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Home Health · Hospice · Personal Care

You bring care home. We bring clarity to your books.

Strategic accounting, tax, and advisory for home health agencies, hospice, and personal care providers — built around PDGM reimbursement, multi-state caregiver workforce, cost report preparation, and the high regulatory burden of Medicare-heavy revenue.

Book a 30-Min Practice Assessment → See the MSO Platform
The fee-for-service MSO partnership for home health & hospice owners. Operating leverage of a healthcare MSO platform — financial infrastructure, tax strategy, KPI dashboards, vendor network, advisory presence — without taking equity. No DSO. No consolidation. The practice stays yours.
Home Health & Hospice owner — MSO partnership with Practice Partner CPAs
The Third Option
Your partner in home health agency success.
Built for
Home Health · Hospice · Personal Care
Typical Practice Revenue
$300K – $10M+
Typical Annual Tax Savings
$25K – $120K+
Live in
30 Days · From $795/mo
Why Owners Choose the Third Way

What every home health & hospice owner is really choosing between.

Most home health & hospice owners are stuck between a generalist CPA who doesn't really know the specialty and a PE-backed buyer who wants the equity. Here's the same comparison side‑by‑side — with your specialty in mind.

Option 1
Generalist CPA
Option 2
PE-Backed DSO / MSO
Option 3 · The Third Way
Practice Partner CPAs
Takes equity in your home health & hospice No Yes · 60–80% No · 0%
Knows your specialty KPIs × ✓ ✓
Monthly close + benchmarks × ✓ ✓
Year-round tax strategy × ~ ✓
You stay the decision-maker Yes No Yes
Investment Hourly 60–80% equity From $795/mo
What It Feels Like

The shift when you finally have someone in your corner.

Most home health & hospice owners aren't looking for another report — they're looking for someone they can think out loud with. A CPA + MBA who already understands the practice, sees the numbers monthly, and can be a sounding board for every decision that matters. Here's what changes when you stop running your back office alone.

Right now
PDGM feeling like a maze you're getting lost in
With Practice Partner
Episode-level visibility — and forecasting that holds
Right now
Medicare cost report happening once a year, in a rush, in stress
With Practice Partner
Prepared methodically, optimized for what's allowable
Right now
Caregiver turnover hurting financially but not measured financially
With Practice Partner
Tracked as a KPI — and addressed strategically
Right now
Multi-state expansion feeling like compliance suicide
With Practice Partner
A coordinated playbook before you set foot in the next state
Right now
M&A conversations starting and you're not ready
With Practice Partner
Sale-ready before anyone calls
Right now
Carrying the agency alone — clinical, regulatory, financial
With Practice Partner
Sharing the financial load — so you can carry the clinical work better
You shouldn't have to be the clinician, the operator, the negotiator, the tax strategist, and the CFO. Be the leader. We'll handle the rest.
How We Show Up for You

You run the practice. We run the financial side — together.

You shouldn't have to be the clinician, the CFO, the tax strategist, and the operator all at once. The same Principal-level CPA — Ronak Bhatt, CPA, MBA — handles the technical work so you can focus on patients, your team, and the decisions only you can make. Here's what that partnership looks like across three areas.

01
Tax — Planned, Not Just Filed

You'll never feel a March surprise again.

Most home health & hospice owners learn their tax bill the same week it's due. We turn that on its head — by October, you know your number, you know your plan, and you've already made the moves that lower it. The technical work happens quietly in the background; what you experience is clarity and control.

The kinds of strategies we routinely run for home health & hospice owners — and what they typically save:

$10K–$20K/yr
S-Corp Reasonable Compensation
Owner-operator home health agencies often pay themselves wrong. A defensible analysis recovers thousands in payroll tax annually.
$15K–$50K
Vehicle & Equipment Depreciation
Section 179 + bonus depreciation on company vehicles, telehealth equipment, and back-office technology.
$3K–$8K/yr
CA PTE Election
SALT-cap workaround for S-corp agencies.
$30K–$150K+/yr
Cash Balance / Defined Benefit Plan
High-revenue agency owners often miss substantial retirement tax shelter beyond a SEP or 401(k).
You don't have to chase the strategy. We bring it to you — and tell you exactly what it means for your bottom line.
02
Numbers — Closed Monthly, Translated for You

Open one dashboard and know exactly how the practice is doing.

You stop guessing. You stop waiting for a CPA to "get back to you." Your books close by the 10th of every month, and we translate the numbers into the few metrics that actually matter for home health & hospice owners — so when you make a hiring, pricing, or expansion call, the math is already done.

What you'll see in your monthly Practice Health Dashboard:

Visits / Caregiver
Productivity benchmark
Revenue / Episode
PDGM tracking
Caregiver Turnover %
Workforce cost driver
Cost Report Margin
Medicare reimbursement vs. actual
See what's included at each Suite tier →
03
Advisory — Someone to Think Out Loud With

A CPA + MBA in your corner for every decision that matters.

Multi-state expansion planning, caregiver retention economics, hospice merger/acquisition prep, and quarterly strategy.

Every business leader needs someone to bounce ideas off — somebody who knows the numbers, knows the industry, and is in the conversation before the decision gets made. Hiring an associate. Adding a location. Buying the building. Bringing on a partner. Selling to a DSO or a group. You don't have to figure those out alone, and you don't have to wait until tax season to talk about them.

  • Benchmarks that actually fit you — your numbers compared against home health & hospice owners in your exact specialty, not "small business" averages
  • A network you can borrow — vetted attorneys, bankers, retirement plan administrators, M&A advisors who already know healthcare
  • Regulatory clarity — CMS rules, state filing changes, reimbursement updates translated into financial impact before they hit your practice
  • A real sounding board — a CPA + MBA in the room when you're making the call, not just reading about it after
What Working Together Looks Like

From signed contract to live partnership in 30 days.

No drawn-out "implementation." No team being trained on your dime. A direct, principal-led onboarding that puts the financial infrastructure of your home health & hospice into place fast — and starts producing wins before you've stopped thinking about whether this was the right move.

01
Days 1–15

Onboarding & Migration

  • Books migrated · chart of accounts rebuilt for home health & hospice
  • Payroll, EHR, and tech stack connected
  • Prior-year tax position assessed · gaps surfaced
02
Days 16–30

Dashboard Live & First Close

  • Practice Health Dashboard live with your specialty KPIs
  • First monthly close completed and walked through with you
  • Tax planning kickoff · year-end strategies identified
03
Days 31–60

Monthly Cadence in Motion

  • Books closed by the 10th every month
  • First major tax move executed · PTE/S-corp/depreciation
  • Strategy questions you'd been carrying alone get answered
04
Day 90+

Compounding the Wins

  • Quarterly strategy call · benchmarks reviewed
  • Vendor introductions matched to what you actually need
  • The partnership becomes the operating rhythm of the practice
"
Ronak rebuilt our PDGM episode tracking, optimized our cost report, and modeled the caregiver retention investment that turned our margin around. Best CPA decision we've made for the agency.
CT
Carmen Torres
Administrator, Heartwood Home Health
Common Questions

What home health & hospice owners ask first.

Do you understand PDGM reimbursement?
Yes. PDGM (Patient-Driven Groupings Model) changed home health reimbursement materially in 2020 and continues to evolve. We track episode-level revenue, LUPA exposure, and OASIS-driven case-mix to keep your forecasting accurate.
Can you handle Medicare cost reports?
Yes. Annual Medicare cost report preparation is one of our core engagements for home health and hospice agencies. We optimize allowable costs, indirect allocations, and ensure compliance with cost reporting principles.
Do you handle hospice practices in addition to home health?
Yes. Hospice has different revenue dynamics (per diem rates, cap calculations, GIP/respite/routine) and regulatory requirements. We adjust our chart of accounts and reporting accordingly.
Can you handle multi-state agencies?
Yes. Multi-state nexus, caregiver licensing, payroll registration, and workers' comp coordination — included from Growth tier onward. Currently serving agencies operating in up to 12 states.
What about caregiver W-2 vs. 1099 classification?
Critical issue for home health. Misclassifying caregivers is a major audit risk and we review classification carefully.
Can you help if we're considering a sale or merger?
Yes. Home health and hospice M&A is active. Practice Exit Readiness ($6,500–$12,000) typically begins 12–24 months before sale to maximize valuation and survive buyer diligence.

Your partner in home health agency success.

30-minute call directly with Ronak. Direct CPA access. 24-hour response.

Schedule a Consultation 925.320.0309