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(618) 656-6010
For Senior Homecare Agencies

Homecare Accounting built for agencies that cannot afford surprises.

Bookkeeping, payroll, tax, and CFO guidance for senior homecare agencies. Caregiver payroll, payer reimbursement planning, and the financial controls that keep your margins intact.

Schedule Your Consultationor call (618) 656-6010
Caregiver assisting a senior client

Books closed by the 10th
Every month. In writing.
3,000+ clients served
Best Accountants, SBM Finalist
AICPA Member Firm
QuickBooks Certified ProAdvisor
Serving clients nationwide
What we solve

The financial challenges we solve for agencies

The reimbursement and compliance gaps that quietly drain homecare margins.

1
The reimbursement gap
Medicare and Medicaid often pay in 60 to 90 days while caregiver payroll is due weekly. Without a plan, that gap becomes a cash-flow crisis.
2
Caregiver classification risk
Misclassifying caregivers as 1099 instead of W-2 creates major payroll-tax and overtime exposure. The penalties land hard and come with back taxes.
3
Thin, fragile margins
When labor is 60 to 70 percent of revenue, small payroll or scheduling errors erase the profit on a visit. Margins this tight require weekly visibility.
4
EVV and payer complexity
Multiple payers, authorized vs. delivered hours, and EVV records that must reconcile cleanly. One discrepancy can delay an entire reimbursement cycle.
What we do

One firm for the whole financial back office.

Four services, one team, one monthly rhythm, all built around how your agency actually runs.

Accounting
Agency financials you can actually use.
Payer-mix and reimbursement tracking
Client- and caregiver-level margins
CFO-level benchmarking and advisory

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Bookkeeping
Clean, reconciled books every month.
Billing and reimbursement reconciliation
Up-to-date books by the 10th
Audit-ready records year-round

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Managed Payroll
Your caregivers, paid right, on time.
Hourly, overtime, and mileage handling
Multi-location caregiver payroll
W-2 and 1099 caregiver reporting

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Tax
Planning all year, not just April.
Protect your QBI deduction
Section 179 and vehicle depreciation timing
Entity and owner-comp strategy

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The difference

We do things differently than most accountants.

Most firms are built around volume. File the return, move on, repeat. Here’s what you get with us instead.

What you’re used to
A generalist who does not know payer mix from a balance sheet
Caregivers misclassified as 1099, creating payroll-tax exposure
No cash-flow plan around 60 to 90 day Medicaid reimbursement lag
Thin margins eroded by payroll errors and scheduling gaps
EVV and payer records that do not reconcile
With Thompson Flaherty
A CPA built for payer mix, reimbursement timing, and caregiver compliance
Correct W-2 setup and overtime handling for every caregiver
Cash-flow forecasting built around your reimbursement cycle
Labor cost per care hour tracked so margin does not leak
Clean payer and EVV records that hold up to audit
Getting started

How working together begins

The first call is completely free, with zero pressure and zero obligation. Just a straight, honest read on your agency.

01
Free intro call
Tell us about the practice and your goals. No pressure and no commitment, just a real conversation.
Step 1
02
We review your numbers
We dig into your books, payroll, and prior returns, then show you exactly where we can help.
Step 2
03
We take the wheel
We transition your accounts, clean things up, and put reliable systems in place. Fast.
Step 3
04
Year-round partnership
Proactive planning, fast answers, and ongoing advisory. We’re in your corner all year.
Ongoing
The team

Who you’ll work with

You’ll work directly with the same CPA every time, someone who actually knows your numbers, your goals, and your industry.

Tyler Hawkins

Tyler Hawkins, CPA
Senior Certified Public Accountant
Kelly Flaherty

Kelly Flaherty, CPA
Senior Certified Public Accountant
Jim Klostermann

Jim Klostermann
Senior Tax Accountant
Christian Kimble

Christian Kimble, CPA
Certified Public Accountant

Common questions about homecare agency accounting

Straight answers about working with us. Anything else? Bring it to the call.

Yes. The cash-flow gap between delivering care and receiving Medicaid or Medicare reimbursement is one of the central financial challenges for homecare agencies. We build cash-flow forecasting specifically around your payer mix and reimbursement cycle so payroll is never at risk.
Let’s talk
Ready to work with a CPA who actually gets back to you?
Whether it’s your books, payroll, or a real tax plan, let’s talk. The first call is free, with zero pressure.
Schedule Your Consultation

Prefer the phone? (618) 656-6010

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