Senior Services

  1. Mark J. Ross

    Mark Ross



  2. Jennifer Schwalm

    Jennifer Schwalm



  3. Brandon Harlan

    Brandon W. Harlan



  4. Laurie Horvath

    Laurie Horvath



  5. Jennifer Cidila

    Jennifer E. Cidila



  6. Steven A. Repko

    Steven Repko



  7. Hawley, Danielle

    Danielle Hawley



  8. James Hunt

    K. James Hunt



  9. Kelly Nord

    Kelly S. Nord



  10. Jeff Petrell

    Jeffrey J. Petrell

    J.D., CPA, CGMA


From development advisory to operational assessments to audit and tax solutions, our collaborative team of senior living, healthcare, real estate and technology industry specialists provide custom solutions to establish organizational and financial resiliency as well as fulfillment of the mission critical task of providing high quality care and services to residents.

    By the numbers

    Senior patient walks with care giver

    2 of 10

    We work with two of the largest not-for-profit, multisite senior living providers in the nation


    Serving more than 500 for-profit and not-for-profit senior living organizations


    Audited and/or advised 30 of the top 100 not-for-profit senior living, multisite organizations

    Top 15

    Top 15 healthcare consulting management firm (Modern Healthcare 2023)

    Our solutions

    Baker Tilly’s team of professionals understand your organization's unique situation and can tailor solutions that address your most pressing needs beyond audit and tax. Our team works alongside our clients every day and can help you and your organization stay nimble and adjust to change while creating the future of senior living through our customized senior services consulting solutions.

    Senior services development projects are critical to an organization’s growth. Planning and executing development projects is time consuming and, at times, difficult to manage internally with many other competing priorities. From concept and planning through construction and completion, our team provides development advisory services throughout the project and business life cycle. We understand the complexity of the development planning process and the challenges and opportunities facing senior services providers.

    Development advisory services

    A viable, active strategic plan is a compass that guides decision-making and brings focus to the priorities and initiatives that will help drive the future direction of an organization. Baker Tilly’s senior services team provides a comprehensive approach to strategic planning to align stakeholder input, financial condition, operational readiness, and market opportunity with the mission and vision of the organization.

    Senior services providers are facing an increasingly complex and challenging environment, specifically in light of the coronavirus pandemic. As such, the execution of strategies that include mergers and acquisitions (M&A), partnerships, affiliations, etc. are becoming much more prevalent in the sector. At Baker Tilly, we help organizations navigate the transaction process by providing comprehensive analyses along with thoughtful and timely insights to respond to M&A and corporate finance questions.

    Transaction advisory services

    In today’s ever-changing and challenging operating environment, there are several points of concern that affect how senior services providers operate, and these issues can have a significant impact on the operating results of an organization. In response to these issues, Baker Tilly’s clinical advisory team has the hands-on operational experience and skill sets to provide assistance with

    • Analysis of nurse management and direct care staffing
    • Mock surveys
    • Assistance with plan of correction development and implementation
    • Direct in-service education.
    • Evaluation and processing of the Five-Star quality rating reports
    • Review of billings and related medical record documentation to ensure billings are properly supported by underlying documentation, and that reimbursement for services rendered is accurate.

    Labor pressures, including staffing shortages, increased staffing level requirements and wage increases, coupled with near stagnant reimbursement levels from third-party payers, all impact the operations and financial performance of SNFs. The COVID-19 pandemic has also accelerated the desire of the population to live at home, or at least in a homelike environment with a minimal number of additional people, which impacts the growth and viability of the SNFS now, and in the future.

    Baker Tilly’s senior living team helps providers identify areas where revenue enhancement and cost savings can be achieved in an effort to improve operating results. Our operational assessments also assist providers by re-evaluating current operations and determining where changes can be made to ensure strategic endurance and financial sustainability.

    Our cost reporting and reimbursement team prepares hundreds of cost reports on an annual basis and provides assistance and advice to clients related to contracts with managed care organizations, billing matters and regulatory compliance.

    Senior services providers are facing changing consumer preferences, demographic and economic trends, and evolving care delivery models that are driving innovation throughout the industry. An increasingly competitive environment, including competition from non-traditional competitors, is speeding up the timeline to adapt and plan to secure market position into the future. Baker Tilly’s senior services team provides the research, analysis and interpretation necessary to develop a deep understanding of your marketplace and current marketing processes and can provide your organization with the insight to succeed now, and in the future.

    Financial planning and feasibility studies are a cornerstone of any project planning process, whether rightsizing, repositioning or renovating an existing campus, or building new construction. The most cost effective and value-added financial planning process starts at the very early stages of planning. This will help to ensure that unnecessary costs are avoided, and all development related costs incurred during the process will add value to the ultimate completion of the project.

    At Baker Tilly, our team of senior living and real estate specialists can support your project development initiatives by analyzing the financial feasibility of your project.

    Financial planning services

    Real estate projects require a comprehensive view of all available financing, incentive and tax credit options. Baker Tilly can help source and secure development financing from various programs including Low-Income Housing Tax Credits and debt sources, such as Fannie Mae, Freddie Mac and the U.S. Department of Housing and Urban Development (HUD).

    Project financing services

    The COVID-19 pandemic has had a significant impact on senior service providers, and understanding and accessing available funding continues to be a challenge. Baker Tilly provides advice and counsel related to accessing COVID-19 related government grant and loan programs, as well as assisting with your organization’s compliance and recovery efforts.

    Coronavirus recovery and growth resources

    Whether you need assistance with portions of your accounting and bookkeeping functions or if you are looking to outsource your entire accounting department, Baker Tilly can help. Our client accounting services team understands the challenges and pressures facing senior services today and can customize solutions that will transform your back office. After assessing your specific situation, we leverage best-in-class technologies and years of industry expertise to deliver customized solutions.

    Discover more

    Senior living providers face complex decisions everyday as they plan a course for the enduring success of their organization. Baker Tilly can help assess your company’s current state and plan for the future by creating a digital transformation pathway that’s right for your organization by leveraging robotic process automation (RPA), artificial intelligence (AI) and data analytics.

    Digital transformation services

    The role of the chief financial officer (CFO) has changed dramatically. In addition to ensuring regulatory compliance, overseeing the financial reporting process, controlling transaction processing and interacting to those charged with governance, the finance organization is often asked to support enterprise strategic initiatives in an increasingly competitive business environment. Baker Tilly works with our clients to develop practical and effective strategies for aligning finance operations to the business objectives, tailored to fit each company’s unique business requirements and size.

    CFO advisory and support services

    Active tourist with backpack standing at mountain lake and pine wood background
    Baker Tilly Advantage

    Spend more time growing your business than running it

    Free yourself up from the operational complexities and responsibilities related to taxes, accounting and HR. Baker Tilly Advantage provides you with the ideal mix of resources and expertise, all with the scalability to support your needs as they evolve throughout the business lifecycle. 

    We have a great appreciation for Baker Tilly’s vast industry knowledge. Their participation in various national committees and associations has helped us stay at the forefront of industry changes. Our relationship with the team is characterized by a high level of partnership with mutual respect on both sides. They listen to us, work with us and are highly responsive to our requests.
    President, senior services client
    Senior couple enjoying ice cream cones
    Healthy Outcomes | A Baker Tilly podcast series

    Healthy Outcomes: A Baker Tilly podcast

    Listen and subscribe to Healthy Outcomes, a podcast series from Baker Tilly, that discusses hot topics in the healthcare industry. This podcast series brings together Baker Tilly’s team of Value Architects™ and other healthcare industry leaders to talk about issues and opportunities that can help your healthcare organization win now, and anticipate tomorrow.

    Baker Tilly’s team members provide us with proactive advice to help us stay at the forefront of industry developments. They listen to our concerns and seek out timely and effective solutions. They are highly responsive, professional and offer an extensive range of services to complement our annual audit. We are confident in their abilities to provide us with beneficial guidance and we view them as a trusted business advisor.
    CFO, senior services client
    senior living healthcare

    At a glance

    Senior services providers are currently faced with several challenges, including dramatic shifts in the healthcare ecosystem resulting from mergers and acquisitions (M&A), increasing competition, declining reimbursement, the evolution of value-based purchasing and healthcare reform, and pandemic related impacts, which include declines in occupancy and labor pressure (i.e., wages, staff shortages, etc.).

    Strategies related to the development of new products and services, repositioning of existing campuses, technological advancements, and service delivery and care models must evolve to attract future consumers and to remain competitive. Understanding market demand, financing options, the regulatory environment and how to navigate the real estate development process all play a critical role in setting and executing future strategies designed to serve this rapidly growing population segment.

    From concept to completion, we deliver a proactive approach to strategically position your business to remain viable. Our team serves a breadth of for-profit and not-for-profit senior services organizations, including:

    • Continuing-care retirement communities (CCRCs) and life plan communities (LPCs)
    • Skilled nursing facilities (SNFs)
    • Assisted living facilities
    • Memory care organizations
    • Home and community-based service clients (i.e., home health, hospice)
    • Active adult and affordable housing communities