Client background
A Continuing Care Retirement Community (CCRC) was experiencing ongoing financial losses in the skilled nursing level of care. Leadership engaged Baker Tilly to evaluate the skilled nursing operation and identify opportunities to improve financial performance.
The situation
The organization faced recurring losses in its skilled nursing level of care. Several key issues were contributing to the losses:
- Staffing inefficiencies: nursing hours per resident day and labor costs in various departments were not aligned with industry benchmarks
- Escalating costs driven by outdated vendor contracts and limited oversight relative to managing costs in various departments
- Limited visibility into cost-per-day performance (by department) compared to industry benchmarks
Leadership needed data-driven insights to identify root causes and prioritize corrective actions.
The strategy
Baker Tilly conducted a comprehensive operational and financial review focused on both revenue optimization and expense management.
Data-driven cost analysis
- Leveraged national benchmarking databases to analyze cost per day by cost center
- Identified performance outliers within nursing, dining services, housekeeping and other departments
- Pinpointed areas requiring deeper operational review and management attention
Staffing optimization
- Evaluated nurse staffing levels—i.e., hours per resident day—by discipline
- Proposed staffing changes aligned with industry benchmarks and best practices
- Engaged with clinical team to ensure the organization’s high quality of care standards wouldn’t be jeopardized by proposed staffing changes
Vendor contract review
- Reviewed various vendor contracts
- Identified outdated agreements and renegotiation opportunities
- Leveraged contract out clauses to reduce expenses
The solution & results
Baker Tilly delivered measurable and sustainable recommendations to achieve financial improvements:
- Identified nurse staffing efficiencies and department-level cost reductions
- Flagged dining services and housekeeping departments as actionable outliers
- Enabled renegotiation of outdated vendor contracts
Beyond immediate cost savings, the organization gained the tools, benchmarks and analytical framework needed to continuously monitor cost performance and make informed operating decisions going forward.
With improved cost visibility and optimized staffing models, the organization is positioned for stronger financial stability. When leadership has the right data better financial performance follows.
We’re here to help
For more information on how comprehensive operational and financial reviews can improve your health care organization’s financial performance, please contact us.

