Dialysis Center Accounting & Bookkeeping
Fairlight CPA runs the books, payroll, and tax for dialysis centers — high-fixed-cost facilities reimbursed per treatment in a Medicare-dominated, bundled-payment world. Margin discipline per treatment is the entire game, and that's what we report.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ CPA-led team
The numbers problems dialysis centers actually have
The bundle caps revenue; costs don't care
Bundled per-treatment reimbursement means drugs, supplies, and labor inside the bundle come straight out of margin — cost-per-treatment tracking is existential.
Medicare mix leaves thin commercial cushions
A handful of commercial patients often carry facility margins; payer-mix shifts of a few patients matter and must be visible immediately.
Missed treatments are unrecoverable revenue
Empty chairs from missed sessions are perishable capacity; utilization against schedule needs monthly measurement.
Staffing ratios are regulated and expensive
Nurse and tech ratios set a labor floor; scheduling efficiency above that floor is where controllable margin lives.
What Fairlight takes off your plate
The core engagement is the same discipline we run for every client — monthly close by the 15th, payroll, tax, and CFO-level reporting — built around how dialysis centers actually make and spend money.
- Per-treatment revenue and full cost-per-treatment reporting
- Payer-mix tracking with commercial-patient contribution highlighted
- Drug and supply cost control inside the bundle, matched to treatments
- Monthly close by the 15th; payroll with ratio-aware labor reporting
- Business tax prep and CFO reporting for chair expansion decisions
The three numbers we keep in front of you
No fabricated benchmarks — your own numbers, measured the same way every month, so trends are real and decisions have a floor under them.
Cost per treatment
labor, drugs, and supplies against each session — the bundle's counterweight
Treatments per station-day
chair utilization against capacity
Commercial-mix contribution
how much margin the commercial minority actually carries
Revenue cycle & tax notes
Revenue & reconciliation
We reconcile bundled remittances and secondary payments to the treatment log, watch sequestration and adjustment patterns, and keep the payer-mix picture current with your billing service.
Tax & entity
Facility buildouts, water-treatment systems, and machine fleets carry depreciation planning; multi-facility operators add entity-structure and state-registration decisions we sequence with growth.
Simple, published pricing
Bookkeeping from $310/mo · All-In-One (books + tax + advisory) from $800/mo. Every fee is quoted and fixed in writing before any work begins.
Dialysis accounting FAQs
What's the single number you'd watch?
Cost per treatment against realized revenue per treatment, trended monthly. Everything the facility controls rolls into it, and it turns arguments into arithmetic.
Can you model adding four more chairs?
Yes — incremental treatments at your utilization pattern, incremental staffing at required ratios, and the capital's after-tax cost produce a grounded expansion model.
What does it cost?
Bookkeeping from $310/month; All-In-One (books + tax + advisory) from $800/month. Exact fee fixed in writing after a short call.
Related healthcare specialties
Get the financial side handled
A free 15-minute call — bring your current setup, leave knowing exactly what clean, specialty-aware books look like for dialysis centers.
The content on this page is for informational purposes only and does not constitute professional tax advice. Accounting and tax considerations for healthcare practices depend on individual facts and circumstances and are subject to change. See our full legal disclaimer.