How it runs for home care and home health agencies
The controller prepares lender and board packages, supports your CPA at year-end, answers finance questions from state surveyors, and gives the owner a monthly call that covers the three things that matter most this month.
What are outsourced controller services?
Outsourced controller services provide the review layer that sits between bookkeeping and the owner: a senior accountant who checks the close, owns the accounting policies, tests the controls around cash and spending, and explains the financial statements. The controller does not do daily posting. They make sure what was posted is right and documented before anyone relies on it.
What we handle for home care and home health agencies
- Review each close for revenue cut-off, accruals and payer-rate accuracy
- Model the margin impact of a new MCO contract or a caregiver wage change
- Prepare lender, board and state survey financial packages on request
- Own the close calendar and the CloseTrack sign-off log
- Hold a monthly call with the owner on cash, margin and payer mix
The KPI that matters here
Every close reviewed and signed off by the controller with a written summary of exceptions and decisions needed.
Home care compliance notes
EVV
The 21st Century Cures Act requires electronic visit verification for Medicaid personal-care and home-health visits, captured through state aggregators such as HHAeXchange or Sandata. We bill only from verified visits and keep an exception log for visits that need a manual correction before they can be claimed.
HIPAA
Client names, diagnoses and authorizations are protected health information. We sign a BAA, our staff are HIPAA-trained, access is limited to the roles that need it, and PHI never appears in ledger memos or emailed spreadsheets.
State Medicaid and MCO rules
Each state waiver and each managed-care organization sets its own authorization limits, unit rounding, timely-filing window and recoupment process. We track authorizations against billed units and record recoupments as reductions to the original claim, not as unexplained bank debits.
FLSA Home Care Rule
Most agency caregivers are entitled to minimum wage and overtime, and travel time between clients counts. Your payroll provider computes the pay; we make sure the ledger and the labor-cost reports reflect it correctly and that live-in and sleep-time arrangements are coded as your counsel directs.
Home care software we work in
- QuickBooks Online
- Gusto
- ADP
- Bill.com
- AxisCare
- WellSky
- Alora
- HHAeXchange
- All 50 platforms
More for home care and home health agencies
Other services for home care
Controller services in other industries
Frequently asked questions
When does a home care agency need a controller?
Usually when revenue passes a few million dollars, a lender or investor wants reviewed monthly figures, or the owner is making rate and hiring decisions on gut feel. A controller adds judgment: is revenue recognized correctly, is a contract profitable after overtime, can the agency afford the next hiring class. It is a fraction of a full-time hire because the bookkeeping is already in place.
How is a controller different from the bookkeeper you assign?
The bookkeeper posts, reconciles and closes. The controller reviews that work, sets the policies behind it, and interprets the results: rate analysis by payer, accrual and allocation decisions, lender packages and cash forecasting. Both are on your team; the controller is the second signature on every close and the person who explains the numbers to your bank.
Can the controller help with a rate negotiation?
Yes. We prepare the loaded cost per billable hour for the contract in question, including overtime, travel time, payroll taxes and workers' compensation, and show the margin at the current rate and at proposed rates. You take that into the negotiation with the MCO or the family. We provide the analysis, not legal or contract advice.
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