If there’s one thing our broad experience has taught us, it’s this: One size does not fit all.
Accounting Today
Accounting Today
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The Rural Health Transformation (RHT) Program was designed to move billions of dollars into rural healthcare systems at a pace rarely seen in federal funding programs. For many organizations, attention has understandably centered on application strategy, state priorities, and funding opportunities.
What recipients are learning now is that winning an award is only the beginning. The operational demands that follow can create challenges every bit as significant as securing the funding itself.
As RHT funding is being awarded, many recipients are moving into implementation while states continue to interpret requirements and seek clarification on federal guidance.
Part of the challenge stems from the program's state-administered structure. Although funding was distributed on a common timeline, contract structures, eligible costs, reporting procedures, and approval processes vary significantly across states and programs, leaving some recipients to launch funded initiatives before all requirements are fully defined.
Organizations are being asked to procure equipment and services, hire staff, deploy technology, establish reporting processes, and demonstrate results within compressed timeframes. The challenge is not only implementing these initiatives quickly, but doing so in a way that satisfies changing compliance obligations.
Organizations that have limited experience administering federal assistance awards may not be familiar with the additional requirements imposed around competition, documentation, conflicts of interest, approvals, and audit thresholds.
A purchase can be operationally necessary and still fail a compliance review if proper procedures were not followed. If an organization cannot demonstrate that costs complied with grant requirements, reimbursement may be disallowed and expenses already incurred may become the organization’s responsibility.
Reporting obligations can create similar challenges. Awards commonly reimburse labor expenses, but federal funding generally requires detailed time-and-effort reporting that for-profit companies are not currently equipped to support. Many recipients are finding that they need to quickly modify their Human Resource Information System (HRIS), payroll, Enterprise Resource Planning (ERP), and reporting systems to capture this information from day one.
Many applicants focus on the size of the award during the pursuit phase. Once funding is secured, attention turns to the resources required to deliver what was promised.
Personnel time, travel, oversight, reporting, program management, vendor coordination, compliance monitoring, and grant administration can add significant costs that are not always fully considered during application development.
With administrative costs capped at 10%, organizations have less flexibility to fund the infrastructure required to manage federal awards. At the same time, states are trying to maximize funding available for program activities, creating a zero-sum dynamic between service delivery and program administration.
Forward-looking recipients, often with advisory support, are proactively addressing compliance, reporting, and program management costs during contract negotiations and advocating for those expenses to be captured in grant terms and conditions.
One issue receiving increased attention is the intersection of RHT funding and program income. Many recipients are participating in funding models that differ from traditional nonprofit or academic grant programs, raising questions about how revenue from grant-funded activities should be treated and reported.
Federal agencies are showing heightened interest in overseeing these arrangements, and states are often seeking additional clarification as they develop implementation requirements. For recipients, that can create uncertainty around reporting practices, reimbursement treatment, the risk of disallowed costs, and compliance obligations as guidance continues to be released.
Organizations are being evaluated on their ability to improve care delivery, expand access, strengthen workforce capacity, deploy technology, and produce measurable outcomes. Those objectives require governance, staffing, accountability, and decision-making structures.
Many providers are discovering that implementing an RHT-funded initiative requires more internal capacity than anticipated. While leadership teams often came together to pursue funding, not all fully planned for the workforce needed to execute and sustain these initiatives over multiple years.
As a result, existing teams are frequently being stretched to absorb grant responsibilities alongside their current workloads.
RHT funding introduces federal expectations around documentation, oversight, internal controls, and audit readiness that differ from many healthcare organizations' experience managing clinical operations, reimbursement, and commercial contracts.
We provide:
As requirements continue to develop, organizations that establish governance, reporting, and compliance processes early can manage funding more effectively throughout the life of the program. We help recipients build that foundation with clearer direction, stronger controls, and documentation that can withstand future scrutiny.
GREENVILLE, South Carolina, October 1, 2026 — Elliott Davis Advisory, LLC, a top 50 accounting, tax, and consulting firm, today announced that effective October 1, 2026, Equify Advisors, a leading NetSuite Alliance Partner specializing in business systems consulting and advanced analytics, will join the firm.
The combination expands the Elliott Davis Digital Consulting practice, adding approximately 36 professionals and enhancing the firm's ability to help clients leverage technology, data, and insights to improve business performance. Co-founder Taylor Kopnitsky will lead the firm's Business Systems Consulting practice, and Co-founder Ben Washburne will lead the Advanced Analytics practice.
Founded on a commitment to helping organizations maximize the value of their technology investments, Equify Advisors has built a strong reputation for delivering NetSuite implementation and optimization services, business systems consulting, and advanced analytics solutions across a variety of industries.
“The addition of Equify Advisors is an important step in the continued growth of our Digital Consulting practice,” said John Otten, Chief Executive Officer of Elliott Davis Advisory, LLC. “The team brings deep expertise in business systems consulting and analytics, along with a strong reputation for helping clients solve complex business challenges. We are thrilled to welcome Taylor, Ben, and the entire Equify Advisors team to Elliott Davis.”
Equify expands the firm’s capabilities in ERP consulting, cloud business systems, advanced analytics, business intelligence, and data-driven decision support. Together, the combined team will help organizations implement and optimize technology investments and gain actionable insights from their data.
“As we continue to invest in the future of our Consulting Practice, Equify stood out because of both its capabilities and its people,” said Jeff Walker, Consulting Practice Leader at Elliott Davis Advisory, LLC. “Their expertise complements our existing strengths, and just as importantly, their culture aligns closely with ours. Together, we're creating exciting opportunities for our teams while helping clients get even more value from their technology, data, and investments.”
“We founded Equify Advisors on the belief that a technology partner has to be more than just a transactional consulting service,” said Taylor Kopnitsky and Ben Washburne, co-founders of Equify Advisors. “We take great pride in how we partner with our clients to guide them through their business systems and analytics journey, and in the age of AI, that kind of partnership matters more than ever. ”
"Elliott Davis shares that mindset and brings real depth behind it," Kopnitsky and Washburne added. "Our clients keep working with the same team they trust, now with a much broader team available as their needs grow. For our people, it equips us to tackle even more complex challenges for our clients."
Equify Advisors and Elliott Davis share a culture grounded in collaboration and exceptional client service. By bringing the teams together, the combination is expanding career paths for its people and strengthening its ability to deliver innovative solutions for clients.
Envoy Capital Advisors served as the exclusive advisor to Equify Advisors on the deal.
About Elliott Davis
Elliott Davis Advisory, LLC is a U.S. top 50 accounting and consulting firm. With a team of over 900 professionals across major U.S. markets and global alliance resources, the firm delivers tailored solutions to diverse businesses, organizations, and individuals.
About Equify Advisors
Equify Advisors is a NetSuite Alliance Partner providing business systems consulting, ERP implementation and optimization, advanced analytics, and technology advisory services. Equify helps organizations improve operational performance through modern business systems, actionable data, and strategic technology solutions.
What do you actually do with AI? In the final episode of this three-part series, Dr. Drew Brannon and Michael Wolinsky move from reflection to action, exploring how individuals and organizations can begin using AI effectively. They explore how individuals can build reps, use AI as a thought partner, protect their critical thinking, and become more, not less, of themselves. They also offer practical guidance for organizations around strategy, governance, communication, and deciding what AI should and shouldn't do. The message is simple: don't outsource your thinking, use AI to amplify it.
