We only work with care homes
DSHS rates, caregiver schedules, Medicaid contracts, Section 131. We deal with them every day, for every client, so you never have to explain your business to your accountant.
Payroll, books and taxes for Washington adult family homes. It's all we do.
A financial team that works only with care homes. We know DSHS rates, Section 131, caregiver payroll and what a six-bed home needs to stay healthy.
Paying a live-in caregiver a daily rate? Since July 2026, live-in caregivers in Washington adult family homes must earn minimum wage and overtime. See what your daily rate works out to per hour.
Open the AFH caregiver hourly rate calculatorWhy us
Care homes are all we do.
We don't take restaurants, contractors or retail. Every client is a care home, so everything we build, from our payroll process to our monthly reports, is built for how a care home really runs.
More Than Accountants, We're Your Partners
Beyond the numbers, we offer strategic advice and ensure you're always supported. Our DSHS familiarity and HIPAA compliance mean you get expert, secure service tailored to caregiving.
We know the details
Section 131, DSHS payments, Medicaid rates by resident, caregiver overtime. Getting these right is the difference between books that look fine and books that help you run the home.
We know every dollar that flows through your facility.
Generic accountants see numbers. We see your facility's financial health, growth potential, and profit optimization opportunities.
Adult Family Home Mastery
Section 131 applied correctly, with the conditions checked
Medicaid rates tracked per resident, so you know what each rate covers
Care and caregiver expenses recorded so nothing deductible is missed
DSHS Payment Coordination (seamless reporting and compliance)
Home and equipment depreciation tracked properly
Assisted Living Excellence
Multi-Level Care Analysis (basic, enhanced, memory care revenue optimization)
Department Cost Allocation (nursing, activities, housekeeping, dietary)
Insurance Billing Support (maximize reimbursement rates)
Service Level Profitability (which care levels make the most money)
Occupancy Optimization (financial planning for census changes)
Nursing Home Sophistication
Medicare Part A & B Optimization (complex reimbursement maximization)
Cost Report Preparation (skilled nursing compliance and optimization)
Therapy Revenue Recognition (PT, OT, speech therapy billing)
Skilled Nursing Analytics (department-by-department profitability)
Quality Measure Integration (how care quality impacts reimbursement)
Everything your home needs from one team
Everything Your Facility Needs in One Expert Team
Adult Family Home
Bookkeeping Services
Starts at:
$25/resident (Max $200)
Perfect for: Seeing what each resident brings in and what the home costs to run
AFH Payroll
Payroll Compliance
Starts at:
$100 per month, flat
Perfect for: Paying your caregivers correctly and on time
AFH Essential
Tax Planning & Preparation
Starts at:
$500 annually
Perfect for: Tax preparation and planning for care home owners
S-Corp Payroll Compliance
For solopreneurs and S-Corp owners needing payroll, S Corp compliance support, and reasonable salary calculations.
$100/month for owner-only payroll
Top Features:
- Compliant self-pay & automatic tax filing
- Reasonable salary calculator
- S Corp compliance dashboard
- Quarterly processing available
Virtual Excellence (Secure & Convenient)
Professional Results Without Leaving Your Facility
Our virtual-first approach saves you time while you focus on your residents.
Privacy first
- Encrypted client portal
- Multi-factor sign-in
- Access limited to the people on your file
Faster & More Convenient
- A named person for your home
- Video consultations
- A real person when you need one
Personal Service, Professional Results
- A named person for your home
- Video consultations
- A real person when you need one
Frequently asked questions
What is Section 131 and how does it benefit AFH owners in Washington?
Section 131 of the Internal Revenue Code can let some providers exclude part of their Medicaid income from federal tax. Whether it applies, and to how much, depends on how your home is set up. We check that for you.
What is the difference between a bookkeeper and a CPA for care homes?
A bookkeeper records daily transactions, reconciles accounts and produces your financial reports. A CPA can also provide audited statements and represent you before the IRS. Most adult family homes need solid monthly bookkeeping, payroll and tax preparation first, and that is the work we do.
Why should AFH owners avoid generic bookkeeping services?
A general bookkeeper may not know how Section 131, DSHS payments or caregiver payroll work, so care-specific items can be recorded wrongly or missed. A bookkeeper who works with adult family homes every day understands how a residential care business is put together.
How much does a bookkeeper for a care home in Washington cost?
Our bookkeeping starts at $25 per resident per month, up to $200. Payroll is a flat $100 a month per home, with no charge per employee. Tax preparation starts at $500 a year. See our pricing page for what each plan includes.
Running a care home? Simplify your accounting today!
CarebearBooks
Financial care for caregivers
Specialists in payroll, books and tax for Washington adult family homes
CarebearBooks is an NSBC brand, providing professional accounting services.
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