Welcome to KramerWeisman and Associates: Auditors, Tax Consultants, CFO/Controllership and Consulting Services serving South Florida and Broward County

Jeff Kramer, CPA, Financial Professional for the Healthcare Industry
By Nancy Kennedy

Jeff Kramer Now more than ever, healthcare organizations of all sizes and types need competent, reliable financial professionals to help them navigate the turbulence and complexity of the American healthcare industry. In South Florida, one such professional is Jeffrey Kramer, Certified Public Accountant, who has been providing exemplary financial services to healthcare clients since 1987. Kramer is a founding partner of Kramer Weisman and Associates, LLC, an accounting firm located in South Broward County that serves the healthcare, wholesale/distribution, technology, real estate, hospitality and manufacturing industries, as well as not-for-profit organizations.

“Approximately half of my clients are in healthcare,” says Kramer, “and that has been true throughout my career. I enjoy working with healthcare organizations and physicians. By being involved in healthcare, trying to help organizations survive and thrive, I feel that I am helping the community. The healthcare industry affects everyone.”

Kramer’s clients include large and small physician practices as well as hospitals and hospital systems, medical groups, managed care organizations and other “hybrid” health care organizations. He and his partner Lester Weisman and a staff of 10 provide a comprehensive menu of services that includes basic accounting, tax preparation and advice, management of IRS issues, auditing, financial forecasting and projection (for funding and licensing), forensics and litigation, consulting on special projects and due diligence on acquisitions.

Kramer is particularly focused on the challenges facing physicians and physician groups. He favors the development of “mega” physician groups, as a means of empowerment and fortification. “Mega groups offer substantial advantages for doctors. Often, doctors are trying to do business with managed care companies and hospitals – entities that are far larger and have enormous resources, including highly skilled teams of attorneys and CPAs. They are simply unable to negotiate because, by comparison, they lack power. They don’t have the resources to match these huge entities.

“Larger physician groups help level the playing field, with power, numbers and greater resources. The trend is towards larger groups with professional management, and a small independent practice can’t afford that. It’s expensive to hire a highly credentialed, skilled administrator, but you need that skill set to compete. Doctors are starting to recognize this, and to form these larger practices. It’s a transition for them; they are used to being independent, to running their own practices.

“I believe that we need better leadership in healthcare, and that physicians, along with politicians or administrators, should be leading the charge. Physicians are the ones who truly know what is needed to transform healthcare.”

Kramer compares physicians to other small business owners. “Doctors are getting squeezed these days, between rising costs and falling reimbursements. They are quite challenged, and need help like any other small business owner. They have to watch their finances closely and need to have a financial professional that they can trust, someone who can provide sound advice.”

Like many of his clients, including physicians, Kramer is himself a small business owner and can relate to the challenges they face. He started his company nine years ago. “I understand the concerns and challenges that my clients have because I have them too. I tend to develop strong relationships with my clients. They know they can call me, bounce things off me and seek my advice. I’m there for them.”

That is confirmed by client Chris Prestera, owner and Chief Executive Officer of Physician Advocates LLC. “I’m a broker to the healthcare industry for property and casualty insurance, specializing in medical malpractice. I have been a client of Jeff Kramer’s since I opened the agency 6 years ago. Jeff is a very capable accountant, as are his colleagues. At the end of the day, I know I will never have IRS concerns, because of Jeff’s prudence in managing my financials and my taxes. When I started my agency, he gave me excellent advice on how to financially structure the company. I would recommend him in a heartbeat, to anyone, and in fact I frequently have. Jeff is completely competent and trustworthy.”

Kramer is a Miami native who is a graduate of the University of Florida, where he earned his Bachelor of Science in accounting in 1986. He began his professional career as an auditor with PriceWaterhouseCoopers. He is married, with two children, and resides in West Broward County, where he enjoys tennis, photography and traveling.

Kramer is an industry leader who has published a number of articles and lectures on healthcare topics. He is a member of the American Institute of Certified Public Accountants, Florida Institute of Certified Public Accountants (where he has served on the Healthcare Committee), South Florida Healthcare Executive Forum (Board Member), Nova Southeastern University H. Wayne Huizenga School of Business and Entrepreneurship Young Entrepreneurs Council, Healthcare Financial Management Association and Memorial Hospital Foundation Planned Giving Committee (Board Member).

To contact Jeff Kramer, call (954) 475-1260 ext. 12, or e-mail jeff@kwacpa.com. To learn more about Kramer Weisman and Associates, visit the website at www.kwacpa.com.

South Florida Hospital & Healthcare Association Healthcare Summit Ad

Suzanne S. Duffy, CPA received the QuickBooks® ProAdvisor Point of Sale Certification

Sue Duffy has successfully completed her training and is now a Certified Point of Sale ProAdvisor for QuickBooks. The Point of Sale Certification demonstrates that Sue has achieved the comprehensive level of knowledge required by Intuit® to provide assistance with the QuickBooks Point of Sale application. Sue is qualified to guide users through the initial purchase of QuickBooks, installation, and setup of the software. Sue is also available to teach clients to use the program for basic accounting, financial reporting, payroll and complex applications. Click here to view Sue's profile on the QuickBooks website. Please contact or call her at (954) 475-1260 Ext. 18 to schedule a consultation.

Jeff Kramer Featured in the August edition of South Florida Hospital News

Outsourced Accounting Services for the Healthcare Industry
by Jeffrey B. Kramer, CPA

Healthcare executives frequently outsource services to accounting firms. Services commonly outsourced include due diligence for mergers or acquisitions, preparation of financial projections, accounting for newly acquired entities and CFO services.

Mergers of medical entities are on the rise. Medical practices are merging to enhance profitability and to increase leverage in managed care contracting. Prior to a merger, it is necessary to assess the finances of the target entity. This job, referred to as due diligence, is commonly outsourced to an accounting firm. The accountants are asked to review financial records to help determine if there is a financial fit.

Accounting firms are frequently asked to prepare financial projections. Financial projections are helpful when entities are seeking financing, considering an acquisition or considering offering new products or services. The accountant interviews management to determine what course of action the business expects to take. This information is then translated into financial terms and the projection is created. Financial projections might include pro-forma income statements, balance sheets or cash flow statements quantifying expected financial results given certain assumptions.

Accounting for newly acquired or merged entities is commonly outsourced. After a transaction, the surviving entity may not immediately have sufficient in-house financial expertise to perform the accounting for the newly acquired entity. Rather than letting the accounting wait until the entity is integrated and additional finance personnel are hired, the initial accounting work is often outsourced.

CFO (chief financial officer) or controllership services are commonly outsourced. For small publicly traded or privately held companies it sometimes makes economic sense to outsource the CFO position. Companies needing seasoned financial expertise but lacking the economic resources to employ such expertise on a full-time basis sometime outsourced these services. Under the outsourcing model, the company purchases only the amount of services that are affordable and necessary. Rather than employing the accountant full-time, services are purchased as needed via outsourcing thereby reducing costs.

With outsourcing, companies benefit from having seasoned professionals available to fill gaps as necessary. Outsourcing can provide a high level of sophistication giving the business access to qualified financial personnel on an as needed basis. Business owners facing time or resource constraints should consider outsourcing as a solution.

Suzanne S. Duffy, CPA received the QuickBooks® ProAdvisor Advanced Certification

Sue Duffy has successfully completed her training and is now a Certified Advanced ProAdvisor for QuickBooks. The Advanced Certification demonstrates that Sue has achieved the comprehensive level of knowledge required by Intuit® to provide assistance with QuickBooks applications. Sue is qualified to guide users through the initial purchase of QuickBooks, installation, and setup of the software. Sue is also available to teach clients to use the program for basic accounting, financial reporting, payroll and complex applications. Click here to view Sue's profile on the QuickBooks website. Please contact or call her at (954) 475-1260 Ext. 18 to schedule a consultation

Jeff Kramer Featured in the July edition of South Florida Hospital News

Florida Medical Business Ad - June 24, 2008

Jeffrey Kramer, CPA, featured in the Memorial Foundation • Joe DiMaggio Children's Hospital Foundation "Chronicle" newsletter

Hurricane Preparation for Healthcare Professionals by Jeffrey Kramer, CPA
South Florida Hospital News - June, 2008 - Volume 4 - Issue 12

Every healthcare practice in Florida should have a hurricane preparation plan. The plan does not necessarily have to be extensive, but should consider the most likely storm scenarios. To create the plan, an assessment of potential risks should be conducted. The plan is then developed based upon the assessment. The plan should be prepared before a storm threatens since time and resources will be limited as a storm approaches.

The hurricane preparation plan serves as a blueprint detailing what steps should be taken when a hurricane risk is eminent. Staff members should be familiar with the plan before a crisis arises. As every practice is different, hurricane plans will vary by practice. The following ideas should be incorporated into the hurricane plan:

After a storm, the practice may be closed for a week or more until disruption issues have been resolved. Management should consider the length of time the practice can survive before its finances are significantly depleted. Covering overhead costs and paying employees for an extended period of time may not be possible if cash flow interruptions occur.

The importance of having sufficient insurance coverage cannot be overemphasized. Evaluate what the current insurance covers and make sure catastrophic events are covered. Basic insurance may not cover events like floods and other so-called "acts of nature," so coverage may have to be expanded. Consider adding business interruption coverage, which reimburses the practice for revenue lost during the time the practice is unable to function.

Preparing for hurricanes is complicated, expensive and time consuming. Unfortunately, the number and intensity of storms seems to be increasing and it should be assumed that hurricanes or other natural disasters will affect most health care practices in Florida. The best advice is to begin crafting an appropriate hurricane response plan so you are ready to react quickly when a storm threatens.

Jeffrey B. Kramer, CPA is a shareholder of the firm Kramer Weisman and Associates LLP. He provides audit, consulting and tax services to medical practices and other businesses in the health care industry. For further information, please email or call him at (954) 475-1260.

Jeffrey Kramer, CPA, attends the Florida Institute of Certified Public Accountants Health Care Industry Conference

Held on April 24-25, 2008, this year's conference was host to more than 300 accounting professionals who are involved in the health care industry. Co-sponsors of the event included the Florida Hospital Association, the Healthcare Financial Management Association and the Georgia Society of CPAs. The event provided attendees with the knowledge, expertise and know-how to remain a leader in the health care industry.

Florida Medical Business Ad - April 8, 2008

Sun-Sentinel Ad - April 7, 2008

Let someone else handle company finances

NEW YORK - Ron Finklestein found a good reason for not compiling his business tax return: $1,600.

That's how much Finklestein says he would have overpaid the government if he had gone ahead and submitted a return he had completed as an experiment. When he ran it past his accountant, he discovered he hadn't claimed all the deductions he was entitled to.

Many small business owners try to compile their companies' returns, and they also try to keep the books too. Many, like Finklestein, discover it's better to turn the financial part of the business over to someone with a head for finances — the work will be done faster and better. Moreover, outsourcing finances allows owners to focus on building their companies.

Finklestein, an author and business consultant in Akron, Ohio, only recently handed over the task of keeping the company's books to his accountant, a step he needed to take to have a better handle on how the business was doing. He wasn't consistently updating the books, and so he didn't know what the state of his cash flow. With his accountant in charge of his finances, he's able to make more informed decisions.

Moreover, "it's allowed me to focus my time on where my strengths are, in the sales and marketing side of the house," Finklestein said, estimating that he's gotten back 10 hours a month from not trying to do the books himself.

"What really helped me is the peace of mind knowing that it's done, and done right," Finklestein said. "I don't stay awake at night anymore thinking about it."

Elizabeth Gordon, who owns a management consulting firm in Atlanta, kept her own books the first year she was in business.

"It was a nightmare," recalled Gordon, president of Flourishing Business. "It's just not my strength. ... I need to put myself in the visionary leader role rather than worry about the minutiae better outsourced to someone else who's good at it."

Her solution is to have a bookkeeper pick up her receipts and other papers every two weeks and enter them into an accounting program. She also uses an accounting firm.

Gordon, who has seen plenty of her clients struggle with running their companies, said it's very common for new business owners to try to do their own financial work. "You feel like you have to do it all," she said — although many entrepreneurs are sitting up at 2 a.m. trying to get these tasks done.

The cost can be more than sleep — it can take the joy out of running a company, she said. "[The business] turns into this chore that you feel negatively about, is the exact opposite of what you need in this start-up stage."

Of course, there are many small business owners who easily handle tax returns and their company books. The important word there is "easily" — if doing these tasks don't encroach on taking care of other aspects of the business, and it makes sense for them to work this way, then why shouldn't they do it?

It's also not necessary to outsource the work if there's an employee or a partner able to take the financial work off an owner's hands.

Richard Dukas said the chief operating officer of his New York-based company, Dukas Public Relations, is handling the company's books after taking time to learn how to use accounting software. The COO, who's Dukas wife, Gail Katz Dukas, doesn't have a financial background, but got some training and is now able to keep track of sales, profits and losses, outstanding balances and more.

Richard Dukas said he doesn't do the work because "I know what my strengths are."

The company also relies on an accountant who periodically looks at the books and also helps with financial planning. Dukas said he had to switch accountants at one point because he wasn't getting the help that a growing small business needs. He said, "I'm paying significantly more money now, but I'm thrilled with the service."

Suzanne S. Duffy, CPA becomes a Certified QuickBooks ProAdvisor

Sue Duffy has successfully completed her training and is now a Certified ProAdvisor for QuickBooks versions 2006, 2007, and Enterprise 7. The Certified QuickBooks ProAdvisor designation enables Sue to provide comprehensive assistance with QuickBooks applications. Sue is qualified to guide users through the initial purchase of QuickBooks, installation, and setup of the software. Sue is also available to teach clients to use the program for basic accounting, financial reporting, payroll and complex applications. Click here to view Sue's profile on the QuickBooks website. Please contact or call her at (954) 475-1260 Ext. 18 to schedule a consultation.

Jeffrey Kramer, CPA published in South Florida Hospital News - "Outsourced Accounting Services"

When you hear of outsourcing, you might think of India since outsourcing to India has become commonplace. Outsourcing is also alive and well in the United States. A service commonly being outsourced locally is CFO (chief financial officer) services. With the introduction of the Sarbanes-Oxley Act many small public companies have no choice but to outsource CFO services; however, non-public companies are outsourcing CFO services as well.

Why outsource CFO services? For small public and privately held companies with sales of less than about three million dollars per year it sometimes makes economic sense to outsource CFO services. Companies that need seasoned accounting professionals but may not have the financial resources to employ these professionals on a full-time basis are candidates for outsourced CFO and accounting services. Under the outsourcing model, the company only purchases those services that are necessary. Rather than employing accounting personnel for 40 hours per week, the company utilizes the personnel on an as needed basis.

With outsourcing, companies benefit from having seasoned professionals on their team. The downside of course is that the professional services are purchased at a higher hourly rate. The upside is that these professionals are available as needed at a lower overall cost. Outsourcing is not appropriate for every situation, but in certain cases it makes a perfect fit.

A number of firms in the tri-county area provide outsourced CFO services. Many are staffed by experienced CPA’s (Certified Public Accountants) trained by national accounting firms. Many of these individuals have worked in accounting for 20 plus years and are highly competent.

Outsourced services can bring a higher level of sophistication to the business. Outsourcing gives businesses access to highly qualified financial executives on an as needed basis often at an overall cost less than that of hiring full-time employees. Any business owner facing time or resource constraints should consider the outsourcing solution. Outsourcing is alive, well and expanding in South Florida.

Jeffrey B. Kramer, CPA is a partner with the firm Kramer Weisman and Associates LLP (www.kwacpa.com), a certified public accounting firm located in Davie, Florida. Kramer is also a partner with the firm Small Cap Advisors LLP which provides outsourced CFO services and consulting services. He can be reached at or (954) 475-1260.

PCAOB’s New Audit Standard for Internal Control Over Financial Reporting is Approved by the SEC

Washington, DC, July 25, 2007 – The PCAOB’s Auditing Standard No. 5, An Audit of Internal Control Over Financial Reporting That Is Integrated with An Audit of Financial Statements, was approved today by the Securities and Exchange Commission. It replaces the PCAOB’s previous internal control auditing standard, Auditing Standard No. 2.

In light of this development, the PCAOB announced today that it is undertaking several initiatives to support the successful implementation of the standard. These initiatives include working closely with the audit firms, early in their process, as they evaluate how the new standard will affect their firms’ audits of internal control. Other initiatives include continued outreach to public companies and smaller audit firms regarding the new standard.

With today’s action by the SEC, registered audit firms are required to use the new standard for all audits of internal control no later than for fiscal years ending on or after November 15, 2007.

“We are pleased with the SEC’s approval of AS No. 5, however, this does not mark the finish line for the PCAOB,” said PCAOB Chairman Mark W. Olson.

“Successful implementation of AS No. 5 is key. The new standard should drive important improvements in the audit of internal control, and the Board is committed to doing its part to aid in its successful implementation,” said Chairman Olson.

On May 24, 2007, the Board adopted AS No. 5, which implements Sections 103 and 404 of the Sarbanes-Oxley Act.

Jeffrey B Kramer, CPA attends PCAOB Forum on Auditing in the Small Business Environment

Jeff Kramer attended the PCAOB Forum on Auditing in the Small Business Environment. The seminar was presented by PCAOB staff who discussed Auditing Standard No. 5. Click here to view proposed Auditing Standard No. 5. The proposed standard is pending SEC approval before becoming effective. Standard No. 5 addresses audits of internal controls over financial reporting.

PCAOB (Public Company Accounting Oversight Board) Approves Application for Registration

Effective Immediately -- Kramer Weisman and Associates LLP is now eligible to perform audits of public companies. We have been providing audit services to non-public companies since inception of the firm and have been providing CFO consulting services to public companies since 2004. We have now merged our two complimentary competencies (audit services and public company services) to provide audit services to our public company clients. Click to view PCAOB Approval Letter.

Jeffrey B Kramer, CPA Presents to the Palm Beach County Medical Society

October 5th & October 19th, 2005 -- Jeff Kramer served as a panelist at an office manager round table discussing Running a Financially Sound Practice - an Accountant's Perspective.

Jeffrey B Kramer, CPA Presents to the Memorial Hospital Foundation

May 12, 2005 -- Jeff Kramer presents a seminar to the physicians at Memorial Hospital. The seminar titled Top Business and Tax Mistakes Physicians Make was attended by approximately 50 Memorial Hospital Physicians. The feedback from the seminar was very positive. Click here to view the PowerPoint presentation from the seminar.

Article about Jeff Kramer in South Florida Hospital News by Nancy Kennedy

South Florida Hospital & Healthcare Association Healthcare Summit Ad

Suzanne S. Duffy, CPA received the QuickBooks® ProAdvisor Point of Sale Certification

Jeff Kramer Featured in the August edition of South Florida Hospital News

Suzanne S. Duffy, CPA received the QuickBooks® ProAdvisor Advanced Certification

Jeff Kramer Featured in the July edition of South Florida Hospital News

Florida Medical Business Ad - June 24, 2008

Jeffrey Kramer, CPA, featured in the Memorial Foundation • Joe DiMaggio Children's Hospital Foundation "Chronicle" newsletter

Hurricane Preparation for Healthcare Professionals by Jeffrey Kramer, CPA
South Florida Hospital News - June, 2008 - Volume 4 - Issue 12

Jeffrey Kramer, CPA, attends the Florida Institute of Certified Public Accountants Health Care Industry Conference

Florida Medical Business Ad - April 8, 2008

Sun-Sentinel Ad - April 7, 2008

Let someone else handle company finances

Suzanne S. Duffy, CPA becomes a Certified QuickBooks ProAdvisor

Jeffrey Kramer, CPA published in South Florida Hospital News - "Outsourced Accounting Services"

PCAOB’s New Audit Standard for Internal Control Over Financial Reporting is Approved by the SEC

Jeffrey B Kramer, CPA attends PCAOB Forum on Auditing in the Small Business Environment

PCAOB (Public Company Accounting Oversight Board) Approves Application for Registration

Jeffrey B Kramer, CPA Presents to the Palm Beach County Medical Society

Jeffrey B Kramer, CPA Presents to the Memorial Hospital Foundation

Article about Jeff Kramer in South Florida Hospital News by Nancy Kennedy

South Florida Hospital & Healthcare Association Healthcare Summit Ad

Suzanne S. Duffy, CPA received the QuickBooks® ProAdvisor Point of Sale Certification

Jeff Kramer Featured in the August edition of South Florida Hospital News

Suzanne S. Duffy, CPA received the QuickBooks® ProAdvisor Advanced Certification

Jeff Kramer Featured in the July edition of South Florida Hospital News

Florida Medical Business Ad - June 24, 2008

Jeffrey Kramer, CPA, featured in the Memorial Foundation • Joe DiMaggio Children's Hospital Foundation "Chronicle" newsletter

Hurricane Preparation for Healthcare Professionals by Jeffrey Kramer, CPA South Florida Hospital News - June, 2008 - Volume 4 - Issue 12

Jeffrey Kramer, CPA, attends the Florida Institute of Certified Public Accountants Health Care Industry Conference

Florida Medical Business Ad - April 8, 2008

Sun-Sentinel Ad - April 7, 2008

Let someone else handle company finances

Suzanne S. Duffy, CPA becomes a Certified QuickBooks ProAdvisor

Jeffrey Kramer, CPA published in South Florida Hospital News - "Outsourced Accounting Services"

PCAOB’s New Audit Standard for Internal Control Over Financial Reporting is Approved by the SEC

Jeffrey B Kramer, CPA attends PCAOB Forum on Auditing in the Small Business Environment

PCAOB (Public Company Accounting Oversight Board) Approves Application for Registration

Jeffrey B Kramer, CPA Presents to the Palm Beach County Medical Society

Jeffrey B Kramer, CPA Presents to the Memorial Hospital Foundation

Hurricane Preparation for Healthcare Professionals by Jeffrey Kramer, CPA
South Florida Hospital News - June, 2008 - Volume 4 - Issue 12