Fall Finance Conference

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October 14 - 15 | Manheim, PA

Registration is now open!

Does your job involve senior living finance, technology, or strategic planning?

This conference is for you!

October 14 - 15, 2025
Nook Meetings & Events @ Spooky Nook Sports
75 Champ Blvd, Manheim, PA 17545

This 2-day educational event offers the following available credit hours:

Nursing Home/Personal Care Home Administrators

This program has been approved for Continuing Education for 11 total participant hours by the National Continuing Education Review Service (NCERS) of the National Association of Long-Term Care Administrator Boards (NAB)

Finance Professionals

LeadingAge PA is a registered program sponsor with the Pennsylvania State Board of Accountancy (PX#000987L). There are 13.2 CPE credit hours available for this program, presented “Group Interactive” at the “Intermediate” level. Specific prerequisites are not necessary.

Each concurrent session provides the following CEUs:

1.2 total participation hours (CPA)
1.0 total participation hour (NAB)

2025 CONFERENCE SCHEDULE:

DAY 1: Tuesday, October 14

7:30 – 8:15 A.M.

Registration

Registration and Continental Breakfast

8:15 – 10:30 A.M.

Keynote information

2.4 total participation hours: CPA
2.0 total participation hours: NAB

Welcome and Opening Remarks

Seth Anthony, Vice President of Member Excellence, LeadingAge PA

KEYNOTE: Ethics Unleashed: Navigating Healthcare Financial Dilemmas with Fun and Games

Harriett Wall, President & CEO, LW Consulting, Inc.
Nikki Oliver, Director, LW Consulting, Inc.
Kyle René, Partner, Whiteford, Taylor, & Preston, LLP (Whiteford)

This session is designed as an interactive learning experience geared towards healthcare C-
suite and financial professionals. The team facilitating this session includes a healthcare consulting and compliance executive, a seasoned healthcare attorney with experience in transactions and regulatory matters, and a PhD in Organizational Development. The facilitators have teamed up to provide a stimulating learning environment that covers pertinent healthcare finance topics with a balance of legal, operational, compliance, and people skills. The session will include a variety of healthcare topics including allocation of capital, fiduciary responsibility, conflicts of interest, fraud prevention and more. The discussion will focus on the intersection of mission, ethics, interpersonal relationships, and regulatory requirements. Attendees will be encouraged to engage with the content and test their knowledge in fun, fast-paced, gameshow-like format.

10:45 – 11:45 A.M.

Concurrent sessions

Ahead in the Medicare Claims Audit Landscape

Stephanie Kessler, Partner at RKL

This session aims to provide attendees with a comprehensive understanding of the ever-changing landscape of external claim audits in the context of Skilled Nursing Facilities (SNFs). This session will explore the regulatory requirements, common types of audits, and strategies for effectively managing and responding to these audits. Through this session, participants will gain a solid foundation in the key principles and practices of Medicare claim audits, thereby enhancing their ability to navigate this complex landscape and improve the financial health and compliance of their organizations.

Little Money, Big Impact: Stretching Funds to Achieve Much Needed Campus Improvements

Deborah Seitz, Principal at Lenhardt Rodgers Architecture + Interiors

How do you move forward when your buildings don’t equal the level of care you provide, and the necessary funds are not available for all the desired upgrades or a new building? This is the case for many communities. Often times workarounds are developed to maintain daily routines which can increase the level of stress for residents and staff. And sometimes it costs more in the long run. Through tough decision making, clever financing, and creative design ideas arise solutions and a path forward to improved resident care and staff needs. Presenters will use project case studies to demonstrate ways of achieving their project and financial goals on a modest budget for a variety of project types and sizes. The renovation of a health care center, of a lobby, of an auditorium, and a corridor refresh will be reviewed. Hear from leadership at two communities: Dr. Carol McKinley, CEO of Simpson, and Ted Leister, Exe. Dir. of The Community at Rockhill, and from Jackie Patterson, Principal and Interior Designer of Lenhardt Rodgers, how they each learned to focus on the main goals, differentiate between wants and needs, and prioritize health and safety to achieve success. This session aims to demonstrate to owners and designers that creative financing can positively affect a budget. And aligning project expectations and designs with that budget can result in a good building or space. The four project types represent the most common renovations found in communities and the finances of each one are different. There will be opportunities for questions and responses during the session as it will be presented as a discussion moderated by Deborah Seitz, Principal and Architect at Lenhardt Rodgers.

11:45 A.M. – 1:00 P.M.

Lunch & EXPO

Lunch with Exhibitors

1:00 – 2:00 P.M.

Concurrent sessions

Acquisitions and Affiliations: How and When to Affiliate

Michael Falbo, CFO at Concordia Lutheran Ministries

From the perspective of an organization that has done 15 acquisitions in the last 15 years, I'd like to share who goes into an acquisition from an evaluation and typical financial turnaround. Have the group understand if their organization should continue in its current condition to seek some form off affiliation. Explain what Concordia does in preparation to acquire and what we do afterwards. The session would also describe the benefits or challenges that can come with an affiliation.

Measuring the ROI of Technology-driven Innovation

Adam Arker, Managing Director, Health and Human Services at Hartman Executive Advisors
Amy Castleberry, Managing Director at Ziegler
Marissa Marsico-Picchini, CEO at Luthercare

Innovation in senior living is essential for long-term sustainability and competitiveness. More than a buzzword, innovation represents a strategic investment that can directly impact financial performance, resident satisfaction, and workforce efficiency. In an industry where every investment must be justified, finance leaders in senior living are expected to not just manage costs, but to help drive innovation. This session will highlight how leaders can move beyond traditional approaches to become strategic partners in innovation, using data to guide decision-making and ensure accountability. By proactively engaging in the innovation process, they can help their organizations stay competitive, adaptable, and financially resilient in an increasingly complex care environment.

In this panel, the audience will hear about how to reposition their organizations to innovate with intention and measurable outcomes. From evaluating the ROI of new care models and technology platforms to identifying scalable, mission-aligned investments, attendees will gain practical tools for aligning innovation with fiscal responsibility. They will come away from the session with a clearer view of how to fund, measure, and sustain innovation that delivers real value for residents, staff, and the bottom line.

2:15 – 3:15 P.M.

Concurrent sessions

Fresh Perspectives in Leadership: A View From the CFO’s Desk

Rafael Haciski, Vice President at JKJ

Fellow CFOs can often bring a fresh lens to organizational challenges, spotting inefficiencies, cultural dynamics, and untapped opportunities that others may overlook, beyond just the financial aspects.

In this session, you'll hear from a panel of fellow CFOs. They’ll share the strategic vision they have for their communities, shaped by their unique perspectives and fresh ideas.

The Third Way: Balancing Financial Performance and Mission in a Challenging Operating Environment

Jay Gormley, COO, Advisory at Zimmet Healthcare Services Group, LLC

Focusing on Pennsylvania-specific dynamics, this session will walk through the full reimbursement picture; Medicare (including TEAMS), Medicare Advantage, Medicaid and ancillary revenue. We will also examine how Pennsylvania’s payment structures can be better aligned to reward quality, efficiency, and mission alignment. We'll also explore what other states have done to rebalance their systems and what lessons Pennsylvania can take from those efforts.

We will provide in-depth analysis of the key components of Pennsylvania’s Medicaid nursing facility reimbursement system and their impact on provider sustainability. Topics will include rebasing, the Budget Adjustment Factor (BAF), the transition to a PDPM-based case mix model, quality incentive payments, and the structure and implications of the nursing facility assessment (bed tax). Particular focus will be placed on how these elements interact to create both financial opportunity and risk. Using proprietary data sets, we will explore how the PDPM transition affects acuity capture, and offer strategies for aligning clinical documentation with reimbursement optimization.

This session will also examine what real value-based care looks like in the nursing home setting, with a focus on Institutional Special Needs Plans (I-SNPs). We’ll explore how I-SNPs can support care coordination, reduce hospitalizations, and create new revenue streams—while highlighting the operational, clinical, and financial considerations necessary for successful implementation in Pennsylvania facilities.

Key topics include:

- Understanding how Medicare’s evolving payment methodologies (e.g., TEAMS model) shift revenue opportunities and risk

- Addressing Medicare Advantage penetration and rates

- Understanding PA Medicaid's unique and some times contradictory incentive structure

- Building flexible financial strategies that support clinical excellence and mission alignment

Through real-world data, policy analysis, and field-tested strategies, attendees will gain actionable insights to support smarter budgeting, better advocacy, and more sustainable operations without compromising the care that defines nonprofit long-term care.

3:30 – 4:30 P.M.

Concurrent sessions

A Shifting Landscape - Senior Living Sector & Financing Update

James Bodine, Executive Vice President at HJ Sims
David Saustad, Vice President at HJ Sims

2025 draws to a close. Among the positives is improved occupancy and rate-setting flexibility, reflecting continuing growth in demand, combined with supply of units/beds that has not kept pace with this demand. Further, after several years of reduced activity, commercial banks have resumed more active lending, resulting in more attractive loan pricing and terms for borrowers. And, in response to elevated construction and financing costs noted below, senior living organizations and their financing partners are employing creative approaches to development and financing – including expanded collaboration between not-for-profit and for-profit senior living providers.

On the other hand, actions by the Federal government combine to further pressure operating expenses, while also reducing healthcare revenue. This includes an aggressive and shifting trade policy with increased tariffs, tightened restrictions on immigration and passage of a budget bill that incorporates significant cuts to Medicaid. Related, elevated construction costs and interest rates, including in the tax-exempt bond market, pressure the financial viability of new construction and, in turn, depress new unit development.

This session will address the above conditions and implications for capital investment and related financing along with strategic initiatives, including affiliations/acquisitions as well as divestitures. It will include discussion of how to evaluate and implement capital investment and growth opportunities and related financing in response. This will include reference to relevant statistics and trend data on senior living industry conditions as well as interest rates and financing market conditions. It will be supplemented examples of recent financing and M&A transactions to illustrate how providers have responded to industry and market conditions and are charting paths forward in what continue to be dynamic conditions.

Planning for Economic Uncertainty

Jonathan Hansan, Principal at CliftonLarsonAllen
Marc Silver, Managing Director at Piper Sandler & Co

The purpose of the session is to:

1) Review RECENT national AND Pennsylvania trends in:

1a) senior living census

1b) revenue/reimbursement

1c) expense inflation

1d) Regulation, including OBBA impact to Pennsylvania providers

1e) Economic conditions impacting financing decisions

1f) Current financial market dynamics for both commercial bank and public bond financing options

2) Communicate RECENT actions national and Pennsylvania providers have taken to address the trends. Examples include:

2a) Evaluating and changing outsourced vendor

2b) Delicensed and closed nursing beds (this is especially true for Pennsylvania, which, per CMS data, has decreased its licensed nursing beds 7% since year 2020)

2c) Changed its reimbursement

2d) Increased entrance fees

2e) Impacts to capital project planning due to heightened economic uncertainty (e.g. tariff policy, stagflation concerns, etc.)

3) Discuss how others are incorporating the shifting environment into their budgets, capital project planning, debt restructuring, and long-term strategic plans

4:30 – 6:30 P.M.

Networking Reception

Networking Reception

Join us at this popular reception to unwind as you conclude your first day of conference — featuring cocktails and appetizers. This event is included in your registration fee. Attendance to only the networking reception is $99.

The Networking Reception is sponsored by Usource

DAY 2: Wednesday, October 15

7:30 – 8:15 A.M.

Registration

Registration and Continental Breakfast

8:15 – 9:30 a.m.

Keynote information

1.2 total participation hours: CPA
1.0 total participation hours: NAB

Welcome and Opening Remarks

Garry Pezzano, President & CEO, LeadingAge PA

KEYNOTE: Delivering Care Where It’s Needed the Most: National Insights from Pennsylvania

Seth Anthony, Vice President, Member Excellence, LeadingAge PA
Katy Barnett, Director Home Care & Hospice Operations and Policy, LeadingAge

Across then United States, rural communities are facing mounting pressures in accessing timely, affordable, and quality health care at all stages of life. Nowhere is this more evident than in the former industrial centers of Northern Pennsylvania. This keynote will explore how geographic isolation, workforce shortages, aging populations, and hospital closures are reshaping the rural health landscape, with a focused lens on the region above Interstate 80.

Drawing on both data and member insights alike, LeadingAge staff will highlight innovative solutions, policy shifts, and community-driven models that are making a difference — not only in Pennsylvania, but in rural areas across the country. Attendees will gain a deeper understanding of the systemic barriers to rural care, and leave with actionable insights for advocacy, collaboration, and sustainable change.

9:45 – 10:45 A.M.

Concurrent sessions

Reimbursement and Compliance Update

Kris Pattison, Senior Manager Clinical Consulting at Baker Tilly
Rick Snyder, Manager Health Care Consulting at Baker Tilly

There are many developments happening within the senior living industry that are affecting the day-to-day operations and long-term strategies of organizations. With staffing shortages, slowly increasing census numbers, industry consolidations, and changing regulations, there are a number of considerations for executives to think about that will impact the direction of their organization. Add in the most recent changes to reimbursement rules on the national and state level, and organizational leaders have even more to evaluate that will impact their organization’s financial performance.

Join Baker Tilly for an educational presentation where our team of senior living specialists will discuss recent events within the industry. We will be discussing Medicare reimbursement and compliance, including the most recent Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2026 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) rule, wage index updates, Patient-Driven Payment Model (PDPM) methodology, and how this impacts payments on the federal side as well as on the state side with Pennsylvania’s transition from RUGs to PDPM for Medicaid. We will also be discussing how to minimize risk through compliance requirements by utilizing auditing and monitoring tools to capture supportive documentation, review status of the CMS 5 Claim SNF Probe and Educate audits, share insights on Payroll-Based Journal (PBJ) audits, as well as providing benchmarking analysis to identify operational outliers as it relates to the revenue cycle.

Navigating Leadership Transitions with Clarity and Courage

Kim Hoppe, President/Founder at KSH Consulting, LLC

Behind every leadership transition, affiliation, or major organizational shift is a very human story—one often marked by uncertainty, fear, and doubt. CEOs and CFOs are not only tasked with leading through complexity—they’re often doing so while quietly wondering: Am I in over my head? Can we really move this forward? Will the team trust this process?

This session invites CEOs, CFOs, and other senior executives into a deeper conversation about what it really takes to lead through transition with steadiness and clarity. Whether you're stepping into an interim role, preparing for succession, navigating a board shift, or managing through an affiliation, these moments stretch even the strongest leaders.

Through real-world stories and candid insights from executive transitions in the senior care sector, we’ll explore the emotional and strategic realities that often get overlooked—like decision fatigue, the pressure to “fix everything,” and the fear of being exposed or falling behind. We’ll talk openly about the internal swirl that comes with leadership change, and how to lead through it in ways that are grounded, confident, and effective.

Participants will walk away with:

Tools to reframe overwhelm and reduce internal chaos

Insights into common leadership fears (exposure, loss of control, drift) and how they show up in high-pressure moments

Practical strategies to rebuild trust with staff, boards, and stakeholders

Approaches for creating momentum without burning out your team—or yourself

This session goes beyond traditional transition management frameworks. It’s about how leaders build clarity in the fog, how they balance steadiness with urgency, and how they support teams who are watching closely to see what happens next.

We’ll also talk about what not to do: rushing to action without alignment, bypassing communication rhythms, or leading through silence. These missteps are common—but they can be avoided with the right structure and mindset.

At KSH Consulting, we often say: We’re the people you call when things get messy, when the next move feels unclear, or when you need someone to help carry the weight with you. This session brings that same steady, behind-the-scenes perspective to the room.

Whether you’re an experienced leader navigating yet another season of change, or stepping into uncharted territory for the first time, this conversation offers both validation and actionable support. It’s designed for those who are holding a lot, doing their best to lead well, and craving a little more calm, clarity, and forward movement.

Because the truth is: transitions don’t have to feel like freefall. With the right approach, they can be a powerful opportunity to reset, realign, and lead from a stronger place.

11:00 A.M. – 12:00 P.M.

Concurrent Sessions

Improving Accuracy, Efficiency, and Decision-Making in Financial Services

Michael Doerr, Vice President at Corpay

Today’s finance teams are being asked to do more with less—fewer resources, tighter timelines, and greater scrutiny. This session will provide an in-depth look at how accounts payable professionals can evolve their processes to improve accuracy, reduce risk, and gain better visibility into spend. We’ll cover common breakdowns in the AP cycle and how modern workflows can help overcome them, from invoice intake to vendor payment.

Designed for finance practitioners, this session will highlight real-world strategies that strengthen internal controls, support better decision-making, and build more sustainable operations—especially in the face of staffing shortages and compliance pressures.

Collection Compliance 2025

Steven Montresor, Shareholder at Latsha Davis & Marshall, P.C.
Dayna Mancuso, Associate at Latsha Davis & Marshall, P.C.

Nursing facility collection practices recently have been the subject of intense scrutiny at the federal level. A number of hearings have been conducted regarding the approach that facilities take, and whether the tactics used by nursing facilities are compliant with federal and state law. The Consumer Financial Protection Bureau (CFPB) issued a report in September 2022 focusing on nursing facility attempts to collect debts of the resident from family and friends of the resident, resident representative clauses, and claims that caregivers engaged in financial malfeasance. Ultimately, the Centers for Medicare & Medicaid Services (CMS) and the CFPB issued a joint Notification Letter reminding providers of their responsibilities under the Nursing Home Reform Act (NHRA), Fair Debt Collection Practices Act (FDCPA) and Fair Credit Reporting Act (FCRA).

These recent activities and publications make it clear that nursing facilities engaging in certain collection practices that are inconsistent with federal law and regulations can place a facility at risk for sanctions by the state survey agency and CMS. While it is often not appreciated or a point of emphasis, providers should also be aware that state law consumer protection laws may also place limits on a facility’s ability to collect a debt in certain circumstances. Likewise, while the FDCPA does not directly apply to a nursing facility, personal care home, or continuing care retirement community in the collection process, it does apply to legal counsel and collection agencies that may be working on their behalf to secure payment. Consequently, providers should be aware of the limits that these laws and regulations impose on their consultants and vendors.

This presentation will focus on the regulatory framework establishing what a facility can and cannot do to obtain payment from a resident and/or family member, agent pursuant to a power of attorney. The speakers will address what is permissible under federal law for creating a valid, enforceable and compliant admission agreement and resident representative agreement, the prohibition against third party guarantees and the circumstances under which a nursing facility can pursue a claim for payment against a third party. The speakers will also address the guidance issued by the CFPB and CMS with respect to resident accounts. An emphasis will be placed on federal and state law limiting the ability of a provider and a provider’s collection agents to pursue an outstanding balance.

12:00 - 1:15 P.M.

Lunch & EXPO

Lunch with Exhibitors

1:15 – 2:15 P.M.

Concurrent Sessions

An Enterprise Approach to Financial Planning

Vincent Klos, Director of Enterprise at PNC Institutional Asset Management
Jarrod Leo, Chief Financial Officer at Messiah Lifeways

Macro (inflation, high interest rates, and emerging labor market stressors) and industry (reduced federal Medicaid contributions, properly setting reserves, and overhead and reimbursement pressures due to Medicare Advantage) challenges have introduced an unprecedented level of uncertainty for senior living leaders. While many nonprofit senior living providers have built substantial long-term investment reserves, these pressures have led to increased demand and stress on said reserves. An enterprise approach to financial asset management may benefit the organization through more thoughtful planning around the uses and growth of invested reserves. This session will provide a framework for an enterprise-focused investment management model. Attendees will benefit by:

1. Understanding the role of balance sheet investment assets in contributing to organizational financial health

2. Analyzing the relationship between investment assets and financial results to determine long-term asset allocation

3. Acquiring strategies to leverage enterprise financial modeling outputs for communication with finance and investment committees

The speakers, who include the CFO of a local senior living organization, will leverage a PowerPoint presentation but will engage the audience throughout with real-world questions to make the session interactive and grounded in the actual operations and strategies of today’s aging services providers

Navigating Risk in Aging Services: Strategies for 2025 and Beyond

Christopher Keith, President - Mid Atlantic at EPIC Insurance Brokers

In 2025, aging services organizations face rising insurance costs and complex risks across property, cyber, liability, and workforce management. Climate-driven disasters, cyberattacks, nuclear verdicts, and staffing shortages are driving up costs and exposing facilities to greater liability. To navigate this landscape, leaders must adopt proactive, innovative risk management strategies, such as improving employee training, enhancing cybersecurity, and collaborating with brokers to tailor coverage plans that reduce total cost of risk and improve operational resilience. Attendees are invited to learn about these strategies and explore practical approaches to managing risk effectively in the evolving aging services environment.

2:30 – 3:30 P.M.

Concurrent sessions

State and Federal Budget and OBBBA Update: Preparing for Impact

Chuck Quinnan, Senior Vice President & Chief Government Affairs Officer at LeadingAge PA
Anna Warheit, Director, Regulatory Affairs at LeadingAge PA
Austin Cawley, Director, Legislative Affairs at LeadingAge PA
Emily Kendall-Brown, Housing & Data Analytics Manager at LeadingAge PA
Linda Couch, Senior Vice President of Policy and Advocacy at LeadingAge National

Linda Couch, SVP of Policy and Advocacy at LeadingAge National, will join the LeadingAge PA Government Affairs Team to provide an overview of recent policy and budget changes at the state and federal level that are anticipated to impact operations and financial stability for aging services providers. Attendees will hear the latest on the PA state budget and various financial challenges and requirements that are most directly impacting providers this year, such as Medicaid (MA) pending delays, the transition to PDPM for Medicaid nursing facilities, and the 70% resident care accountability requirement. We’ll take a close look at the One Big Beautiful Bill Act (OBBBA), which was passed by the U.S. Congress on July 3rd, and highlight anticipated impacts most likely to impact aging services providers, including provider tax changes, Medicaid coverage, the Rural Health Transformation Program, non-profit tax issues, affordable housing impacts, and more. A brief overview will also be provided on various federal appropriations and deregulation efforts.

Strategic Planning for Independent Living Expansion: From Land to Lifestyle

Brad Brubaker, Director of Business Development, EGStoltzfus Commercial Construction at EGStoltzfus
Alex Piehl, Principal at RGS Associates

As demand for independent living options continues to grow, aging services providers are increasingly exploring expansion projects that include cottages and apartment-style residences. This session, presented by team members from EGStoltzfus Construction, will guide attendees through the critical financial and planning considerations for launching a successful independent living expansion.

Drawing on our experience—over 500 independent living cottages built and the landmark Woods Building at Moravian Manor—we will walk through the full project lifecycle: from land development and site feasibility to design decisions, buyer experience tools, and budget forecasting.

Attendees will gain practical insights into how to assess site readiness, optimize unit mix and amenities, and manage cost volatility in today’s construction environment. The session will be interactive, featuring real-world examples, planning tools, and lessons learned that attendees can apply directly to their own communities.

Pricing

Early bird registration ends September 23!

Registration Type	Early Bird	Registration
2-day full Member	$299	$329
2-day full Non-Member	$529	$529
1-day Member	$209	$229
1-day Non-Member	$439	$439
Non-Expo Business Member	$399	$399
Reception Only	$99	$99

Hotel Information

Overnight accommodations for Monday, October 13 and/or Tuesday, October 14 can be made by calling the adjoining hotel directly or visiting their website by no later than Friday, September 19 as follows:

Warehouse Hotel at the Nook

75 Champ Blvd.

Manheim, PA 17545

Call 855-618-6181 and ask for the LeadingAge PA room block, Code 15368

Or, visit www.warehousehotel.com and use Group Code 15368

Rate: $139/night + taxes

Check-in: 4:00 pm

Check-out: 12:00 pm

Hotel cancellation policy: 72 hours prior to arrival