LTC Financial Assessment Coordination Services
We run financial assessment at LTC intake so Medicaid eligibility is mapped before private-pay funds run out. Medicaid 5-year asset look-back review, spend-down planning, Qualified Income Trust (QIT) coordination in income-cap states, spousal impoverishment community spouse calculations, and state-specific Medicaid income limits. Staffingly coordinators work inside PointClickCare, MatrixCare, and state Medicaid portals. 800+ providers trust us. Pilot in 2 weeks.
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0:48Financial assessment skipped at intake creates 90-day Medicaid pending and $50K write-offs.
Three financial pressures hit every SNF and LTC facility that runs long-stay beds. Business office staff feel it on every aging Medicaid pending case. Owners feel it in the 90-day aging buckets, the disallowed transfers, and the spousal impoverishment cases that should have been mapped at admission.
5-year look-back transfers caught too late
When the family transferred a vacation home to a child in year three of the look-back window and nobody asks at admission, the Medicaid application is denied 6 months later for an uncompensated transfer. The penalty period creates an unfunded LTC stay and a write-off that lands on the operator.
Spend-down planning missed at admission
Countable assets above the resident's state limit (often $2,000) block Medicaid eligibility until spend-down completes. When the conversation does not happen at admission, the family spends down on the wrong things, retroactive coverage windows are missed, and cash sits in pending for 90+ days.
Spousal impoverishment community spouse rules ignored
When the LTC resident has a community spouse at home and nobody runs the Community Spouse Resource Allowance (CSRA) calculation, families either spend down too much or refuse Medicaid entirely. The resident moves out, the bed goes vacant, and the operator loses 6 to 9 months of census.
Tell us about your agency.
Send us your situation and our team will scope the right setup, usually within one business day. No obligation.
What is an LTC financial assessment service ?
An LTC financial assessment service is a remote intake team that runs the structured financial conversation at LTC admission so Medicaid eligibility is mapped before private-pay funds run out. The team captures countable and exempt assets, runs the 5-year look-back interview, identifies spousal impoverishment cases requiring CSRA calculations, sets up Qualified Income Trust (QIT) referrals in income-cap states, and produces a Medicaid application timeline. Not a generic intake VA. A trained financial assessment specialist who knows the state-by-state variation in Medicaid rules.
What your LTC financial assessment coordinator actually handles, day to day
Pick the financial-assessment queues that hurt most. Your coordinator absorbs them. Your on-site business office focuses on billing, AR, and family payment conversations.
5-year asset look-back review
Runs the structured 5-year look-back interview with the resident or responsible party. Captures real estate transfers, gifts above the state threshold, trust transfers, and joint account changes. Flags potential uncompensated transfers for the elder law referral.
Spend-down planning at admission
Documents countable assets, exempt assets, and the gap to the state Medicaid asset limit. Produces a written spend-down plan including burial reserve setup, prepaid funeral, accessible vehicle, and home repairs where exempt.
Qualified Income Trust (QIT) coordination
In income-cap states such as Florida, Texas, and Oklahoma, identifies residents over the income cap and refers families to set up a Qualified Income Trust before Medicaid application. Tracks QIT funding monthly.
Spousal impoverishment calculation
When the LTC resident has a community spouse, runs the Community Spouse Resource Allowance (CSRA) calculation, captures the snapshot date assets, and identifies the protected resource amount. Coordinates the elder law referral where retitling is needed.
State-specific Medicaid income caps
Tracks the state-specific Medicaid LTC income cap, asset limit, transfer penalty divisor, and CSRA min and max. Updates the building's playbook annually when state Medicaid plan amendments change the numbers.
Medicare IRMAA awareness
For higher-income LTC residents still drawing pensions, the coordinator flags Medicare Income-Related Monthly Adjustment Amount (IRMAA) impact so families understand the resident's Medicare Part B and Part D premiums during the spend-down period.
Medicaid application packet assembly
Assembles the application packet. Birth certificate, marriage certificate, Social Security card, Medicare card, bank statements for 60 months, tax returns for 5 years, deeds, life insurance face value, and burial reserve documentation.
Elder law referral coordination
When the case requires legal work such as Medicaid Asset Protection Trust, Caregiver Child Exemption review, or a transfer penalty appeal, the coordinator refers to the facility's preferred elder law network and tracks the referral status weekly.
Intake-trained coordinators, not generic VAs
Most outsourcing companies offer call-center agents and call them "financial assessors." We do not. Our LTC financial assessment specialists are trained on the 5-year look-back rules, spend-down planning, QIT setup in income-cap states, spousal impoverishment CSRA calculations, and state-specific Medicaid rules before they ever touch a live financial intake.
Intake-trained, not generic
Every LTC financial assessment coordinator passes an assessment on 42 USC 1396p Medicaid eligibility rules, 5-year look-back transfer analysis, spend-down planning including burial reserves and home repair exemptions, Qualified Income Trust setup in income-cap states, Community Spouse Resource Allowance calculation, and Medicare IRMAA awareness before placement.
Stacked compliance posture
HIPAA + SOC 2 Type II + ISO 27001 + HITRUST. Plus alignment with 42 CFR 483.10 resident rights, 42 CFR 483.20 resident assessment, and the 45 CFR 164.514 de-identification standard for analytics. Ask your current vendor for proof of all four. We will wait.
2-Week Risk-Free Pilot
Industry offers no trial. We give you 14 days of live intake and admissions work at the same rate. Cancel before day 14, owe nothing. No annual contracts after.
Staffingly vs DIY in-house vs generic VA vs onshore BPO
The real cost math for a single full-time intake coordinator role at a mid-size SNF, ALF, or home care operator.
From "let's talk" to live in 1 to 2 weeks
Six steps. Each one is documented. Nothing is mysterious.
Discovery call (15 min)
Tell us which intake pain is loudest. PASRR delays? Medicaid pending pile? Slow admit cycle? Home health start-of-care? We map it on a shared call. No prep needed from you.
BAA + platform access
Business associate agreement signed. Role-based access provisioned in PointClickCare, MatrixCare, Net Health, American HealthTech, HHAeXchange, AlayaCare, AxisCare, or ECP.
Workflow shadow (2 to 3 days)
Your coordinator shadows your on-site admissions team in NJ, NY, TX, or FL. Referral scripts captured. Tone matched. Escalation rules locked. Bed-decision SLAs set.
Parallel pilot starts
Week 2 to 3. Your intake coordinator runs alongside your team. Daily 15-minute sync. You see every PASRR screen, every benefits check, every admit packet built.
Decision point (end of week 2)
Pilot results reviewed. Go or no-go. No penalty if you cancel. Most operators keep going.
Full handoff, cadence locked
Admit cycle time, Medicaid pending aging, and referral conversion KPIs in your inbox. Weekly review with your account lead. Monthly QA audit. Expansion paths discussed.
How your intake coordinator's day actually looks
A real shift, hour by hour. Times shown in your local time. We rotate coverage so your admissions phone is never dark during business hours.
How Staffingly works, in practice
Inside the workA trained Staffingly specialist works inside your existing platform, with clear escalation back to your team.
One Flat Weekly Rate. No Surprises.
Dedicated senior care schedulers at a fixed weekly cost. Per scheduler FTE, per week. No contracts, no minimums, no hidden fees.
Want to compare against an in-house hire? Use the savings calculator.
Frequently asked questions
How does the Medicaid 5-year look-back interview work?
Our coordinator runs the look-back interview with the resident or responsible party at admission. The conversation captures all transfers in the 60-month look-back window including real estate sales below market value, gifts above the state annual exclusion threshold, trust funding, joint account changes, and family transfers tied to a Caregiver Child exemption claim. Flagged transfers are referred to the facility's preferred elder law network for a transfer penalty analysis before the application is filed.
What spend-down strategies do you document at admission?
The spend-down plan is documented in writing at admission. Common strategies include burial reserve setup using the state's irrevocable burial trust limit, prepaid funeral arrangement at a licensed funeral home, accessible vehicle purchase where the resident has a need, home repairs on the exempt primary residence, and pay-down of legitimate medical or long-term care debt. Strategies that risk Medicaid denial such as gifting or fraudulent annuity setup are explicitly excluded.
How is Qualified Income Trust (QIT) handled in income-cap states?
In income-cap states such as Florida, Texas, Oklahoma, Arizona, and others, residents whose income exceeds the state Medicaid LTC income cap must funnel excess income through a Qualified Income Trust to qualify. Our coordinator identifies these cases at the financial assessment, refers the family to an elder law attorney to set up the QIT, captures the QIT trustee information, and tracks QIT funding monthly to keep the resident eligible.
How does spousal impoverishment protection work for community spouses?
When the LTC resident has a community spouse, federal law protects the community spouse from total impoverishment through the Community Spouse Resource Allowance (CSRA). Our coordinator captures the snapshot date assets, runs the CSRA calculation against the state's CSRA minimum and maximum, identifies the Protected Resource Amount that the community spouse keeps, and coordinates retitling and Monthly Maintenance Needs Allowance (MMNA) calculations with the elder law network.
How do state-specific Medicaid income caps and asset limits work?
Every state sets its own Medicaid LTC income cap (often 300% of the SSI federal benefit rate), asset limit (commonly $2,000 individual), transfer penalty divisor (state average private-pay nursing home rate), CSRA minimum and CSRA maximum. Our coordinators maintain the current numbers for each state where the facility operates and update the playbook annually when state plan amendments change the numbers.
Why does the coordinator track Medicare IRMAA?
For higher-income residents still drawing pensions or required minimum distributions, Medicare imposes the Income-Related Monthly Adjustment Amount (IRMAA) on Part B and Part D premiums. During the spend-down period before Medicaid eligibility, the IRMAA surcharge can be significant. Our coordinator flags IRMAA exposure so the family understands the resident's Medicare premium cost during the private-pay months.
How much does Staffingly LTC financial assessment coordination cost?
Per-FTE weekly pricing. $399 per FTE per week for single-facility SNFs, $349 per FTE per week for 3 or more FTEs across a mid-size SNF group, and $299 per FTE per week for 10+ FTEs across a multi-state SNF network. No setup fees. No annual contracts. Flat weekly billing. Add or remove FTEs by the week.
How does the 2-Week Risk-Free Pilot work for financial assessment?
The pilot is 14 days of live LTC financial assessment work at the same per-FTE weekly rate. Your coordinator runs 5-year look-back interviews, documents spend-down plans, identifies QIT cases, runs CSRA calculations for community spouses, and assembles Medicaid application packets during the pilot. At day 14, you review packet completeness, spend-down clarity, and elder law referral quality. Cancel before day 14, owe nothing.
President and CEO, Staffingly, Inc. 25+ years in IT consulting and healthcare BPO operations. One of the earliest US operators to set up an RPO/BPO delivery network in India. Leads AI-driven home care workflows that help agencies, home health providers, and multi-branch operators cut admin cost without compromising care.
