Senior Living finance: A focus on operational excellence is paramount

Senior Living organizations are operating in an environment where demand is rising and complexity is increasing. Providers must balance expanding care needs with persistent challenges; staffing shortages, evolving federal and state regulations, reimbursement pressure across Medicare, Medicaid and commercial payors and rapid advancements in technology. For skilled nursing providers, these pressures have especially been severe, contributing to the closure of hundreds of facilities in recent years.

Sustaining operational excellence has become essential. Leadership teams must navigate daily operational decisions while also shaping long-term strategy, including determining the right mix of skilled nursing, assisted living and independent living within their continuum of services.

To do this effectively, organizations need access to timely, accurate information. High-performing back-office functions are critical; they give leaders confidence that the data guiding both operational and strategic decisions is dependable.

Integrating industry expertise with finance functions

In Senior Living, strong financial management requires deep industry expertise. Organizations need professionals who understand the complexities of the sector, yet these specialists can be difficult to find, as this level of knowledge is niche and in short supply.

Baker Tilly’s Senior Living team brings decades of experience guiding organizations through growth and transformation, and provides a combination of industry expertise and in-depth industry-specific accounting and finance knowledge.

Modern Managed Services functions that power organizational transformation

Elevating the use of technology platforms to more effectively run a business has become an expectation across all industry sectors, including Senior Living, but true differentiation comes from effective execution. An outcome-based managed services platform leverages integrated platforms, automation and artificial intelligence (AI). The goal is to prevent a slide back into manual processes or underperforming tools and instead ensure that technology serves as a strategic engine of transformation, driving sustained productivity, improving workflows, building confidence and accelerating decision-making.

Modern managed services bring this vision to life by supporting critical operational functions through scalable, tech-enabled delivery models, including:

• Monthly accounting and financial statement reporting
• Payroll processing
• Financial Planning and Analysis (FP&A)
• Human Resources
• Treasury management
• Digital and technology solutions

Sage Intacct and Managed Services

Baker Tilly’s Sage Intacct and Managed Services teams provide powerful solutions for Senior Living organizations. Managed Services provides the industry expertise and full-scale operational support that Senior Living providers rely on, while Sage Intacct strengthens those managed services functions through its tailored, cloud-based system designed with a focus on automation.

Modern Senior Living organizations are replacing manual spreadsheets, delayed reporting and disconnected systems with AI-enhanced, cloud-based financial platforms. These systems go beyond task automation; they speed decision cycles and elevate the overall quality of financial decision-making through automation.

Where many finance systems may fall short:

• Multi-entity structures
• Rapid acquisition cycles
• Diverse community-level operations
• Regulatory reporting (Medicaid, HUD, grants)
• Real-time PPD and labor analysis

Advantages of cloud-based financial platforms and how they close these gaps:

• Automating multi-entity consolidation and intercompany eliminations
• Reducing close cycles
• Providing real-time visibility into census, labor variance and margin performance
• Strengthening audit readiness
• Scaling seamlessly as the business grows

This shift moves finance teams from reactive reporting to strategic, forward-looking insight.

Common challenges and opportunities

Senior Living organizations can vary in size and service lines. Organizations may have different pain points related to financial and accounting functions. Common areas that organizations often struggle with are:

1. Disconnected systems across communities
2. Non-standardized charts of accounts
3. Manual consolidations
4. Delayed reporting
5. Inconsistent AP/AR processes
6. Limited visibility into labor, agency usage, or PPD cost drivers

Baker Tilly’s Sage Intacct and Managed Services practices provide Senior Living organizations with the opportunity to improve and modernize existing technology platforms and processes, delivering immediate returns. Adopting a cloud-based financial system empowers operators to:

• Close books 3-4x faster, delivering timely insights
• Reduce manual errors and improve data accuracy
• Reallocate finance time toward forecasting and strategic planning
• Focus on growth

This is not just a technology shift; it is a competitive differentiator for organizations seeking stability and freedom to focus on operations and strategic planning.

Explore how Baker Tilly supports Senior Living organizations through Sage Intacct and Managed Services solutions.