Home Care Providers
Home Care Provider CPA Services in Washington and Oregon
Lewis Group CPAs is a home care provider CPA firm in Vancouver, Washington, working with in-home care businesses and adult family homes in Oregon and Washington since 1994.
A caregiver classified the wrong way. Mileage reimbursements handled three different ways in the same quarter. A payer that takes 45 days while your staff gets paid every two weeks. An accountant for in-home care providers who understands that rhythm saves you a lot of second-guessing.
In this industry, payroll often is the business. So payroll is where our work starts.
Complete Financial Support for Home Care Providers
We offer practical accounting solutions tailored to the daily operations of Home Care Providers and owner-operators.
Accounting Services
What does a Vancouver, WA tax accountant do for a small business?
Bookkeeping
Bookkeeping with extra oomph
Payroll Services
We Take the Pain out of Cutting Checks
Tax Preparation
A Game-Changer for Your Business
Virtual CFO Services
The Expert Guidance of a Top Executive at a Fraction of the Cost.
Payroll Is Most of Your P&L
Caregivers work split shifts, overnight shifts, and travel between clients, sometimes across two states if you operate near the Columbia River. Overtime, sleep time, travel time, and mileage all have to be tracked and paid correctly.
The U.S. Department of Labor publishes guidance specific to direct care workers under the Fair Labor Standards Act. Washington employers also carry workers’ compensation and paid leave obligations administered through Labor & Industries.
We run payroll in-house for our care clients rather than handing it off. Our payroll services keep filings, deposits, and year-end forms on schedule so you are not reconstructing a quarter in April.
Worker Classification You Have to Defend
Some agencies treat caregivers as contractors. Sometimes that holds up. Often it doesn’t, and being wrong costs back taxes, interest, and penalties.
The IRS weighs these categories in its guidance on independent contractor versus employee status:
- Behavioral control. Who decides when, where, and how the work gets done, and how much training and direction you give.
- Financial control. Who supplies equipment, who can realize a profit or loss, and whether the worker offers services to the general public.
- Type of relationship. Written agreements, benefits, how permanent the arrangement is, and whether the work is central to your business.
We would rather help you think this through before an agency asks than after.
Client Success Stories
Results That Speak for Themselves
Get a Plan That Works For YouI have trusted Lewis Group CPAs with my taxes for over a decade. They go far beyond basic tax preparation, by providing sound ADVICE. This is extremely valuable to my business and has saved me much more than I pay them for their service. Honest, straight forward and always available to answer my questions - this accounting firm is exceptional.
Cash Flow That Doesn’t Match Your Pay Cycle
Private-pay clients, long-term care insurance, and public program reimbursements all pay on different timelines. Your payroll doesn’t wait.
Current books tell you how much cash you actually have versus how much is sitting in receivables. That’s the difference between confidently hiring another caregiver and guessing. Our bookkeeping services keep those numbers current instead of six weeks behind.
Difficulty-of-Care Payments and Household Employers
If you live in an adult family home and care for residents on Medicaid, those Medicaid payments may not be taxable income to you. That’s the single largest tax benefit we see in this niche, and it turns on facts about where you live and who you’re caring for.
The rule sits in IRSÂ Notice 2014-7, which treats certain Medicaid waiver payments for care provided in the home differently for income tax purposes. It’s narrow, and it’s worth confirming how it applies rather than assuming.
If you’re a family member or individual caregiver rather than an agency, this is usually the question you came here to answer. Bring us your situation and we’ll tell you plainly whether the exclusion reaches your payments.
What Is Different for Hospice Providers
Hospice shares most of the home care cost structure: a payroll-heavy P&L, a mixed payer base, and owner compensation that lands on both the business and personal returns. The differences are in reimbursement structure and the way clinical staffing is scheduled and paid.
We’ll be straight with you about scope. Our care-sector clients today are in-home care businesses and adult family homes, and we haven’t taken on a hospice engagement yet. If you’re shopping for a hospice provider CPA and the rest of this page describes the firm you want, contact us and we’ll tell you honestly whether we’re the right fit before you commit to anything.
Home Care Financial Services We Provide
We normally work with business owners who need the business return and the personal return handled by one firm that understands how each affects the other. In-home care fits that pattern almost exactly, since owner compensation, distributions, and entity structure show up on both sides.
| Service | What you get | Who it’s for |
|---|---|---|
| Payroll | Caregiver payroll run in-house, with deposits, quarterly filings, and year-end forms on schedule | Agencies and adult family homes with W-2 caregivers |
| Bookkeeping | Books kept current through the year, not rebuilt in the spring, on a system we help you set up correctly | Owners flying blind between tax seasons |
| Tax preparation and planning | Tax services covering the entity and the owners’ individual returns, with planning conversations before year-end | Owner-operators filing business and personal returns |
| Monthly accounting and consulting | Accounting services with financial statements you can actually read, plus consulting time included in the plan | Owners weighing a hire, a rate change, or a second location |
Owners of adult family homes face many of the same issues on a residential model, which is why we maintain a separate page on accounting for adult family homes.
Frequently Asked Questions
Cost depends on scope, and we quote it as a monthly service plan rather than an hourly rate. The main drivers are caregiver headcount, which services you need, how many bank and credit card accounts we reconcile, and your transaction volume. Consulting time is included in the plan.
Most caregivers in an agency setting are employees, because the agency controls the schedule, the client assignment, and how the work is performed. The IRS looks at behavioral control, financial control, and the type of relationship rather than at what your contract calls the worker. If you’re currently issuing 1099s, that’s a conversation worth having now rather than after a state or federal inquiry.
You need a firm that understands payroll-heavy service businesses and can defend your worker classification, which is not every accountant. Care businesses live and die on labor cost, so an accountant for in-home care providers should be fluent in direct-care wage rules, Washington L&I and paid leave obligations, and how owner compensation flows to your personal return.
Certain Medicaid waiver payments for care provided in the home are excludable from gross income for income tax purposes under IRS Notice 2014-7. The most common situation we see is an owner who lives in an adult family home and cares for residents on Medicaid, where those payments aren’t taxed to them. Whether it applies to you depends on your living arrangement and the program making the payments, so confirm it rather than assume it.
Have three things ready before you call. First, who’s paying the bills: insurance, private pay, or state Medicaid. Second, how you own the business, including whether the home or agency sits in a separate LLC. Third, your employee count and how they’re paid, whether hourly, salary, or per diem. After that, documents come through our secure client portal.
It depends on the complexity of the returns, how complete your documentation is, and when we receive it. We begin gathering information from many clients in December or January, which is the single biggest factor in getting filed early rather than extended.
Ideally, no. We work with business owners who need both business and personal returns and who want a firm that sees how the two interact.
Yes. We advise Washington-based and Oregon-based businesses. One mistake we see with out-of-state businesses is paying Washington taxes without first checking whether they fall below the applicable minimums.
No. Consulting is included in our monthly service plans, so you can ask questions during the year instead of saving them all for tax season.