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Patient care is built on trust—and that trust can be compromised when financial relationships aren’t transparent. That’s why compliance laws like the Anti-Kickback Statute (AKS), the Sunshine Act, and the Open Payments Program (OPP) exist. They are designed to promote transparency in healthcare. This article breaks down the essentials and explores what the laws mean for healthcare organizations and clinicians. 

The AKS: Why free isn’t always free  

Imagine this: A medical device company offers a clinician an all-expenses-paid trip to a conference in Maui. Sounds great, right? Under AKS, it could be a felony. 

What the AKS says 

According to the AKS, it’s illegal to offer, solicit, or receive anything of value to influence referrals for services covered by federal healthcare programs. 

Real-world example: 

A physician accepts lavish dinners from a pharmaceutical representative and then prescribes that company’s drug more often. That’s a red flag under AKS. 

The penalties for convictions under the AKS are up to $100,000 per violation, 10 years in prison, and exclusion from Medicare/Medicaid. 

The Sunshine Act and OPP: Shining a light on industry relationships 

The Sunshine Act, enacted in 2010 as part of the Affordable Care Act, created the Open Payments Program (OPP) to make financial relationships between healthcare providers and the industry more transparent. 

How the Sunshine Act and OPP work 

Manufacturers of drugs, devices, and biologics report payments or transfers of value to physicians and teaching hospitals. CMS publishes OPP data annually, and anyone can look it up.  

Real-world example: 

A clinician attends a dinner sponsored by a medical device manufacturing company. That $150 meal? It’s reported and will appear in the Open Payments database for anyone to see. 

In 2024, CMS reported $13.18 billion in disclosed payments made to clinicians and hospitals, including general payments, research payments, and ownership or investment interests. Patients, journalists, and regulators review this data—so accuracy and transparency are critical. California now requires physicians to inform new patients about reviewing provider data in the OPP.

Key dates for the Sunshine Act and OPP: 

  • Data is collected year-round and submitted annually between February 1 and March 31. 
  • Covered recipients can review and dispute reported data between April 1 and May 30. 
  • Data for the preceding year is published by June 30 and then made publicly available. 

Practical tips for healthcare organizations:

  • Develop organizational policies: Many hospitals and healthcare organizations have ethical guidelines and policies surrounding the acceptance of gifts and other remuneration. 
  • Educate your team: Share basics with new staff as part of orientation and provide education regarding organizational policies, reporting limits, and how to review and dispute Open Payments data. 
  • Review annually: Ensure compliance by reviewing data reported under your institution yearly. 

Practical tips for clinicians:

  • Familiarize yourself with policies: Know your organization's ethics guidelines and gifts policies. 
  • Learn how to review data reported under your name:
    • Check your OPP profile: Review your Open Payments data annually between April 1 and May 15 to ensure accuracy and dispute any reported data, if necessary.  
    • Ask before you accept: If it feels like a reward, ask yourself, Would I do this if there were no gift involved? If unsure, consult your organization’s compliance department.

Why transparency matters 

Compliance isn’t about saying no to everything—it’s about making informed decisions that protect patients and your reputation. A “gift horse” might look appealing, but if it compromises trust and reputation, it’s not worth the ride. 

BerryDunn can help 

Our healthcare compliance team incorporates deep, hands-on knowledge with industry best practices to help your organization manage compliance and revenue integrity risks. Learn more about BerryDunn’s team and services.   

Additional resources on healthcare transparency laws 

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Navigating the Anti-Kickback Statute, Sunshine Act, and Open Payments Program

In small towns and rural communities, parks and recreation spaces are vital to quality of life. They’re where neighbors connect, children play, and local traditions thrive. Yet, developing a master plan for these spaces can feel overwhelming—especially with limited budgets and staff. The good news is that effective planning doesn’t have to be complicated or costly. With a right-sized approach, small communities can create practical, actionable master plans that reflect their unique needs and aspirations. 

Learn from real-world success 

Across the country, small communities are proving that right-sized planning works. The most successful efforts share common traits: 

  • A clear, shared vision. 
  • Strong community engagement. 
  • Practical, phased implementation. 

These communities don’t try to do everything at once. Instead, they focus on what matters most, build momentum with early successes, and adapt as they go. 

Let’s break it down: 

1. Build a shared vision for your community, with your community

A compelling vision is the foundation of any master plan. This vision should capture the hopes and dreams of the community, not just the preferences of a few. 

To build this vision: 

  • Learn about your community's demographics, existing facilities, and unique character. 
  • Engage residents, staff, and local leaders in open conversations. 
  • Host visioning workshops to gather ideas and priorities. 
  • Draft a vision statement and set strategic, measurable goals. 
  • Validate your vision with the community to ensure broad support. 

2. Take stock: inventory and level of service 

Understanding what you have is just as important as knowing what you want. Conduct a thorough inventory of parks, trails, and amenities, and analyze how well they serve the community. 

Key steps include: 

  • Mapping all facilities and amenities. 
  • Assessing access and quality using level of service (LOS) analysis. 
  • Identifying underserved neighborhoods or groups. 
  • Visualizing gaps and opportunities for improvement. 

3. Engage the community creatively 

Community engagement is the heart of right-sized planning. Small communities may lack big budgets, but they have strong relationships and local knowledge. 

Effective engagement strategies: 

  • Meet people where they are—at markets, festivals, or parks. 
  • Use pop-up booths and intercept surveys for informal feedback. 
  • Form advisory groups representing diverse interests. 
  • Leverage existing community events to reach more residents. 
  • Use digital tools like online surveys and interactive maps for broader input. 
  • A mixed-method approach ensures everyone has a voice, from youth to seniors. 

4. Conduct a needs assessment 

A thoughtful needs assessment combines data with lived experience. This process uncovers what’s working, what’s missing, and what could be improved. 

Best practices: 

  • Collect quantitative data (surveys, usage stats, demographics). 
  • Gather qualitative insights (focus groups, interviews). 
  • Pay special attention to underserved groups. 
  • Compare current offerings with community desires to identify clear priorities. 

5. Prioritize and implement your master plan strategically 

Not every idea can be implemented at once. Prioritization ensures resources are used effectively and progress is visible. 

How to prioritize: 

  • Focus on actionable, high-impact projects rather than long wish lists. 
  • Break large projects into manageable phases. 
  • Match available resources—funding, staff, partnerships—to your goals. 
  • Collaborate with local schools, nonprofits, and neighboring communities. 

A helpful tool is the urgency-versus-feasibility matrix: 

Top priority High urgency, high feasibility (quick wins with big impact) 
Strategic challenges High urgency, low feasibility (important but harder to implement) 
Opportunistic projects Low urgency, high feasibility (easy to do, not urgent) 
Low priority Low urgency, low feasibility (not urgent, hard to do) 

Here's an example of how an urgency/feasibility matrix may look:

Right-sized planning empowers small communities to create parks and recreation master plans that are practical, inclusive, and achievable. By clarifying your purpose, building a shared vision, assessing needs, and prioritizing action, even the smallest community can create parks and recreation spaces that enrich lives for generations to come. 

BerryDunn's consultants work with you to improve operations, drive innovation, identify improvements to services based on community need, and elevate your brand and image―all from the perspective of our team’s combined 100 years of hands-on experience. We provide practical park solutions, recreation expertise, and library consulting. Learn more about our team and services. 

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Right-sized planning: practical steps for small community parks and recreation master plans

The FDIC's Quarterly Banking Profile for quarter three 2025 reports the performance for the 3,953 community banks evaluated. Here are the key highlights: 

Note: Graphs are for all FDIC-insured institutions unless the graph indicates it is only for FDIC-insured community banks. 

Financial Performance 

  • Quarterly net income rose by $756.9 million (9.9%) from the previous quarter to $8.4 billion, with 63.9% of community banks reporting an increase. 

  • Pretax return on assets increased to 1.46%, up 13 basis points quarter over quarter and 25 basis points year over year. 

  • Net interest margin rose to 3.73%, up 10 basis points from the prior quarter and 37 basis points year over year.

Costs and Efficiency 

  • Noninterest expense increased by $303 million (1.7%) from the previous quarter and has increased 7.9% year over year. 

  • Provision expenses decreased by 0.5% quarter over quarter and have increased 33.1% year over year, signaling growing concern over potential credit losses. 

  • Efficiency ratio declined to 60.28%, down 2.59% basis points from the prior quarter, indicating better cost control relative to revenue. 

Loan and Deposit Trends 

  • Loan and lease balances increased by $24.4 billion (1.3%) quarter over quarter and 5.2% year over year, led by nonfarm nonresidential CRE and 1–4 family residential loans. 

  • Domestic deposits rose 1.6% quarter over quarter and 5.1% year over year, with stronger growth in noninterest-bearing than interest-bearing accounts. 

  • Nearly 70% (69.5%) of community banks reported loan growth, and 60% reported deposit growth during the quarter. 

Asset Quality 

  • Past-due and nonaccrual loans (PDNA) decreased one basis point to 1.26%. 

  • Net charge-off ratio increased four basis points from the prior quarter to 0.23%, rising above the pre-pandemic average of 0.15%. 

  • Reserve coverage ratio continued to decline to 157.1%, indicating that allowance growth lagged increases in noncurrent loan balances. 

Capital and Structural Stability

  • Capital ratios improved modestly across the board: CBLR rose to 14.27%, and the leverage capital ratio remained at 11%. 

  • Unrealized losses on securities fell by $7.8 billion (18.8%) from the prior quarter to $33.6 billion total. 

  • Community bank count declined by 26 during the quarter due to mergers and transitions. 

Conclusion and Outlook 

The third quarter of 2025 reflected steady progress for community banks, with net income rising nearly 10% from the prior quarter and more than six in 10 institutions reporting stronger earnings. Net interest margin continued its upward trajectory, climbing 37 basis points year over year, while pretax return on assets also improved. At the same time, efficiency gains were evident as the ratio declined, signaling better cost management relative to revenue. However, rising noninterest expenses and elevated provision costs underscore ongoing concerns about credit quality. Although past-due and nonaccrual loans edged lower, net charge-offs increased above pre-pandemic averages, and reserve coverage ratios continued to weaken, suggesting that allowance growth will continue to rise for the foreseeable future. 

As we move deeper into the final stretch of 2025, community banks must remain attentive to both economic and regulatory developments. Recent federal tax changes allowing deductions for vehicle loan interest could stimulate consumer lending activity, particularly in auto finance, but may also introduce new competitive pressures and portfolio concentration risks. In this article, we provide further information on the impacts of the change in taxes on vehicle loan interest. Meanwhile, the issuance of ASU 2025-08 introduces updated accounting guidance that will affect recognition and measurement practices for acquisitive institutions, requiring banks to reassess reporting processes and internal controls related to the accounting for acquired loans. Further discussion of this change can be found in this article. Speaking of internal controls, the FDIC recently issued a final rule raising several key thresholds, including those that determine which institutions must comply with Part 363’s audit and internal control requirements. The final rule notably raises the asset threshold requiring an independent attestation of internal control effectiveness over financial reporting from $1 billion to $5 billion. To learn more, including a summary of the other threshold changes, read this article. Coupled with the active merger and acquisition market—evidenced by the decline in community bank count—these shifts highlight the importance of adaptability. With credit risk likely to continue to rise and regulatory changes on the horizon, community banks face a complex environment where resilience and proactive risk management will be critical. 

BerryDunn has a Federal Impacts page, where we frequently post updates related to the federal landscape. Check out this page for timely information that may impact your institution or your institution’s borrowers. We wish you the best of holidays and, as always, your BerryDunn team is here to help.

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FDIC Issues its Third Quarter 2025 Quarterly Banking Profile

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. As the challenges facing companies grow increasingly complex, from disruptive technological trends to shifting societal expectations, the board's role has never been more critical.  

This series is designed to empower board members with the insights and tools necessary to navigate change with confidence. Our experts, each a leader in their respective fields, will share real-world examples, practical frameworks, and actionable advice in a Q&A format, as well as lessons learned from their personal and professional journeys.   

Succession planning and developing future leaders

For the latest installment of our board leadership series, BerryDunn Director of Executive Recruiting, Sarah Olson, shares key insights on leadership transitions, including identifying high-potential employees, offering internal leadership development, and prioritizing the development of a strategic succession plan. 

Q. What do you consider the most critical elements of a successful succession planning strategy for leadership roles? 

A. There are several elements to succession planning, and the first one is clarity—being clear about how you want people to perform in your organization. You want to be consistent when eyeing possible internal candidates for leadership roles, and you want to make sure that you are developing them for future success.

Once you identify a potential successor for a leadership role, you want to make sure that you look at the skills they have today that they will need to take on that next-level role. You want to make sure you have the training, coaching, and mentoring in place to allow that person to grow into the role. The employee also needs to have a clear understanding of where the organization is going because if we just look at people to take over roles as of today, as opposed to the future, then you are not going to have the skill set that will allow the organization to grow.   

Finally, you must plan. It takes thoughtful discussions, and often it requires outside consultants to assist and keep you on track. It's easy to get caught up in the day-to-day of the organization and think that this is just going to happen without any pre-planning. But that's not true. It requires a solid plan to get you where you want to be. 

Q. In your experience, what are the biggest challenges companies face when preparing for leadership transitions, and how can they be mitigated?  

A. Planning. Leaders might know they want to grow the organization, but they don't always have the road map to get there, and succession planning for that growth is a key element. You need to sit down and be willing to talk openly about what this is going to look like from a transition standpoint. As an example, let’s consider an organization that unexpectedly loses its longtime CEO and has no succession plan in place. Not having someone marked to take over such a critical role is a huge disruption. As a result, they find themselves unable to make decisions that should have been addressed long ago. This puts the organization in a difficult position, and it will take time to move forward because no prior planning or consideration was done. It’s exactly the kind of scenario an organization should avoid—major transitions need intentional, proactive planning. 

Q. How do you assess and prepare internal candidates for C-suite readiness while maintaining confidentiality and minimizing disruption?  

A. It’s a struggle because not everyone is suited to take on that next-level role. Sometimes people reach a ceiling, but they may think that they can do more. Organizations must be clear about expectations, development, and skill sets—both current skills and gaps. If you are looking at an internal candidate for a potential leadership position in the future, you have to understand where they need to grow and tailor a growth plan for them through stretch assignments and training. You must be transparent about what you're doing. If someone is thinking that they're going to be taking on a leadership role, but they really don't have the skill set to do so, you need to be open to having conversations with them about those gaps. This includes sharing how they match up against others, without naming names, and making sure they understand what they must do to get to that next-level role, and whether they are even capable of it. You have to be realistic with them. These are difficult conversations, which is why most people avoid them. If you're not honest up front, it can cause angst and resentment down the road. 

Q. How do you identify and develop high-potential employees for future leadership roles without creating perceptions of favoritism or exclusivity?  

A. You need to be transparent and upfront about their capabilities, as well as where they need to grow and if they need training. Giving them a stretch assignment and analyzing their reaction can tell you a lot. If they really struggle with the assignment, you can have that conversation. You can explain that you are looking at everyone's capabilities, and this project didn't go as expected, which tells us that you're not ready yet. Here, you can offer the employee feedback on what they need to do to reach the leadership level. 

Q. In your experience, how can organizations balance the need for external executive hires with the development of internal talent pipelines?  

A. You need to really go back to your awareness of people's capabilities. If you don’t have anybody in the organization that can fill the vacant leadership role, and if you’ve never made a succession plan, then you need to view it from a recruiting standpoint. What’s the pipeline out there for talent for C-suite positions? Leaders in an organization can start by networking with others in the industry, with an eye for potential talent for the future.   

You need to always look towards that future vision, making sure that you're networking early and often. You've got to think deeply about whether you've done your succession planning. If there is no one that you're seeing who you can tap to take on that role, no matter how much development you do with them, it’s time to look externally.  

Q. What role does mentorship or coaching play in effective succession planning, and how do you structure those programs for impact?  

A. Coaching and mentoring play a significant role in most employees’ development. How do you help them become their best selves and advance their careers? Growth can’t rely solely on external training or earning additional degrees. It also comes from observing and modeling the behaviors of others—whether leaders or colleagues who have done the work before. You can’t overlook the skills, knowledge, experience, and education people already bring to the table. 

It’s especially frustrating when a long-term employee leaves and, when asked about their replacement, you discover that little to no effort was made to capture that person’s organizational knowledge. Too often, their expertise wasn’t transferred to anyone else. When they walk out the door, their institutional knowledge disappears with them. While starting fresh isn’t always a negative, in many cases, it forces the organization back to square one, requiring more time and effort. With proper foresight, that knowledge could have been captured, documented, and shared to make the transition seamless. 

Q. What strategies do you use to ensure succession plans reflect the organization’s long-term strategic goals and evolving leadership competencies?  

A. There needs to be alignment with your strategic plan. If you haven't executed a strategic plan, you need to make sure that you create one so you grow in the right direction. You want to make sure that the right people have the right skill sets for that growth. Succession planning should link directly to the organization's mission. Vision and strategic priorities can't be separated. Watch for methods used to anticipate future leadership needs, including emerging skills, leadership styles, and industry trends. You want to know where other organizations in your industry are headed and what tools they are using. What people are they tapping into? What new services are they offering? Make sure that your development program is solid and that it contributes to finding strong leaders in your organization. Have a robust mentoring program and training opportunities, and make sure that you're identifying those high-potential employees and have a conversation with them about the future. This is important because you don’t want a high-potential employee to leave thinking there is no future growth for them at the organization.  

Also, look for ongoing evaluation methods of talent reviews, performance metrics, and feedback loops that are going to ensure that your succession plan remains relevant over time. You're always going to be looking at that plan and updating it. Adaptability is also important. You have to stay relevant, making sure that you're changing over time to fit the needs of the organization today and in the future. 

Q. How do you measure the effectiveness of succession planning efforts in terms of leadership readiness, retention, and organizational resilience? 

A. It's important to track the number of key positions with at least one successor identified. You need to very succinctly look at each position and determine who your high-potential employees are for that role. Evaluate those successors through performance reviews and feedback loops, doing assessments and simulation exercises, such as what-if scenarios. Examine how often an internal candidate is successfully promoted to a leadership role compared to filling it with an outside candidate. From a talent management perspective, you want to keep a healthy balance between the two.  

Measure retention and consider your turnover rate, as well as what is causing it. What needs to be adjusted? Make sure that you know where all your employees stand, that your high performers know they're high performers, and that you're having conversations with them to let them know how valuable they are.  

The resiliency of an organization is another big piece. It’s essential to make sure that the organization can adapt to unexpected changes caused by departures or role transitions. You don’t want a change to cause a panic situation; you want to be prepared for the unexpected. 

Q. Looking ahead, how do you see succession planning evolving in response to changing workforce demographics and leadership expectations?  

A. Succession planning is becoming more strategic and forward-looking. Organizations are increasingly recognizing that failing to plan creates significant challenges. They must prioritize diversity, skills, and potential—not just tenure. A shorter-tenured employee can still be a high-potential performer who brings valuable perspectives. In fact, the two-year employee may be a stronger leadership successor than someone with 30 years in the organization, depending on their broader experience and background. Length of service alone shouldn’t be the determining factor. The workforce itself is shifting: the population is aging, and fewer young workers are entering the pipeline. Organizations must stay laser-focused on what this means for their future and for their industry as a whole. 

It’s also essential to be clear about your organization’s values, especially at the board level. Boards can’t sit passively and assume the organization will take care of everything—they need to ask thoughtful, informed questions to ensure long-term stability, success, and readiness. The more intentional the planning, the stronger the organization becomes. Boards should be accountable for understanding and overseeing the organization’s critical processes. 

About Sarah

As Director of Executive Recruiting, Sarah partners with clients to create high-impact leadership teams that support an organization’s mission and culture. Drawing from more than two decades of recruiting experience and a large network of professionals, she has the knowledge and resources to help connect clients with the best talent for their specific needs. Learn more about Sarah. 

BerryDunn partners with organizations to create work environments where business success and personal growth coexist and where people are confident knowing their workplace positively contributes to their well-being. We take a comprehensive approach to our workforce and well-being work, considering how business needs, organizational capacity, and the employee experience work together to drive your business forward. That’s why we initiate each executive search by learning our client’s values—allowing us to find a candidate who shares those values while also meeting technical qualifications. Once we understand a client’s culture and business demands, we go beyond the pool of “available” executives and turn to our deep resource network to find the ideal candidate. Learn more about our executive recruiting team and services. 

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Corporate board leadership: Core principles in strategic C-suite succession planning

Rolling out new software isn’t just clicking “Install” and calling it a day. It’s more like planning a wedding. There’s the venue (servers), the guests (users), and yes, the unexpected costs that show up like distant relatives. In today’s digital-first world, implementing software is a strategic investment that can boost efficiency, strengthen compliance, and support long-term growth. However, the true cost goes beyond the sticker price on that shiny new platform. For nonprofits operating on limited budgets, careful planning is essential to avoiding hidden costs when making a technology upgrade. 

What are software implementation costs? 

Software implementation costs include all expenses tied to integrating a new system into your organization’s operations. Whether it’s internally developed software, purchased solutions, or a cloud-based platform like SaaS, these costs vary based on complexity, company size, and scope.  

Where do hidden system implementation costs hide? 

Here’s the short answer—everywhere. The long answer? They lurk in: 

  • Licensing and subscriptions: These are the more obvious places where costs can surface.

  • Customization and configuration: "Out of the box” rarely fits perfectly, which often means additional work. 

  • Integration with existing systems: Getting your new system to work with your existing systems can be challenging. 

  • Data migration: Moving years of data is complicated and time-consuming. 

  • Training and change management: Much time and effort go into getting users up and running on the new system. 

  • Testing and post-launch support: Planning and getting support can sometimes lead to additional costs based on what you uncover. 

These costs stretch across phases—planning, development, testing, deployment, and post-launch support. If you’re not tracking them, your budget might feel like a magician’s hat: costs keep popping out of nowhere. 

Accounting for these hidden costs 

Here’s where the rules come in. According to Financial Accounting Standards Board (FASB) guidance (ASC 350-40, Accounting for Internal-Use Software), you need to separate costs that can be capitalized from those that must be expensed

  • Capitalize: Development-phase costs like coding, testing, installation, and direct labor. These go on the balance sheet and get amortized over the software’s useful life. 

  • Expense: Early-stage activities (e.g., feasibility studies, vendor selection), post-implementation efforts (e.g., training, maintenance), and general overhead. These hit your bottom line immediately. 

Materiality can also be considered. Smaller costs may be expensed for simplicity. 

Why hidden software implementation costs matter to nonprofits 

Software implementation costs aren’t just accounting trivia; they’re the difference between a smooth upgrade and a budget wedding. In today’s digital-first world, knowing which costs to capitalize and which to expense isn’t just good practice; it’s essential for keeping your financials clean and your auditors happy. Think of it like planning a wedding: some items are lasting investments—like the photography and rings (capitalized), while others are one-day details, like flowers or catering (expensed). When in doubt, lean on the pros—your accounting team and trusty guidance like ASC 350-40. Treat these costs like the strategic investment they are and your balance sheet will be better for it. 

BerryDunn can help 

The right system can help your organization increase efficiencies, reduce risk, and make informed, data-driven decisions. Implementing a new system is a critical decision with significant business impacts. BerryDunn’s team can provide assessment, system evaluation, and implementation services for ERP systems for nonprofits, such as financial and student information systems, and can expertly guide you through the process. Learn more about our services and team.  

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Hidden software implementation costs: What nonprofits need to know

The affordable housing landscape in the United States is on the cusp of significant change with the introduction of the Renewing Opportunity in the American Dream (ROAD) to Housing Act of 2025. For nonprofit organizations operating in the affordable housing sector, this proposed legislation brings both new opportunities and important considerations. Here’s what you need to know. 

What is the ROAD to Housing Act? 

The ROAD to Housing Act is a comprehensive bill designed to increase the supply of affordable housing across America. It addresses barriers to housing development, modernizes regulatory frameworks, and introduces new funding and incentive programs. The Act is broad, touching everything from financial literacy to manufactured housing, disaster recovery, and homelessness reduction. 

Key provisions affecting nonprofits 

Expanding housing supply and streamlining development: 

  • Rental Assistance Demonstration (RAD) expansion: The Act extends and enhances the RAD program, allowing more public housing units to convert to long-term, project-based Section 8 contracts. This is a major opportunity for nonprofits to participate in preservation and redevelopment projects with more stable funding streams. 

  • Incentives for building in opportunity zones: HUD may give priority to grant applicants serving Opportunity Zones, potentially increasing funding access for nonprofits working in these areas. 

  • Whole-Home Repairs Act: Grants will be available to nonprofits and local governments to repair and rehabilitate homes for low- and moderate-income homeowners and small landlords, with a focus on accessibility, safety, and energy efficiency. 

Regulatory reform and local zoning: 

  • Housing Supply Frameworks Act: The Act directs HUD to develop best practices and guidelines for state and local zoning reforms, encouraging the reduction of barriers such as restrictive zoning, parking minimums, and lengthy permitting processes. Nonprofits may find it easier to develop affordable housing as localities adopt these reforms. 

  • Streamlined environmental reviews: The Act simplifies environmental review requirements for certain HUD-funded activities, which could reduce project timelines and administrative burdens for nonprofit developers. 

Manufactured and modular housing: 

  • Modernization and parity: The Act updates definitions and standards for manufactured and modular homes, aiming to expand their use as affordable housing solutions. Nonprofits may see new opportunities to develop or manage these types of housing, especially in rural or high-cost areas. 

Funding and grant programs: 

  • Innovation Fund: Competitive grants will reward localities that demonstrate measurable increases in housing supply, with eligible uses including infrastructure, planning, and direct housing development. Nonprofits may partner with local governments to access these funds. 

  • Community Investment and Prosperity Act: Expands the ability of community development financial institutions (CDFIs) and nonprofits to support affordable housing and community revitalization. 

Homelessness and supportive services: 

  • Reducing Homelessness Through Program Reform: The Act streamlines and enhances funding for homelessness prevention, rapid rehousing, and supportive services, with a focus on coordination between housing and healthcare providers. Nonprofits specializing in these services may benefit from increased flexibility and resources. 

Opportunities for the affordable housing industry and nonprofits 

  • Increased funding and flexibility: More grant programs and streamlined regulations mean nonprofits can access new resources and deliver projects more efficiently. 

  • Partnerships and collaboration: The Act encourages partnerships between nonprofits, local governments, and private developers, especially in Opportunity Zones and through RAD conversions. 

  • Focus on preservation: Emphasis on repairing and preserving existing affordable housing stock aligns with the missions of many nonprofits. 

Challenges for the affordable housing industry and nonprofits 

  • Compliance and reporting: With new funding streams come new compliance requirements, especially around performance measurement, reporting, and public accountability. 

  • Capacity building: Nonprofits may need to invest in staff training and systems to take advantage of new programs, particularly those involving modular/manufactured housing or complex financing. 

  • Local adoption of reforms: Many benefits depend on state and local governments adopting HUD’s recommended zoning and permitting reforms. Advocacy may be needed to ensure these changes are implemented at the local level. 

What should nonprofits do now? 

  • Stay informed: Monitor the progress of the ROAD to Housing Act and related HUD guidance. 

  • Assess readiness: Evaluate your organization’s capacity to participate in new grant programs or RAD conversions. 

  • Engage locally: Work with local governments to advocate for zoning and permitting reforms that will unlock new development opportunities. 

  • Build partnerships: Explore collaborations with other nonprofits, CDFIs, and public agencies to maximize impact. 

The importance of the ROAD to Housing Act 

The ROAD to Housing Act represents a significant federal commitment to expanding affordable housing and supporting the organizations that make it possible. Nonprofits in the affordable housing sector should prepare to leverage new opportunities, adapt to evolving compliance requirements, and continue their vital work in building stronger, more inclusive communities. 

BerryDunn can help 

We understand that affordable housing organizations are unique and dynamic organizations with specific challenges and opportunities. Our commitment to specialization provides our clients with a team of specialists who understand the complex accounting, regulatory, and tax issues of affordable housing organizations. We have experience with affordable housing agencies subject to audits under both FASB and GASB, as well as the various tax credits available, HUD compliance, annual Real Estate Assessment Center (REAC) submissions, and other compliance matters. Learn more about our team and services. Reach out to discuss how your organization can prepare for the upcoming changes. 

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ROAD to Housing Act: What affordable housing nonprofits need to know

In healthcare, coding compliance isn’t just about accuracy—the true why behind it is to protect integrity, revenue, and trust. When hospitals and health systems need to develop an internal coding compliance audit plan, it’s important to focus on education, building a culture of accountability, and accuracy. Starting with the why will help staff understand the importance of proactive auditing. It’s far better to identify issues internally than to discover them during an external review. 

Assess your coding compliance process

After connecting staff and leaders to the “why” of proactive coding audits, assess current processes by asking: 

  • Where are the gaps?

  • Are coders supported with regular education?  

  • What topics have been covered?  

  • Is the education provided by an accredited source? 

  • When are the audits conducted (monthly, quarterly, yearly)? 

  • Are the audits conducted internally or from a vendor? 

  • Has a clear baseline been established to make it easier to design an effective, realistic plan? 

Key ingredients for a good audit plan 

Every good audit plan should define the what, how, who, and why: 

  • What services will be audited and why? 

  • How often will audits be conducted and what triggers expanded audits?  

  • How will results be communicated with staff? 

  • Who is responsible for implementing corrective action plans? 

  • Why is this audit being conducted? (Is it based on payer denials or has an internal issue been identified?) 

Corrective action plans and oversight

While conducting audits and reporting findings is essential, it is equally imperative to implement documented, corrective action plans to ensure that any identified deficiencies are properly addressed and resolved. Throughout this process, establishing a strong partnership with the revenue cycle team can be invaluable, especially for managing rebilling, processing refunds, or addressing charge master discrepancies.  

This collaborative approach helps drive meaningful improvements and supports the overall integrity of the organization’s compliance efforts. Once corrective action plans are in place, ongoing monitoring is crucial to verify their effectiveness and to ensure that identified issues do not recur. Continuous oversight not only validates the success of corrective actions but also reinforces a culture of sustained compliance and accountability. 

Strengthen your organization with an audit plan

In the Health Care Compliance Association’s® 2025 Healthcare Industry Compliance Staffing & Budget Benchmarking Survey, more than half of publicly traded healthcare organizations reported annual compliance budgets of $1 million or more—reflecting the investment being made in compliance functions, which typically includes audits, monitoring, etc. This seems like a hefty budget, but the key here is scalability. Healthcare organizations across the care continuum, regardless of size or tax status, should focus on developing a reasonable, risk-focused plan. 

Remember, an audit plan isn’t a one-time project. It’s an ongoing process that evolves with regulatory and payer policy changes, new technology implementations, and organizational growth. Even more important than adapting to these changes is fostering a non-punitive culture. The goal isn’t to assign blame; it’s to strengthen accuracy, compliance, and confidence across the organization. 

BerryDunn can help

BerryDunn’s healthcare compliance team includes experts in coding, auditing, clinical documentation improvement, and revenue integrity. We can assess or develop your organization’s coding compliance audit plan, perform regular audits, and provide coder or provider education. Reach out to learn more about our team and services.  

Article
How to build a strong healthcare coding compliance audit plan

Read this if you are a CEO, CFO, or COO at a Federally Qualified Health Center (FQHC). 

This article is the second in a three-part series to help FQHCs understand how site- and program-specific accounting is essential to sustainability. Next up: Gaining operational insights on programs and sites from your data.

Site- and program-specific accounting can be a lifeline to FQHCs struggling with sustainability by providing a more granular look into operations. This approach allows an FQHC to gain key insights into the performance of its programs and sites and use those insights to make data-driven decisions to improve operations. To implement this method, an FQHC must set up its general ledger (GL), payroll, and Electronic Health Record (EHR) systems to report at the appropriate level of detail so that data flows cleanly into its accounting system. 

Step 1: Restructuring your general ledger 

The first step is to fine-tune the GL. This requires defining all programs and sites in the GL and creating processes for identifying expenses so that you can begin to record them accordingly. Programs and sites need to be set up to include a general administrative program, along with a mechanism to ensure those administrative costs are coded into that cost center. It’s imperative to establish a consistent allocation method for applying those overhead costs to the respective programs and sites. This will give you the gross margin for each program and site. Overhead costs, which are generally fixed, must also be factored in to give a view of your bottom-line profitability. 

Having this level of insight into programs and sites gives FQHCs a clearer view to determine strengths, weaknesses, and opportunities for maximizing efficiencies and operational effectiveness. This data helps an FQHC model what is possible and make informed operational decisions. 

Step 2: Modifying your payroll data 

Next, an FQHC must adjust its payroll system setup. Payroll data is typically exported to generate journal entries for recording in the GL or is uploaded directly to the GL. The same principles for identifying programs and sites apply to payroll. While the GL is the easiest route to refining payroll setup, an entity may not be able to define sites due to limitations on the number of labor distribution elements in its payroll system. Another option is to export payroll data into Excel and use lookup tables that denote an employee’s role (i.e., medical provider, dental provider, behavioral health provider) and location, so that their salaries can be assigned to the appropriate program and site. Using the Excel spreadsheet, an FQHC can generate a journal entry by site and program and then upload it to the GL. This is often the easiest and most effective method.  

If an entity has a payroll system that can be defined at this level of site- and account-specific detail, that is another possible route. However, this approach requires significant upfront and ongoing resource commitment, and many smaller entities do not have the bandwidth to dedicate staff and time to configure and maintain the system, which often makes it impractical. 

Step 3: Setting up your EHR 

The third step is to record patient service revenue by program and by site. This requires structural adjustments within the EHR system to clearly define programs and sites. Once set up, EHR reports can be exported to generate revenue entries that are uploaded to the GL. Expenses can be viewed by program and site, indicating profitability and providing visibility into the ROI of providers. Looking at patient revenue less direct expenses serves as a good measurement tool.  

How much data is enough? 

With processes in place and systems modified appropriately, an entity can start measuring profitability with a greater level of detail. When generating financial statements for the month, additional income statements by program and site should also be produced, which makes viewing data monthly a good starting point.  

A month’s worth of data helps an entity uncover if one site or program is excelling, or others are underperforming or have higher costs. A closer look can reveal how success in one program might be replicated in others, or how a high-performing site could be masking the failure of another site. Site- and program-specific accounting supplies the data needed to support key decisions related to programs and sites.  

About BerryDunn 

Faced with rapid changes in an increasingly competitive environment, community health centers rely on our seasoned professionals to refine business strategies, streamline operations, and introduce proven best practices to enhance performance while managing costs. Our team works with a comprehensive range of community health providers, including FQHCs, FQHC Look-Alikes (LALs), and Rural Health Clinics (RHCs). Learn more about our team and the services we provide. 

Article
Three steps to modify accounting for FQHC sustainability

November 25, 2025 updateOn November 25, 2025, the FDIC finalized its regulatory threshold updates rule. As mentioned in an FDIC press release, “the changes set forth in the final rule provide a more durable framework preserving certain regulatory thresholds in real terms, thereby avoiding unintended and undesirable consequences.” Although effective January 1, 2026, the final rule provides immediate burden relief to insured depository institutions that are currently subject to part 363 requirements but will no longer be subject to such requirements under the updated thresholds in effect as of January 1, 2026.

Originally published on August 29, 2025

The FDIC has proposed raising several key regulatory thresholds, including those that determine which institutions must comply with Part 363’s audit and internal control requirements. The primary driver behind these proposed changes is the growth experienced by institutions since the original thresholds were set decades ago. Due to inflation, the proposal aims to cover a similar number of institutions as when the thresholds were originally set. For example, the proposed increase to $5 billion for the Internal Control over Financial Reporting (ICFR) threshold, as described below, would still cover approximately 75% of institutions today.  

In addition to increasing these thresholds, the proposal also recommends that the thresholds be automatically adjusted based on some inflationary factors going forward. While the changes are designed to ease compliance burdens for smaller institutions, they also come with a cautionary tale—they would reduce regulatory requirements, but not the risk. 

What the FDIC proposal means 

Under the proposal

  • Approximately 800 institutions may find themselves newly exempt from Part 363 compliance due to changes in 24 regulatory asset thresholds. The following items are the most likely to be relevant for community banks:

    • Banks under $1 billion in total assets would no longer be required to: 

      • Create a separate audit committee as part of the institution’s board of directors

      • File annual reports 

    • Banks under $5 billion would no longer need to: 

      • Include management assessments or auditor attestations on ICFR 

      • Require the audit committee directors to be independent from management 

      • Require the audit committee directors to include members with banking or related financial management expertise, have access to its own outside counsel, or exclude large customers of the institution 

    • Audit committee independence criteria would increase from $100,000 to a $120,000 compensation threshold. This threshold would not be indexed against inflation as it is meant to align with the listing standards of national securities exchanges. 

  • Parts 303, 335, 340, 347, and 380 would also have changes if this proposal is enacted: 

  • Part 303 – de minimis thresholds: 

  • Increased from $1,000 to $1,225 and from $2,500 to $3,500 for certain criminal offenses 

  • Part 335 – Insider loan disclosures: 

  • Raised the threshold from $5 million to $10 million 

  • Parts 340 & 380 – Asset sales restrictions: 

  • Raised the “substantial loss” threshold from $50,000 to $100,000, which could allow an increase in potential bidders who are eligible to purchase failed institution assets 

  • Part 347 – International banking: 

  • Raised limits for foreign underwriting and dealing from $60M to $120M and from $30M to $60M. This is less likely to have an impact unless you have foreign operations. 

Why ICFR still matters for community banks 

Even without a federal mandate, effective ICFR offers tangible benefits: 

  1. Fraud prevention: Segregation of duties, account reconciliations, and control monitoring are critical to detecting and preventing fraud—especially in lean staffing environments. 

  1. Operational efficiency and reducing material misstatements: ICFR can help identify process inefficiencies and reduce errors. It can also help with training, as processes tend to be more clearly documented when they are being tested on an ongoing basis. 

  1. Regulatory confidence: Examiners still expect clear documentation of key controls and risk assessments—even if an ICFR opinion is no longer required. 

  1. Merger and acquisition readiness: Strong internal controls enhance bank value in due diligence settings, especially in today’s consolidation-driven environment. 

  1. Board-level accountability: Internal controls provide visibility into operational risk that supports informed governance and oversight. 

  1. Preparing for the next threshold: Many hours have been spent getting your documentation ready for audits, including creating, updating, and monitoring your internal controls. Walking away from the effort already put forth would mean a significant amount of time and resources to re-establish your documentation and controls as you prepare for the next threshold. Keeping your current internal practices in place with annual updates and regular monitoring will help make that next transition as smooth as possible. 

What we recommend 

For banks that would be newly exempt under the FDIC’s proposed changes, we suggest a right-sized, risk-based approach

  • Maintain documentation of your key accounting controls and processes, including reconciliations, journal entries, and credit loss provisioning. This documentation should be updated at least annually by control owners. 

  • Conduct periodic walkthroughs of high-risk processes (e.g., wire transfers, loan approvals) to identify gaps, inefficiencies, and areas of documentation that need to be updated. 

  • Leverage internal or outsourced testing of controls. The frequency of this testing will likely be dependent on your institution’s risk assessment of each operational area. 

  • Educate your board on how ICFR practices support accountability, even without formal reporting requirements. 

  • Create a compliance checklist related to threshold changes to stay up-to-date with compliance requirements going forward: 

  • Indexing monitoring plan 

  • Establish a process to track inflation-based threshold changes: 

  • Every 2 years, or 

  • More frequently if the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) rises above 8%. Thresholds will not be reduced in deflationary periods. 

  • Assign responsibility for monitoring CPI-W and updating compliance scope 

  • Governance and board oversight 

  • Reassess audit committee composition and independence under new thresholds 

  • Review director compensation against the $120,000 independence threshold 

  • Document any changes to board and/or audit committee structure or oversight responsibilities 

  • Audit planning adjustments 

  • Revise audit scope and frequency based on updated regulatory requirements 

  • Coordinate with external auditors to align expectations and engagement terms 

  • Adjust risk assessments to reflect changes in compliance burden and oversight 

  • Reporting and documentation 

  • Ensure proper documentation of decisions not to file Section 19 applications due to new thresholds 

  • Maintain records of threshold applicability reviews and indexing updates 

  • Prepare for potential regulatory inquiries regarding compliance scope changes 

  • Stakeholder communication 

  • Brief the board on regulatory changes, compliance impacts, and audit committee implications 

  • Provide training or guidance to relevant teams (e.g., HR, compliance, finance) 

Final thoughts 

We understand the burden of ICFR compliance—and for many small banks, the relief reduces their already heavy regulatory burden. However, a move to step away from a well-established control environment has the potential to create downstream issues you might not see until it’s too late. 

Strong internal controls are not just a box to check for regulators and auditors—they're a tool for protecting your institution, your people, and your reputation. Regulators, investors, and auditors still care about the strength of your bank’s control environment—whether or not it's required by regulation. 

Maintaining strong internal controls remains a best practice—and a strategic imperative. Both are essential to your bank’s resilience, integrity, and long-term success. 

Let’s talk 

If your bank is approaching a new threshold or deciding whether to scale back ICFR documentation, we’d love to help you build a right-sized internal control approach that matches your risk profile. Reach out to our team with questions. 

Article
FDIC Proposal: How community banks can adopt a right-sized risk-based approach