August 17th, 2017

Health Care Compliance Expert, Corky Rockwell, Joins Wipfli LLP/HFS Consultants’ Revenue Cycle and Clinical Operations Practices


20170731_HFS_3504-croppedCorky Rockwell has joined Wipfli LLP/HFS Consultants as a manager in its revenue cycle and clinical operations practices. She brings extensive clinical knowledge in skilled nursing, health care compliance, and critical access hospitals. With close to 30 years’ experience in nursing and health care management consulting, Rockwell will help support the firm’s services and contribute to growing its value to clients. She is based in Idaho and will often practice out of the firm’s Oakland office.

“Corky’s expertise and solid reputation in bringing facilities, whether it be acute care, or skilled nursing, into compliance is outstanding,” says Richard Gianello, a partner at Wipfli/HFS. “As our health care clients face new challenges and complex regulations, Corky is uniquely qualified with a wealth of knowledge and experience to address their compliance issues.”

Rockwell has worked with Wipfli/HFS for many years as an outside consultant. Most recently, she assisted with the management of a hospital in Northern California that had been de-certified, and she successfully brought it back into compliance and re-certification. Her recent work has also included serving as a director of nursing, performing audits, and providing mock surveys.

“I am pleased to be joining the firm and have high regard for its solid reputation serving clients across management, financial, operational, regulatory, and strategic planning areas,” says Rockwell. “I look forward to continuing my working relationship with this talented team of experts to bring positive solutions to our clients as they navigate today’s health care landscape.”

Rockwell holds an associate of science degree in nursing from Boise State University.

For more information, contact Corky at, or call 800-888-4966.






June 20th, 2017

Health Care Consultant, Kiki Nocella, PhD, a Nationally-Recognized Expert on Establishing Teaching Health Centers, Joins Wipfli LLP/HFS Consultants


Kiki NocellaKiki Nocella, PhD, has joined Wipfli LLP/HFS Consultants’ clinical operations practice and will be based in Southern California. With expertise in FQHCs, RHCs, and setting up physician residency programs, Nocella’s extensive health care industry experience will serve to expand the firm’s practice and be an excellent resource for clients.

Nocella is considered a national expert on establishing Teaching Health Centers, a program that was created with a $230 million appropriation in the Affordable Care Act. She wrote and was awarded one of the first 11 Teaching Health Center grants funded by HRSA, via the Patient Protection and Affordable Care Act, receiving the largest award of all applicants. Her work in the Teaching Health Center arena has been recognized by The New England Journal of Medicine, which published details of a project she did with George Washington University for HRSA on the cost of training health center residents.

Among Nocella’s numerous achievements are: developing a graduate medical education program and strategy for a five-county region in Northern Florida; writing the Health Information Exchange (HIE) Strategic Plan for the State of North Carolina and the Narrative (Application) for its ONC Cooperative Agreement for State HIE; developing a consortium of health care providers in Fresno County; and developing an Electronic Record Sharing Roadmap for the Children’s Partnership and the County of Ventura for an innovative project of interoperability between CWS/CMS, Health, and Education.

“Kiki brings to the firm a strong professional reputation, a national presence, and unique expertise related to the physician workforce in FQHCs and RHCs,” says Richard Gianello, a partner at Wipfli/HFS. “Her deep knowledge of primary care strategies and primary care financial models will serve to strengthen and grow our team and our client relationships. She is an outstanding addition to our firm’s clinical operations practice.”

Prior to joining Wipfli/HFS, Nocella was the founding vice provost of health affairs at the University of California, Riverside, where she developed the business and implementation plans that led to the establishment of the university’s graduate medical education program. She has taught at the University of Southern California’s School of Policy, Planning, and Development, and the Keck School of Medicine. In addition, she has lectured nationally and internationally on issues related to rural health delivery, quality, and workforce.

Nocella holds a PhD in public administration and organizational theory from the University of Southern California, a Master’s degree in health administration from the University of Southern California, and a Bachelor of Science degree from University of California, Los Angeles.

For more information, contact Kiki at, or call 800-888-4966.







April 18th, 2017

The Most Sought After Competencies for Executive Talent in Health Care


This is the first in a series of blogs highlighting trends in the market for executive talent.

Business meeting in an office

Despite – or because of – wrenching changes initiated by the executive administration in Washington, DC, the demand for health care executive talent remains healthy due to a couple of trends. As boards of directors and executives contemplate yet more tumultuous change in reimbursement models and via executive orders from CMS and the Department of Health and Human Services, many baby boomer executives, with their retirement savings mostly recovered from the 2008 recession and not wanting to lead another retrenchment effort at their organizations, are scaling back by leaving full-time positions in favor of interim executive work or outright retirement. On another front, as boards of directors become more focused on metrics when evaluating CEOs, they have become increasingly critical of performance and shown a greater willingness to initiate a change in the executive suite.

Key Competencies of Senior Health Care Executives

Amidst these trends and across various functional areas, the most sought-after senior health care executives possess a few key competencies: Innovation, cross-functional collaboration, and leadership development. Though these competencies are not new, I have highlighted the emerging ways in which they are finding expression in provider organizations.

Read the rest of this entry »


February 8th, 2017

Information Clinics and Safety Providers Need to Know


magnifying glass and stack of papersThe following are updates on regulatory and other changes that impact FQHCs and other clinic-based providers including: new consolidated licenses available for community clinics; DHCS proposes a revised State Plan Amendment; HPSA updates are suspended; and a change to the Medi-Cal fiscal intermediary.

Read the rest of this entry »


January 13th, 2017

How to Not Lose Your SNF’s Medicare Certification


The efforts required to achieve and/or maintain Medicare certification have grown significantly and require ongoing accountability to develop, implement, and maintain systems to ensure regulatory compliance at all times. If your facility undergoes a survey and the amount of F-Tags increases, it is time to get a consultant into your building to assess the processes and identify opportunities to close the gap and bring the facility back into compliance. Optimally, bringing in a consultant prior to the survey to perform a mock survey can go a long way in avoiding the subsequent fines and/or loss of billing capabilities.

It is a leadership imperative to use strategies that will bring fresh eyes to a situation that you see every day to ensure survey readiness and assist in identifying actual or potential issues needing to be addressed. The human-factors phenomena of seeing an action or a behavior and disregarding it as little, not important, or doing the same thing over and over and expecting different results get facilities into trouble with both the accreditation and licensing departments of both the state and federal agencies. The impact is too great to ignore.

Read the rest of this entry »


August 15th, 2016

Revenue Cycle Review and Recommendations


revenue-cycle-gwen-300x200This article focuses on revenue cycle review. In an upcoming blog we will focus on implementing recommendations and outcomes of the implementation.

Three-Step Process

A fine-tuned revenue cycle is the backbone of a financially stable health care organization. Hospitals, clinics and physician offices that have financial issues need to look at their revenue cycle processes to improve cash flow and patient satisfaction. HFS has a three-step process to do just that, Review, Analyze and Recommend. Read the rest of this entry »


August 10th, 2016

HFS is Celebrating 25 Years!


25-years-of-successThis year HFS Consultants celebrates 25 years in business. What began with four people working out of their homes is today a thriving company with 80 employees and offices across the U.S. As the company marks a quarter century, it now finds itself embarking on a new chapter that offers the potential for exciting opportunities and continued growth.

In 1991, Rich Gianello and Steve Rousso founded HFS Consultants (formerly Healthcare Financial Solutions), and remain at the helm of the company today. They, along with their first employee, John Pfeiffer, (who today is a principal and head of the firm’s reimbursement practice), share their thoughts about 25 years in business.

How did the company start? Read the rest of this entry »


August 5th, 2016

Wipfli/HFS Profile: Megan Hartman, Director, Financial Feasibility & Capital Planning


blog-megan-hartmanWhether working on a financial feasibility study to support the financing for construction of a new healthcare facility, or an analysis of a proposed hospital expansion, Megan Hartman looks forward to creating the professional relationships that each project brings. She values the trust that clients and the entire Wipfli/HFS Feasibility team put in her to forecast the future financial potential of health care organizations of all sizes.

What has been your career path?

After college, I worked in Boston at KPMG as an auditor, primarily in the high tech sector, and also did some governmental audits. Being from Southern California, I wanted to move back West, and decided on San Francisco. Through my network of contacts I met HFS executives, Rich Gianello and John Pfeiffer and they offered me a job. That was 15 years ago. Read the rest of this entry »


July 26th, 2016

S-10 Bullet Dodged! (temporarily): Overlooked Cost Report Worksheet S-10 May Soon Drive $6B of Hospital Medicare Payments


header-proposed-changes-to-dish-payments-blogStarting in FFY14, CMS changed the long-standing methodology for paying Medicare Disproportionate Share Hospital (DSH) payments. It revised DSH reimbursement to pay 25 percent of the existing formula-driven amount and placed the other 75 percent into a new Uncompensated Care (UC) payment.

The UC payment is basically a pool (currently about $6B), which is shared by all hospitals nationwide in proportion to their percentage of uncompensated care. To date, each hospital’s percentage of the UC pool, known as Factor 3, has used a proxy composed of Medicaid Days plus Supplemental Security Income (SSI) days. The FFY17 proposed Inpatient PPS rule startled the industry by proposing a major change starting in FFY18–to allocate the UC pool using the cost of Bad Debts and Charity Care reported on cost report Worksheet S-10, using historical cost reports already on file at CMS. This would dramatically redistribute UC funds from high-Medicaid hospitals to those having high amounts of charity care and bad debts.

The industry inundated CMS with critical comments about the proposed rule, and fortunately CMS decided to soften the S-10 blow. In the FFY17 final rule, released August 2, 2016, CMS postponed implementation of the S-10 approach until no later than FFY21 (could be earlier). They also promised to implement quality control and data improvement measures before using S-10 to compute Factor 3.

Read the rest of this entry »


July 19th, 2016

Health Care Capital Markets Access: Smooth Sailing or Choppy Waters Ahead?


banksWhile there have been many pressing issues facing health care executives during the past year, fairly ready access to the health care facility financing markets interestingly has not been one of them.

Bond Market Overview

With current thirty-year tax-exempt bond rates hovering around 4.00%, these favorable market conditions have held equally true for both highly rated, large multi-hospital systems, urban medical centers as well as smaller community or rural hospitals, the latter of which may be below investment grade or unrated by the major credit rating agencies. Read the rest of this entry »


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