The 2026 CTO Hotline: Why Revenue Operations Tops Senior Living's Automation List

Billing and revenue cycle work is the number one function not-for-profit senior living operators have automated or plan to automate. That is one of the clearest signals in the 2026 CTO Hotline, the second annual technology benchmark from Ziegler Link•age Funds and LeadingAge CAST, based on responses from more than 100 senior technology leaders.

Five Key Takeaways

1) At 52%, billing and revenue cycle work tops the automation list for the second year running.

2) AI is the top investment priority. Large language models lead planned technology spend at 65%, and operational efficiency is the biggest AI opportunity operators name, at 85%.

3) Operators still rank financial performance mid-pack for AI opportunity at 55%, even though revenue work carries the heaviest manual load.

4) The bigger shift is from systems of record to systems of action, a layer that acts on the data EHRs and CRMs already hold.

5) Sunbound is named in the report among the companies working on these financial challenges.

What is the 2026 CTO Hotline?

The CTO Hotline is an annual benchmarking report from Ziegler Link•age Funds and LeadingAge CAST, now in its second year. It surveys senior technology leaders at not-for-profit senior living and care organizations on how they adopt, govern, and measure technology, and the 2026 edition drew on responses from more than 100 of them. You can download the full report from Ziegler.

Why revenue operations tops the automation list

Revenue in a senior living community does not arrive in one clean stream. Families pay private-pay invoices every month. Medicare and Medicaid pay claims on their own timelines. On top of that sit recurring fees, move-in deposits, and one-off charges for everything from a full admission to an afternoon activity. Each of those has different rules and different ways to break down. Handled by hand, the work eats staff hours and leaves cash sitting uncollected.

Automating the repetitive parts hands that time back. Business office managers spend less of the week chasing paper checks and re-keying data, and more of it on work that needs a person.

It also lines up with what operators say drives their technology decisions. Operational efficiency is the top motivator for adopting new technology, named by 77% of respondents, well ahead of every other reason.

Where AI fits in the revenue cycle

AI runs through the entire 2026 report. Large language models are the number one technology operators plan to invest in this year, at 65% of respondents, and operational efficiency is the biggest opportunity operators see for AI, at 85%.

Financial performance, though, sits in the middle of the pack for AI opportunity at 55%, even while billing and revenue cycle work tops the automation list. The report flags this itself. Many finance tasks that take heavy manual effort today are repetitive enough to run on basic automation, without much intelligence behind them. Revenue work carries a heavy load, but it is not yet where most operators are aiming their AI.

The harder revenue work is where AI actually pays off. Reading an authorization to catch a denial before a claim goes out, or learning a payer's rules so the same denial stops recurring, is the kind of work basic automation cannot handle.

From systems of record to systems of action

The report's other running theme is the move from systems of record to systems of action. Electronic health records, CRMs, and general ledgers have been the nerve center of senior living operations for years, and they still are. What is changing is what operators build on top of them. The interest now is in a layer that reads the data those systems already hold and acts on it, whether that means flagging a payer risk or working a denial before it ages out.

Financial operations is a natural place for that layer to land. The data already lives in the EHR and the billing and admissions systems. What has been missing is the piece that turns it into timely action, without asking operators to replace the systems they already run.

Where Sunbound fits

Sunbound appears in the 2026 CTO Hotline as one example of companies pairing service and technology to solve financial management challenges. We were glad to see revenue operations called out as a priority, because it is the problem we set out to solve.

Sunbound is the first AI-powered Revenue Operating System built for U.S. senior living operators. It runs three financial workflows most communities still handle by hand:

• Admissions screens payer risk before a bed is committed, so bad debt gets caught at the front door instead of written off six months later.
• Private Payments replaces paper checks with digital payments families actually use, which speeds collections and cuts the manual follow-up that eats staff hours.
• End-to-End RCM manages Medicare and Medicaid claims from eligibility through payment posting, with real-time visibility, so denials get worked and reimbursement lands sooner.

AI runs through all three workflows. Admissions scores payer viability in about 30 seconds, so risk surfaces before a bed is committed. Private Payments adds billing intelligence that checks charges before a bill reaches a family and catches revenue that would otherwise go unbilled. And in claims, the system reads authorizations and remittances and catches denials before submission, learning each payer's rules over time. Applying AI to the revenue cycle this way is exactly what operators told the report they have barely started.

Operators already on the platform can also tap Financial Agility, a working capital benefit that unlocks funds from receivables already moving through Private Payments and End-to-End RCM, without a new lender or new debt on the books.

The platform processes more than $1 billion in payments and claims a year for operators across the country. The result is predictable cash flow and reclaimed staff hours, so leaders can spend their attention on care.

FAQs

What is the 2026 CTO Hotline report?
‍It is the second annual technology benchmark from Ziegler Link•age Funds and LeadingAge CAST, based on responses from more than 100 senior technology leaders at not-for-profit senior living and care organizations. It tracks how these organizations adopt, govern, and measure technology.

What are senior living operators automating first?
‍Billing and revenue cycle work. In the 2026 CTO Hotline, 52% of not-for-profit operators said they have automated this function or plan to, ranking it first for the second year in a row.

What technology are senior living operators investing in for 2026?
‍The report ranks large language models as the top investment priority at 65%, followed by data analytics software at 52% and cybersecurity testing at 43%.

Where do senior living operators see the biggest opportunity for AI?
‍Operational efficiency, named by 85% of respondents in the 2026 CTO Hotline, ahead of data integration and predictive analytics. Resident-facing uses such as engagement and care planning ranked near the bottom.

Why is revenue cycle automation important for senior living?
‍Senior living revenue comes in through many channels at once, including private pay, Medicare, Medicaid, and recurring fees. Handling it by hand slows collections and burns staff hours. Automation speeds up cash flow and gives business office teams their time back.

Is Sunbound in the 2026 CTO Hotline?
‍Yes. Sunbound is named once in the report, as an example of companies combining service and technology to solve financial management challenges in senior living.

Ready to see what a Revenue Operating System looks like for your communities? Book a walkthrough of Sunbound.

‍