Question 1 of 10
How often are resident invoices reviewed for accuracy before they’re sent out each month?
π‘ Care level billing errors are the #1 source of silent revenue leakage in assisted living. A resident who moved from Level 2 to Level 3 care 45 days ago, are they billed at Level 3?
Question 2 of 10
When did you last audit what each payor (Medicaid, Medicare, private pay, LTC insurance) is actually reimbursing vs. what your contracts say they should pay?
π‘ Payor underpayment is rarely intentional, it’s usually a contract rate loaded incorrectly into the billing system. The longer it goes unchecked, the larger the cumulative loss.
Question 3 of 10
What is your average Days in Accounts Receivable (AR) for private-pay residents?
π‘ Every day in AR past 30 is a cash flow cost. A facility with $500K/month in private-pay revenue running at 60-day AR is effectively lending $1M interest-free to residents.
Question 4 of 10
How do you track census (occupied vs. available units) and its impact on revenue day-to-day?
π‘ A 2-unit vacancy at $5,500/month AL rate costs $11,000/month, $132,000/year. Operators who track census daily respond to move-outs 8β12 days faster on average.
Question 5 of 10
When a resident’s care needs increase (e.g., moves from AL Level 2 to Level 3), how quickly is their billing updated?
π‘ In a 60-unit AL community, even 5 residents billed at the wrong care level for an average of 45 days represents $6,750β$15,000 in unbilled revenue per quarter.
Question 6 of 10
What is your Medicaid/Medicare claims denial rate, and what happens to denied claims?
π‘ Industry average denial rates run 5β9%. At a denial rate of 7% on $200K/month in Medicaid billing, that’s $14,000/month in claims at risk, most operators recover less than 40% of denied claims.
Question 7 of 10
Do you have a formal collections process for overdue private-pay balances?
π‘ Private-pay bad debt typically runs 1β3% of private-pay revenue for operators without a formal process, vs. under 0.5% for those with documented collections workflows.
Question 8 of 10
How is your payor mix, the ratio of private pay vs. Medicaid vs. Medicare vs. LTC insurance, managed strategically?
π‘ The difference between a 60% private-pay and 40% private-pay facility can be $800β$1,500/occupied unit/month in net revenue on the same physical asset.
Question 9 of 10
How quickly does your team close the books each month, and what does the financial report include?
π‘ A 4-week reporting lag means you find out about a $40K labor overrun 60 days after it started. At that point, you’ve compounded the problem before you even knew it existed.
Question 10 of 10
Who in your organization is responsible for identifying and fixing revenue leakage, proactively, not reactively?
π‘ Revenue leakage is a systems problem, not a people problem. Without CFO-level oversight, even well-run facilities hemorrhage 4β8% of potential revenue annually through process gaps.



