SEGMENT 1:

Joe Becht, Jr., CPA, FHFMA, P&P Board Vice Chair,Partner,
Ernst & Young

Status of Healthcare Industry, Challenges:
- Deteriorating bottom lines
- Very tight and costly credit
- Increase in bond downgrades
- Increases in bad debts
- Increases in charity care
- Federal payments
- State payments
- Documenting community benefit
- Not for profit healthcare forecast: stable --> negative

SEGMENT 2:

Paul R. DeMuro, Partner,
Latham & Watkins LLP

- Obvious financial and legal consequences of the failure to meet debt covenants.
- Negotiating with lenders and others
- Legal consequences of the failure to pay vendors in a timely manner, deferring
  capital expenditures, failing to comply with Charity Care Policies
- Negative Effects on Compliance Programs, internal audit and privacy
- Greater scrutiny of representations and warranties, conflicts of interest, executive
  compensation, and whether a tax-exempt entity should maintain its tax-exempt status.

Please click the links below to download a copy of Paul DeMuro's article and co-authored article:

Financial Meltdown: Key Legal Issues for Healtchare Organizations
Author: Paul R. DeMuro

Recession opportunities: Compliance with charity care obligations and maintaining tax exempt status
Authors: Paul R. DeMuro, C.P.A., M.B.A., J.D., CHC, Julie S. Marder, J.D. & Robert C. Levels, J.D.

SEGMENT 3:

Laura Ann Gabrysch, Sr. Associate,
Fulbright & Jaworski LLP

1. Challenges
  - Down healthcare market
  - New reporting, governance requirements
     a. Revised Form 990
     b. Schedule H
     c. New focus on governance and policies, including in revised Form 990
  - Potential for new legislation
     a. Grassley comments
     b. GAO report on charity care
     c. 2007 staff hospital discussion draft
     d. Health care reform is wild card
  - Revenue-hungry states and localities
     a. Property tax challenges
     b. Sales tax challenges
  - Legal uncertainty as to some cost-savings techniques
     a. Gainsharing
     b. Electronic health records
  - Other challenges
     a. Concern with executive compensation
     b. Challenges from state AGs, public interest groups, private litigants
     c. VSP case

2. Legal Assessment and Analysis
  - Determining community need
  - Determining amount of community benefit/charity care that organization can provide
  - Measuring and documenting community benefit and charity care
  - Reporting charity care
  - Separating bad debt from charity care
  - Charity care policy
  - Executive compensation and billing and collection techniques
  - Governance/policies in general
  - Establishing use of property for property tax purposes
  - Other issues

SEGMENT 4:

John Valenta, CPA, MBA, Senior Manager,
Deloitte & Touche LLP

- Impact of Obama healthcare plan on providers
- Importance of properly reporting bad debt vs. charity care and the impact on community
  benefit and how it supports tax-exempt status
- Potential for decreased payments to Medicare Advantage organizations and how that may
  impact providers
- Requirement for providers to optimize revenue through the implementation and maintenance of
  optimal revenue cycle processes, including those related to contracting, denials, MS-DRGs
  and clinical documentation excellence and upcoming RAC audits.