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Year-End Accounting for Senior Living & Long-Term Care Organizations

Dive into best practices, challenges to consider, and strategies to boost your financial health.

With the year more than halfway over, it is a great time to take a closer look at your organization’s financial performance. Doing a financial checkup in preparation for year-end not only helps ensure your records are accurate and compliant, but also gives you the opportunity to identify and address potential issues in advance before they become costly challenges. In this article, we’ll explore key steps you can take to prepare for year-end accounting processes and highlight strategic considerations to help you close the year with confidence.

Year-End Reminders

In preparation of your year-end accounting process, which might also include cost reports or tax preparation, consider these key tasks:

1. Review Bank & Credit Card Statements

Make sure your transactions are accounted for and reconcile discrepancies early to help prevent future errors, detect fraud, and maintain accurate records.

2. Review Financial Statements

Schedule time to go over your balance sheet, income statement, and cash flow statement. Identify discrepancies, unusual items, or areas that need to be addressed. Reflect on these critical areas:

  • Performance Goals
  • Expense Alignment
  • General Ledger Accuracy
  • Intercompany Reconciliations
  • Income Statement Review
  • Balance Sheet Integrity
  • Variance Analysis
  • Documentation & Readiness

Looking over these items can help you identify issues early and make informed adjustments to reduce surprises at year-end. A detailed financial review not only helps with compliance and accuracy but also provides valuable insight into whether you’re on track with your annual financial goals.

3. Strengthen Financial Oversight: Review Accounts Receivable (AR) & Accounts Payable (AP) 

Reviewing AR can help improve cash flow, reduce bad debt risk, and strengthen resident relationships. Reviewing AP can help uncover missed or duplicate payments, unlock vendor discount opportunities, and identify cost-saving opportunities. 

4. Investigate Business Expenses & Deductions 

Going over expenses and deductions can help control costs, create strategies for operational efficiency, and improve budget accuracy. It also helps ensure proper documentation is available at year-end for cost reporting and other regulatory filings.

5. Gauge Compliance With Tax & Regulatory Requirements 

Now is a great time to review your payroll and estimated tax payments. If your organization has experienced a significant change in revenue, consider adjusting your estimated payments to stay ahead of potential audits or filing requirements.

6. Scrutinize Internal Controls & Cybersecurity 

Considering internal controls and cybersecurity frameworks can help reduce the risk of fraud or errors, strengthen data protection, maintain compliance, protect financial and resident data, encourage accountability, and maintain business continuity.

For more details on the most common fraud types that organizations face, and actions to mitigate them, read our in-depth 2025 Small to Midsize Business Report.

7. Plan for Year-End Closing & Tax Preparation

Proactively organizing your financial records ahead of cost report and tax filing deadlines can help streamline your year-end processes, reduce stress, and improve accuracy.

“Strong processes and early preparation are the foundation of a smooth year-end for organizations. When teams take the time to prepare and follow best practices ahead of time, year-end becomes far less stressful. It’s not just about compliance. It’s about creating clarity, reducing risk, and freeing up time to focus on what matters most: caring for your residents. The payoff for being proactive is real, and it starts with good processes and thoughtful planning.”
– Juli Pascoe, Partner

Common Regulatory Compliance Issues Impacting Senior Living & Long-Term Care Accounting

Tackling the complexities of regulatory compliance in senior living and long-term care accounting requires attention to several key areas, including:

  • Medicare, Medicaid, & Managed Care
  • Cost Reporting
  • Resident Trust Funds
  • Financial Record-Keeping
  • Internal Controls
  • Tax Compliance
  • Staffing & Payroll
  • Regulatory Changes
  • Financial Reporting
  • Audit Readiness

Financial Performance Considerations

Evaluating financial performance is a strategic tool for driving sustainability, operational efficiency, and growth for your organization. Key focus areas should include:

  1. Revenue Analysis
  2. Expense Management
  3. Profitability
  4. Cash Flow
  5. Financial Ratios & Benchmarking

How the State of Your Organization Can Impact Financial Health

Maintaining a strong operational foundation is essential for preserving your organization’s financial health while continuing to deliver exceptional care. Regularly evaluating the following areas can help you stay ahead of challenges and position your organization for long-term success with the following:

  • Occupancy Rates
  • Quality of Care
  • Staffing Levels
  • Strategic Planning
  • Community Engagement

How Forvis Mazars Can Help

Preparing for the year-end is not just a task, it’s also a strategic opportunity. By proactively addressing key financial considerations, identifying potential challenges and opportunities, you can position your senior living and long-term care organization for stronger performance year after year. These efforts can lead to improved cash flow, enhanced reimbursement and tax strategies, and support better decision making.

Don’t wait until year-end to start. As we like to say, “Less mess means less stress.” If you have any questions or need guidance, our Outsourced Accounting Services team at Forvis Mazars is here to help. We understand the unique cost reporting, tax, audit, and financial complexities of your organization and can offer high-level support to help you navigate them with clarity and confidence. 

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