associates, CPAs prepares the self-determined CAP report and monitors CAP monthly, so the number is visible while it can still change.

If no one on your team can say where the agency stands against the new CAP year today, set up the monthly check this week:

https://waltersaccounting.com/services/hospice-cap-accounting-services/

10/14/2026

A home health agency files its Notice of Admission (NOA) six days after the start of care, one day past the five-day window. That can cut the 30-day Medicare payment by 20%.

The reduction is 1/30 of the 30-day payment for each day from the start of care until the NOA is filed. Six days is 6/30, so missing the window by one day costs six days of payment.

In Episode 4 of The Home Health and Hospice Profitability Podcast, Doug Walters and Amanda Sheldon, who leads the billing team at Walters Billing Solutions, walk through what happens at intake and before billing that decides whether an agency gets paid.

Listen to the episode:
https://www.youtube.com/watch?v=csoGWPGP9VU

09/30/2026

Is your hospice agency over the Medicare aggregate cap? Or not sure yet?

That uncertainty is the expensive part: a cap demand can range from a few thousand dollars to well into the millions, and the exposure can continue to change after the cap period closes.

So, Doug Walters, CPA, brought Lisa Rivard, Healthcare Consultant at Walters Accounting, back on the podcast to talk through exactly that.

After their first conversation on hospice cap exposure brought in a lot of listener questions, they went further this time: what to do once you know a liability is developing.

In this episode:

- Why cap exposure does not end when the cap period closes
- What proactive cap monitoring catches that a single year-end report cannot
- What to do the moment a potential liability starts forming

Watch episode three: https://youtu.be/VQgbAC666b4

The earlier the risk exposure is identified, the more opportunity there is to plan ahead of a demand.

09/22/2026

Most agencies have a productivity target: 30 points a week, five visits a day, a caseload of 15. Few can explain where the number came from.

And that matters, because when a target does not match what a clinician can complete in a week, someone absorbs the gap: documentation pushed into the evening, visits getting rushed, and eventually the agency's best clinicians leaving.

In episode two, Doug Walters, CPA, builds a productivity number from the ground up, using real hours and real visit times instead of a number that was simply inherited.

In this episode:

- Why 2,080 paid hours a year is not the same as 2,080 hours available for visits
- How productivity affects labor cost per visit, and why more visits does not always mean a lower cost
- The three productivity mistakes agencies make most often

Watch episode two:
https://www.youtube.com/watch?v=WMqFWYUNMJY

More episodes are coming.

09/14/2026

The Home Health and Hospice Profitability Podcast is now live.

Hosted by Doug Walters, CPA, the new Walters podcast brings practical conversations about the financial, operational, and regulatory issues affecting home health and hospice agencies.

In the first episode, Doug is joined by Lisa Rivard, Healthcare Consultant at Walters Accounting, to discuss hospice cap exposure and why an agency can appear to be under the limit and still receive a demand later.

Watch the first episode:
https://www.youtube.com/watch?v=IEwt2F5Ad-o

More episodes are coming.

Walters & Associates, CPAs: https://waltersaccounting.comWalters B...

09/04/2026

A Medicare settlement notice rarely reflects the decisions made at the time of filing. By the time a final number is available, the fiscal year has long since closed, and the exposure has already been locked in.

Your cap position was shaped months earlier by admissions patterns and length-of-stay dynamics. Overhead allocations were set the moment administrative or clinical leadership salaries were split across cost centers. Often, those decisions are finalized in an afternoon and never revisited.

A cost report merely reconciles exposure; operational and accounting practices create it.

The strategic question for leadership isn't what the settlement looks like at year-end, but whether those key cost drivers are being monitored while you still have runway to adjust course.

Identifying the three or four variables with the greatest impact on your bottom line, and shifting them from an annual filing checklist to a proactive quarterly review, transforms reimbursement from a retrospective surprise into a manageable financial process.

08/25/2026

Doug Walters recently joined The Nurse Registry Podcast to discuss Proof of Financial Ability to Operate and the financial requirements prospective Florida nurse registry owners need to address during the AHCA licensing process.

The conversation covers financial projections, funding requirements, and common issues that can delay an application.

If you are planning to open a nurse registry in Florida, this episode will help you better understand what to expect.

Listen here:
https://open.spotify.com/episode/7KgLl4nZBRLhIokB9mUNsj

Nurse Registry Podcast · Episode

08/07/2026

Week three, and the first claim comes back denied. Everyone looks at each other.

The license came through. The EMR was configured, the billing vendor was signed, payroll ran clean twice. Every box on the go-live checklist was ticked.

None of that told anyone who works a denial, how fast it gets worked, or where the delay lands in the numbers three months from now, when somebody is trying to work out why cash is behind the census.

That is the test the checklist never runs.

Before go-live, walk one denied claim through your process out loud. Name the person at each step. Wherever the room goes quiet is the part you have not built yet.

07/30/2026

A home health or hospice organization can be busy, growing, and meeting its compliance requirements while leadership still lacks a clear view of what is happening financially. Cash becomes less predictable, reports arrive too late to guide decisions, and reimbursement or CAP exposure surfaces when there is less room to respond. These problems can begin earlier in gaps between documentation, billing, accounting, and reporting.

Walters & Associates CPAs provides specialized, CPA-led financial structure and revenue visibility for home health and hospice organizations. We help leadership strengthen accounting, reporting, tax coordination, reimbursement-related financial oversight, and business financial planning, so leadership has clearer revenue visibility and more reliable information for decisions.

This Page is for owners, CFOs, administrators, and billing or reimbursement leaders. We will share practical guidance on:

- Cash conversion and revenue visibility
- Reporting quality and management decision support
- Medicare cost reports and Hospice CAP
- The financial structure required for growth
- Financial readiness before Day 1

Follow Walters & Associates CPAs for practical guidance on financial visibility, reporting, reimbursement risk, and the structure required for sustainable growth.