Milestone Certified Public Accountants logo — boutique CPA firm Pleasanton CA
Industries · Assisted Living Facilities

Accounting and tax for assisted living and senior care.

For Bay Area assisted living facilities, senior care operators, and residential care for the elderly (RCFE) — facility economics, payer mix, staff classification, and the compliance work that comes with regulated senior care operations.

The Realities of Assisted Living Facilities

What assisted living operators need from a CPA.

Assisted living and senior care combine healthcare regulatory requirements, real estate ownership, and operating business economics — each side with its own accounting and tax implications.

01

Private-pay vs. long-term-care insurance

Facilities accepting private pay, long-term care insurance, and limited Medicaid all need accounting that tracks each payer with its own timing, rates, and reporting needs.

02

Facility ownership vs. lease

Operators who own their facility have meaningful cost segregation, depreciation, and entity-structure decisions that change after-tax economics significantly.

03

Care staff classification

Caregivers, certified nursing assistants, and contracted specialists each carry classification considerations — AB 5 in California, federal classification rules, and overtime exposure.

04

RCFE licensing and reporting

California RCFE licensing requires specific financial reporting and audit-ready records that generic small-business accounting does not produce.

What We Do

Specialized work for assisted living facilities.

We work with Bay Area assisted living operators on the financial side of running a regulated senior care operation.

Multi-facility entity structure

Operating entity vs. real estate entity separation, multi-facility holding structures, and asset protection coordination.

Cost segregation studies

For facility ownership — engineering firm coordination, deduction acceleration modeling, and depreciation schedule integration.

Payer-mix accounting

Private pay, long-term care insurance, and Medicaid revenue tracking with payer-level reporting and aging analysis.

Care staff classification

AB 5 analysis for caregivers and CNAs, federal classification rules, overtime tracking, and contractor agreement structuring.

RCFE financial reporting

Financial reporting formatted for California RCFE licensing reviews, audit-ready records, and accreditation reviews.

Monthly accounting & reporting

Facility bookkeeping, payroll oversight, monthly P&L with facility-level and payer-level detail, tax-ready year-end coordination.

Why It Matters

Senior care work deserves a CPA who has seen it.

An assisted living facility lives at the intersection of healthcare regulation, real estate ownership, and labor-intensive operations. Each side has its own reporting expectations. Working with a CPA who has seen these facilities before changes both the compliance posture and the financial visibility leadership has into the operation.

An invitation

Let's see if we are a fit.

A complimentary 30-minute consultation. We review your situation and tell you honestly whether Milestone is the right firm.

Call directly: 925-320-0309