Hospice Agency Accounting & Bookkeeping
Fairlight CPA runs the books, payroll, and tax for hospice agencies — per-diem businesses with a federal cap, four levels of care, and a cost structure spread across an interdisciplinary team. We keep patient-day economics and cap exposure visible all year.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ CPA-led team
The numbers problems hospice agencies actually have
The aggregate cap is a year-end landmine
Medicare's per-beneficiary cap can claw back revenue an agency already spent. Cap exposure must be modeled through the year, not discovered at reconciliation.
Four levels of care, four economics
Routine home care, continuous care, GIP, and respite pay and cost differently; level-mix reporting is where hospice margin becomes legible.
Costs accrue per patient-day
Pharmacy, DME, and supplies ride the census daily; per-patient-day cost tracking is the counterpart the per-diem revenue demands.
Long lengths of stay cut both ways
LOS drives both revenue and cap risk; census composition needs monitoring, not just census size.
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 hospice agencies actually make and spend money.
- Per-diem revenue by level of care with census reconciliation
- Cap-exposure tracking through the year, by beneficiary cohort
- Pharmacy, DME, and supply cost per patient-day
- Monthly close by the 15th; interdisciplinary payroll including on-call
- Business tax prep and CFO reporting for census and service-area 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.
Margin per patient-day
per-diem revenue against daily cost, by level of care
Cap headroom
estimated position against the aggregate cap, updated monthly
Pharmacy/DME cost per day
the controllable daily spend, trended
Revenue cycle & tax notes
Revenue & reconciliation
We reconcile per-diem remittances to census days by level of care, keep sequestration and adjustments visible, and maintain the running cap model alongside your billing partner.
Tax & entity
Nonprofit and for-profit hospices carry different filing worlds; for-profit agencies get full entity and owner tax planning, and both get books that stand up to cost-report scrutiny.
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.
Hospice accounting FAQs
Can you really track cap exposure monthly?
Yes — beneficiary counts and payments against the cap allowance produce a running headroom estimate. It's an estimate until reconciliation, but a monthly estimate beats an annual surprise.
Do you prepare the Medicare cost report?
We prepare books structured so your cost-report preparer's work is fast and consistent, and we coordinate directly with them — one clean set of numbers end to end.
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 hospice agencies.
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.