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
Do caregivers in Adult Family Homes qualify for overtime pay?
Yes. Caregivers in Washington adult family homes are entitled to overtime at 1.5 times their regular rate for hours worked over 40 in a workweek. Since a July 2026 Washington Supreme Court decision, that includes live-in caregivers, who were previously outside the state's minimum wage law.
What payroll taxes do Washington Adult Family Homes need to pay?
Washington AFH employers must pay federal payroll taxes (Social Security and Medicare at 7.65%), federal unemployment tax (FUTA), Washington State unemployment insurance (varies by experience rating), paid family and medical leave premiums, and workers' compensation insurance through L&I. Washington has no state income tax, but caregivers' federal withholding must still be calculated and remitted.
How do I calculate Section 131 exclusion for my Adult Family Home?
The Section 131 exclusion calculation involves identifying qualifying difficulty-of-care payments, separating them from room-and-board payments, and confirming your home meets the principal-residence requirement. The amount depends on the number of qualifying individuals in your care and the payment rates. We work through this for every client before relying on it.
Who qualifies for the Section 131 tax exclusion in Washington State?
To qualify for the Section 131 exclusion in Washington, you must be a licensed Adult Family Home provider who receives difficulty-of-care payments through Medicaid or similar programs. The home must be your principal place of residence, and the exclusion applies to payments designated for the care of qualified individuals. We review which payments qualify before a return is filed.
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.
©2026 NSBC, LLC