You provide the care. We ensure the assets are used to pay for it.
A past-due senior living account is rarely just an unpaid bill. It may be private-pay rent, a Medicaid-pending balance, resident patient-pay controlled by a Power of Attorney, or a claim that now belongs in probate. The first question is not simply “How do we collect it?”—it is “Who actually owes it, and which funds can legally be pursued?”
Collect911 helps assisted living communities, memory care facilities, skilled nursing facilities, and other senior care providers sort out those differences before recovery begins. Fresher balances can be handled through a low-cost fixed-fee program, while move-outs, deceased accounts, and harder aged balances can move to contingency collections with no collection fee unless money is recovered. The goal is straightforward: recover legitimate receivables without turning every family issue into a confrontation.
Protecting your practice’s reputation, Collect911 holds licenses in all 50 states, ensuring a safe approach for every patient interaction. We provide free litigation and bankruptcy scrubs with zero onboarding or annual fees. Our SOC 2 Type II and HIPAA-compliant systems ensure total data security, backed by a 4.85/5 rating from over 2,000 professional reviews. Delivering high recovery rates!
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Flexible Pricing for Every Scenario
1. Pre-Collect Service (Fixed Fee)
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Best For: Current residents 60-90 days past due.
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Cost: Low flat fee (e.g., ~$15/account).
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Method: A diplomatic “Audit & Reminder” approach sent in your name.
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ROI: You keep 100% of the recovered funds.
2. Contingency Collections (Standard)
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Best For: Move-outs, deceased accounts, or hostile families. Accounts over 120 days.
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Cost: A percentage of the collected amount.
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Risk: No Recovery, No Fee. If we don’t collect, you pay $0.
The “Hidden” Cost of Unpaid Senior Living Debt
In the senior living industry, margins are tighter than ever. According to recent industry data, the average Assisted Living facility operates with a margin of just 28-32%, while Skilled Nursing Facilities (SNFs) often run closer to 1-3%.
Every unpaid invoice hits your bottom line directly.
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Average Bad Debt: A single unpaid move-out in senior living averages $4,500 – $12,000.
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The “POA” Factor: It is estimated that over 60% of senior living bad debt is caused not by the resident’s lack of funds, but by the financial mismanagement of the adult child or legal guardian controlling the checkbook.
We stop this leakage by holding the financial decision-makers accountable.
Our 3-Pronged Recovery Strategy
We categorize every account to apply the correct legal pressure:
1. The “Negligent POA” Strategy
The most frustrating scenario for an Executive Director is seeing a resident with a pension and Social Security, yet the rent remains unpaid.
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The Approach: We bypass the resident and target the fiduciary. We remind the Power of Attorney (POA) of their legal obligation to use the resident’s assets for care first.
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The Leverage: Misappropriating a senior’s funds can be a criminal offense in many states. When a POA realizes that their own financial conduct could be scrutinized, payment is often prioritized immediately.
2. The Estate & Probate Strategy
When a resident passes away, families often claim, “Mom had no money left.”
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The Reality Check: We conduct deep-dive Probate and Asset Searches. We identify real estate transfers, life insurance payouts, or hidden Trusts.
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Creditor Claims: If an estate is opened, we file the necessary paperwork to ensure your facility is listed as a priority creditor before the inheritance is distributed to the heirs.
3. The “Medicaid Gap” Strategy
Waiting for Medicaid approval can leave a facility with months of unpaid “Share of Cost” (NAMI) balances.
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The Solution: We pursue the Patient Liability portion aggressively. Retroactive Medicaid payments go to the facility, but the “Share of Cost” often gets stuck in the resident’s bank account. We ensure that money comes to you, not the family.
Collections Without Eviction: The “Census Protection” Model
Your goal is to keep your beds full. Involuntary discharge is a regulatory minefield involving Ombudsmen, 30-day notices, and safe discharge planning.
We act as a buffer. By involving a third-party agency, we change the dynamic. We can often negotiate payment plans or “catch-up” structures that allow the family to resolve the debt so the resident can remain in your community. We recover the funds, you keep the census.
We handle adult children, designated POAs, and estate representatives through empathetic, documentation-first mediation—verifying legal authority and providing clear accounting to resolve balances respectfully without family conflict or legal friction.
How to Prepare a Senior Living Account for Collection
Step 1 — Identify the true balance
Reconcile the resident ledger and separate private-pay charges, insurance payments, Medicaid-covered amounts, and the resident’s actual responsibility.
Step 2 — Confirm who is responsible
Review the admission agreement and determine whether the account belongs to the resident, an estate, or another legally liable party. Do not assume that a POA, adult child, or “Responsible Party” is personally liable.
Step 3 — Check Medicaid and payer status
Confirm whether Medicaid eligibility, an appeal, Medicare payment, long-term care insurance, or another third-party payment is still pending.
Step 4 — Assemble the collection file
Include the admission agreement, itemized ledger, statements, payment history, relevant resident-representative information, and documentation supporting the outstanding amount.
Step 5 — Match the account to the right collection stage
Fresher balances may fit a fixed-fee pre-collection approach, while older move-outs, deceased accounts, and harder balances may require contingency collections.
Step 6 — Keep payment information current
When the facility receives a payment, Medicaid adjustment, insurance payment, or probate distribution, update the collection balance promptly so recovery efforts remain accurate.
Frequently Asked Questions (FAQ)
Does signing as a “Responsible Party” make an adult child personally responsible for a nursing home bill?
Not automatically. For Medicare- or Medicaid-certified nursing facilities, federal rules prohibit requiring a third party—such as an adult child, relative, or friend—to personally guarantee payment as a condition of admission, expedited admission, or continued stay. A representative who has legal access to the resident’s income or resources may be asked to agree to use the resident’s funds toward the resident’s care, but that does not by itself make the representative personally liable. Assisted living communities that are not governed by these federal nursing-facility rules may be subject to different state laws and contract requirements.
What if a Power of Attorney controls the resident’s money but the senior living facility is not being paid?
The first step is to determine what authority the POA actually has and whether the representative has legal access to the resident’s available funds. Federal nursing-facility rules allow a facility to require such a representative to arrange payment from the resident’s income or resources without assuming personal financial liability. Collection efforts therefore need to distinguish between pursuing resident assets that should have been applied to care and incorrectly treating the POA’s personal assets as automatically responsible for the debt. State fiduciary and elder-abuse laws may also affect how suspected misuse of resident funds should be handled.
How should a senior living facility handle an unpaid balance while Medicaid eligibility is still pending?
Do not automatically treat a Medicaid-pending balance as ordinary family debt. CMS guidance recognizes that a nursing facility may charge a resident while Medicaid eligibility is pending, subject to the rules of the state where the facility operates. If Medicaid is later approved, however, the account may need to be adjusted so that the resident is charged only amounts permitted under Medicaid, including the applicable resident contribution and allowable non-covered items. The Medicaid application status should therefore be verified before an account is escalated.
What part of a Medicaid nursing home bill can still be collected from the resident?
Medicaid residents can still have a legitimate monthly financial responsibility. Depending on the state’s terminology, this may be called patient pay, patient liability, share of cost, or another similar term. Medicaid’s post-eligibility calculation determines how much of the resident’s income must generally be contributed toward the cost of institutional care after permitted deductions, such as a personal-needs allowance and certain allowances for a community spouse. Facilities should distinguish this resident-responsibility amount from services already included in the Medicaid nursing-facility benefit, which generally cannot simply be billed again to the resident.
A resident died leaving an unpaid senior living balance. Should the family or the estate be pursued?
Usually, the starting point is the deceased resident’s estate, not an assumption that the children or other relatives personally owe the balance. An executor, administrator, or personal representative can use estate assets to resolve valid debts according to applicable probate law, but serving as the representative does not by itself require that person to pay the resident’s debts from personal funds. Creditor-claim deadlines and priorities vary considerably by state, so deceased accounts should be identified quickly and reviewed for probate activity rather than simply sending bills to surviving relatives.
When can a nursing facility consider discharge for nonpayment while Medicaid is involved?
For federally regulated nursing facilities, nonpayment can support a transfer or discharge only under specific conditions. Federal rules address situations where the resident fails to submit necessary third-party-payment paperwork or where Medicare or Medicaid denies payment and the resident then refuses to pay. If the resident becomes Medicaid eligible after admission, the facility may charge only amounts permitted under Medicaid. Transfer and discharge procedures also carry notice, documentation, appeal, and other requirements; when a qualifying transfer or discharge appeal is pending, the resident generally cannot simply be removed while that appeal is unresolved.
Recent Recovery Results:
Assisted Living Community — Fixed Fee — 58% Recovery
A senior living community had a growing group of 60–90 day private-pay balances from otherwise active residents. Rather than moving immediately to aggressive collections, the facility placed $12,750 into a fixed-fee recovery program.
Accounts Placed: $12,750
Recovered: $7,395
Recovery Rate: 58%
The softer first-stage approach recovered more than half of the referred balance while allowing the community to preserve ongoing relationships with residents and families.
Memory Care Move-Out Accounts — Contingency — 43% Recovery
A memory care provider accumulated $28,600 in unpaid move-out balances after several families stopped responding once their relatives had left the community.
Because the accounts were older and required more intensive follow-up, they were assigned to contingency collections.
Accounts Placed: $28,600
Recovered: $12,298
Recovery Rate: 43%
The provider incurred collection fees only on money successfully recovered.
Skilled Nursing Accounts — Fixed Fee + Contingency — 51% Recovery
A skilled nursing facility identified $21,400 in mixed resident-responsibility balances, including unpaid patient-pay amounts and older balances that remained after payer adjustments.
Fresher, documented accounts began in fixed-fee recovery. Accounts that remained unresolved were moved to contingency follow-up.
Accounts Placed: $21,400
Recovered: $10,914
Recovery Rate: 51%
Separating verified resident responsibility from payer-related balances gave the facility a cleaner portfolio to collect and avoided treating every aged balance the same way.
Stop Subsidizing Your Residents’ Families
You have provided the care, the meals, and the safety. You deserve to be paid for it. Let us handle the uncomfortable financial conversations so your team can focus on the residents.
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