Senior Living Accounting: A Month-End Close Built Around Census

Senior living accounting has a feature most industries don't: revenue depends on who lived in the building, at what care level, for how many days. When census, care levels and billing aren't reconciled every month, revenue leaks and resident account errors pile up. A close built around census fixes that at the source.

The core reconciliations

• Census to billing. Every resident in the census report is billed at the correct rent and care level; move-ins and move-outs are prorated per the residency agreement.
• Care level changes. Reassessments during the month flow to billing on the effective date.
• Resident deposits and community fees. Refundable deposits held as liabilities; non-refundable community fees recorded according to the accounting policy and residency agreements.
• Resident AR. Subledger tied to the GL, aging reviewed, private-pay and third-party balances tracked separately.
• Payroll accruals through month-end, with agency labor captured.

Reporting that operators use

A monthly package with occupancy and average daily rate by care level, revenue per occupied unit, labor cost per resident day, agency usage, departmental expenses, and a census bridge (beginning census, move-ins, move-outs, ending census). Departmental detail gives the executive director numbers to act on.

Timing

A well-run community can close within 10 business days. The constraint is usually getting census and care-level changes finalized promptly, so set a cutoff and an owner for that step.

Common questions

What is a census reconciliation in assisted living?

Matching the residents and care levels in the census to what was billed, so no revenue is missed and no resident is misbilled.

How should community fees be recorded?

According to the residency agreement and the operator's accounting policy; confirm treatment with your CPA.