CLHF Bookkeeping for a Small, High-Acuity House
Booxmax is a bookkeeping, payroll, and advisory firm.
A Congregate Living Health Facility runs 24-hour skilled-nursing labor in a home with a handful of beds, mostly on private pay. At that size, every empty bed and every staffing dollar moves the whole P&L, so the books have to be current and read per resident.
[ Book a 20-minute per-bed books check ]
At eighteen beds, there is nowhere to hide a bad month
A CLHF is capped at around eighteen beds and staffed for continuous skilled nursing, so the cost base is heavy and the revenue base is small. One empty bed, or a swing in agency-nursing hours, moves the margin right away. There is no scale to absorb it. The only real protection is books that are current and read per resident and per bed, so a soft month shows up while you can still respond to it.
Mostly private pay, so collections are the business
Most California CLHFs are not Medi-Cal certified and bill residents, their families, long-term-care insurance, or a waiver directly, at a high daily rate. At that rate, one slow-paying account becomes real money fast. We keep per-resident A/R and aging tight, so a high day-rate does not quietly turn into a high receivable.
If you are Medi-Cal or waiver certified, that has to reconcile
Some CLHFs are certified for Medi-Cal, which pays up to a daily cap, or serve residents on the Home and Community-Based Alternatives waiver. Those payments and each resident’s private-pay balance have to reconcile against what the resident actually owes, or money goes uncollected on one side while you chase it on the other. We keep the two reconciled to what each resident owes.
What we keep, every month
- Per-resident and per-bed revenue and day tracking, kept current.
- Private-pay A/R and aging, tight, because the day-rate is high.
- Medi-Cal or waiver reconciliation against private-pay balances, if you are certified.
- Skilled-nursing payroll (RNs, LVNs, aides, on-call, and agency hours tracked separately).
- Books reconciled to your bank, with monthly reports in QuickBooks Online by Certified ProAdvisors.
We track beds, days, and dollars, not the nursing chart
Bookkeeping works from financial and census data. Your residents’ clinical records stay in your system, and we do not take them.
What we do, and what we don’t
We are a bookkeeping, payroll, and advisory firm. We do not prepare tax returns, give legal advice, handle your CDPH licensing, or enroll you with Medi-Cal. Licensing routes to your administrator and CDPH; Medi-Cal enrollment routes to you and DHCS. Income tax routes to your tax preparer. Clinical records stay in your system. We keep the financial numbers underneath.
Local, secure, QuickBooks-based
A CLHF is a California facility, and we keep California books. Certified ProAdvisors, a secure 256-bit SSL/TLS client portal, based in Burbank and serving the LA metro.
[ Book a 20-minute per-bed books check ]
FAQ
What is a CLHF? A California-licensed residential home, generally capped at eighteen beds, that provides 24-hour skilled nursing in a home-like setting, a step above a skilled nursing facility and below a hospital. It is licensed by CDPH under Health and Safety Code section 1267.13.
Are CLHFs mostly private pay? Yes. Most are not Medi-Cal certified and bill privately at a high day-rate. If you are certified, Medi-Cal pays up to a daily cap, and we reconcile that against private-pay balances.
Do you handle our licensing or Medi-Cal enrollment? No. Those route to your administrator, CDPH, and DHCS. We keep the books.
Do you handle our residents’ health information? No. Bookkeeping works from financial and census data only. Clinical records stay in your system.
Are you local? Yes. Booxmax, Inc., Burbank, CA, serving the LA metro.
This page explains general bookkeeping mechanics. It is not legal or tax advice, and it is not facility licensing or Medi-Cal enrollment. Licensing routes to CDPH and your administrator; Medi-Cal enrollment routes to DHCS; tax matters route to your tax preparer; clinical records stay in your system.
Booxmax, Inc. · 224 E Olive Ave, Ste 217, Burbank, CA 91502 · (818) 485-2669 · Info@booxmax.com · booxmax.com