Home care accounting
Home Care Agency Accounting Services
Bookkeeping, tax, CFO support and caregiver payroll in one retainer, for home care agencies billing private pay, IDOA, VA and MCOs.
- CPA firm since 1985
- 20+ years in healthcare
- 5.0 on Google · 16 reviews
Why it matters
Financial Management Designed for Home Care Providers
We serve home care agencies nationwide, fully remote, from our office in Lisle, Illinois. Home care agencies — whether private pay, Medicaid waiver, or IDOA-funded — face unique financial compliance requirements that demand specialized accounting knowledge. From caregiver payroll classification to IDOA and DHS cost report filing, the financial side of running a home care agency requires a CPA who knows this industry.
Soriaga & Associates, LLC has been a CPA firm since 1985, with 20+ years in healthcare accounting. We understand the difference between personal care, homemaker services, and skilled nursing — and how each is reimbursed and reported differently.
Bookkeeping, tax and CFO support in one monthly retainer
Your home care agency gets one team for the whole back office. Monthly retainers start from $800 per month and can include bookkeeping, tax planning and filing, Fractional CFO support, and caregiver payroll as part of the same package.
You get clean monthly financial statements, a CPA who reviews them with you, and one team that handles your payroll, your taxes and your cost reports.
What we handle for home care agencies
- Monthly bookkeeping and financial statement preparation
- Caregiver payroll processing (W-2 employees and 1099 contractors)
- Payroll tax compliance and year-end filings
- IDOA, DHS, and CILA cost report preparation and filing
- Business and owner tax preparation and planning
- Cash flow management and financial planning
- Fractional CFO services for growing agencies
How much does home care accounting cost?
Monthly retainers starting from $800 per month. A retainer can include bookkeeping, payroll, and tax planning and filing, with cost report support where it applies. The exact fee depends on the size and scope of your agency, and we confirm it in writing after your free 20-minute call.
We serve home care agencies in all 50 states, fully remote. See our pricing page for every fee.
How we work with your agency
Getting started is simple, and you know the cost before we begin.
- 01Free 20-minute call. We learn about your agency, your books and what you need help with.
- 02Written flat-fee quote. You get the price in writing before any work starts.
- 03Onboarding and catch-up. We take over your books and clean up anything that is behind.
- 04Monthly close and review. We close your books each month and review the numbers with your CPA.
We work in QuickBooks Online and QuickBooks Desktop, and Xero if needed. Ready to start? Book a free 20-minute call.
Overtime, travel time and caregiver classification
Caregiver payroll is a weekly calculation. Under the federal domestic service rule, third-party home care agencies pay overtime after 40 hours in a workweek, and travel between clients during the workday counts as hours worked. Stricter state rules can apply on top of that.
Classification matters too. Caregivers who take assignments you set, at the rate you set, are generally W-2 employees, and misclassifying them can bring back taxes and penalties. This is general information, not legal advice. For the full picture, read our guide to caregiver payroll for home care agencies.
Private pay, IDOA, VA and MCO billing
Our home care clients bill private pay clients, the Illinois Department on Aging (IDOA), the VA, and managed care organizations (MCOs). Each payer pays differently, so we keep your books by funding source and tie them to your billing.
Two free tools help you price and plan: the home care hourly rate calculator and the Medicaid 80/20 rule calculator.
IDOA and DHS cost reports for Illinois home care agencies
Many Illinois home care agencies receive funding through the Illinois Department on Aging (IDOA) or the Department of Human Services (DHS). These programs require annual cost reports that document your actual service delivery costs and reconcile them against program reimbursements.
We have extensive experience preparing IDOA and DHS cost reports for home care agencies throughout Illinois — accurate cost allocation, proper documentation, and on-time submission, every year.
Client reviews
What our clients say
5.0 from 16 Google reviews
“Soriaga & Associates LLC has expertly handled our Medicare Cost Report preparation and filing for several years. They are reliable professionals ensuring compliance and efficiency in filling out cost reports. They respond quickly to emails and provide proactive support.”
“I've been working with this Accounting firm for many years across multiple companies, and they've consistently delivered exceptional service... a team you can truly depend on.”
“Very professional, completed all our company tasks in a timely manner, we will certainly recommend.”
FAQ
Frequently asked questions
Still have questions? Ask them on a free 20-minute call.
What financial records does a home care agency need to maintain?
You should maintain payroll records by employee and service type, service delivery logs by client, receipts for all operating expenses, bank statements and reconciliations, and separate records for each funding source — private pay, IDOA, DHS, and Medicaid waiver. We help you build systems that make recordkeeping manageable and audit-ready.
How are caregivers classified — W-2 or 1099?
This is one of the most common compliance issues we see. Most caregivers who work regular hours, follow your agency's protocols, and use your equipment are often classified as W-2 employees; classification depends on the facts and on state and federal rules. Misclassification can result in significant back taxes, penalties, and legal liability. We review your classification structure and help you get it right.
Do home care agencies need to file cost reports?
If your agency receives IDOA or DHS funding, yes — you are required to file annual cost reports with those agencies. Unlike Medicare cost reports, these are filed with Illinois state agencies and have their own formats and deadlines. We handle both.
How much does home care agency accounting cost?
Our monthly retainers start from $800 per month. A retainer can include bookkeeping, payroll, and tax planning and filing, with cost report support where it applies. The exact fee depends on the size and scope of your agency and is confirmed in writing after your free 20-minute call. We serve home care agencies in all 50 states, fully remote.
Serving home care agencies in Lisle, Naperville, Westmont, Chicago, Aurora, Joliet, Downers Grove, and across the greater Chicago area.
Call 630-491-1268 for a free consultation with a home care accounting specialist.
Related pages: Free home care hourly rate calculator · Free Medicaid 80/20 rule calculator · Switching accountants · Caregiver Payroll: Overtime, Travel Time and Live-In Rules for Home Care Agencies · 2027 Caregiver Wage Floors: What Is Confirmed, What Is Not, and What It Does to Home Care Margins
Free 20-minute call
Get your home care books and filings under control.
Talk directly with Christian Soriaga, CPA. No pitch deck, no obligation.
On the call we’ll cover
- Your situation and what is due next
- Deadlines and filing status
- A clear written fee quote
- Clear next steps, no obligation
Christian Soriaga, CPA
Soriaga & Associates, LLC