Bookkeeping for assisted living facilities
Care revenue is per resident and per month: base rates, level-of-care charges, Medicaid and private pay all mix in one census. On the cost side, staffing, food and supplies move on their own cycles. When resident billing and costs live in spreadsheets, census changes quietly become margin changes. Mispar keeps the census-to-cash trail clean. Plans start at $229/mo.
Best for: Small residential care homes, boutique assisted living operators and owners running one or a few facilities who need resident-level billing and honest monthly numbers.
Per resident
Resident billing
Tracked
Care levels
Reconciled
Staffing costs
Visible
Payer mix
How Mispar keeps your facility books clean
Industry-specific accounts and categorization, with the reporting scope agreed before work starts.
Resident monthly billing
Record each resident's base rate and care-level charges per month, matched to payments received, so no account quietly falls behind.
Level-of-care changes
Track care-level adjustments with their effective dates, so billing reflects the current assessment instead of last quarter's.
Medicaid and private-pay mix
Keep payer sources on distinct lines per resident, so the revenue mix is visible and remittances reconcile to their statements.
Staffing and payroll
Reconcile payroll records against the schedule each month, keeping agency or overtime costs visible as their own lines.
Food and dietary supplies
Track kitchen and dietary spending per month against census, so per-resident food cost stays reviewable as occupancy moves.
Licensing, insurance and compliance
Record licensing, inspections, insurance and training costs on their own lines, so fixed compliance spend is planned rather than surprising.
A simple, predictable process
From kickoff to your first clean close, here is exactly what happens.
Review your current records
We start from your census, billing records, payroll reports and bank feeds as they are.
Map the chart of accounts
Resident revenue, payer sources and cost categories are mapped to an agreed chart of accounts.
Reconcile billing and payroll monthly
Each month's census billing is matched to receipts, and payroll is reconciled against the schedule.
Close the month
Monthly statements with an exceptions list and the per-facility reporting agreed for your operation.
Illustrative example
A twelve-bed home has three rate changes and one Medicaid conversion in a single month. Each resident's billing is adjusted from its effective date, the remittance is reconciled to the statement, and the owner sees the month's real revenue per occupied bed. This is an illustration of the method, not a customer case or a guarantee.
Assisted Living Facilities bookkeeping — your questions
How do you track billing when care levels change mid-month?
Each change is recorded with its effective date, so the month's billing reflects the current assessment. The method for mid-month proration follows the policy we agree with you up front.
Can you separate Medicaid revenue from private pay?
Yes. Payer sources are kept on distinct lines per resident, and each remittance is reconciled to its statement, so the mix and any shortfalls are visible.
How is staffing cost reviewed against occupancy?
Payroll is reconciled monthly and reviewed against the census, so you can see staffing cost per occupied bed as move-ins and move-outs happen.
We run one facility now but plan a second. How does that scale?
Each facility's revenue and costs are kept separate from the start, so adding a location extends the same structure instead of mixing two operations into one ledger.
Does the $229 starting plan cover my facility?
The final plan and scope depend on census size, payer mix and accounts. We agree that scope before starting; catch-up work is discussed separately.
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