Accounting and CFO services for skilled nursing facilities
Census-driven revenue, Medicare and Medi-Cal reimbursement and multi-facility closes need an accounting partner who works in skilled nursing every day.
The finance challenges skilled nursing facilities face
General accountants often miss what makes this part of healthcare different. These are the areas we focus on first.
Census-driven revenue
Revenue moves with census and payer mix every day, so books and forecasts need to track patient days by payer.
Complex reimbursement
Medicare PDPM, Medi-Cal rates, quality assurance fees and supplemental payments all need to be recorded and reconciled correctly.
Cost reports and audits
Medicare and Medi-Cal cost reports and CDPH audits depend on clean, well-documented books all year.
Multi-facility operations
Operators with several buildings need consolidated reporting, intercompany entries and related-party documentation.
How we help skilled nursing facilities
Accounting, audit support and CFO leadership, tailored to how your organization operates.
Accounting
- Monthly close and financial statements by facility
- Patient days and revenue by payer
- AP management and facility-level AP aging
- Prepaid expense amortization and accruals
- Multi-facility and multi-entity consolidation
Audit and compliance
- Medicare and Medi-Cal cost report audit support
- CDPH cost report and financial audit support
- Related-party transaction documentation
- Supplemental payment and grant fund compliance
Fractional CFO
- Census and cash flow forecasting
- Labor cost per patient day tracking
- Facility-level profitability and benchmarking
- Lender, investor and board reporting
Frequently asked questions
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Do you work with multi-facility SNF operators?
Yes. We handle facility-level closes, consolidation across entities, intercompany entries and related-party documentation, with reporting for each building and for the group.
Can you support Medicare and Medi-Cal cost report audits?
Yes. We prepare schedules and supporting documentation and work with auditors during Medicare and Medi-Cal cost report audits and CDPH financial audits.
Which accounting systems do you use for skilled nursing?
We work in QuickBooks, NetSuite and Sage Intacct and connect them with your billing and EHR systems.
Book a free consultation
Tell us about your organization and what you need help with. We typically respond within 24 hours.