Hospice & Palliative Care
Accounting support for hospice and palliative care providers. Per-diem revenue, interdisciplinary staffing costs, and heavy compliance expectations mean the books have to be right. Hunter Green CPA handles the financial records so your team can focus on patients and families.
The Industry
Hospice and palliative care providers operate under a financial model that looks different from most healthcare businesses. Revenue comes primarily through per-diem payments from Medicare, Medicaid, or private payers. You receive a set daily rate for each patient based on their level of care, and that rate is expected to cover everything your team provides. There are no separate bills for each nurse visit or social worker call. The per-diem is it.
The largest cost in this business is staffing. Hospice care requires an interdisciplinary team working together for each patient and family. Nurses, aides, social workers, chaplains, and a medical director all contribute time and travel. When the cost of that team exceeds what the per-diem rates cover, there is no way to bill for the difference. The financial sustainability of your organization depends on understanding and managing these costs clearly.
Who This Covers
Who This Covers
Hospice agencies and palliative care programs providing end-of-life and comfort-focused care. Medicare-certified hospices, Medicaid providers, and organizations serving private-pay families. Whether you operate in a single county or across multiple states, the per-diem model and staffing-heavy cost structure apply.
What Makes It Complex
What Makes It Complex
Per-diem revenue that must cover all services. Multiple payer sources with different rates and requirements. Staffing costs spread across several disciplines and varying visit schedules. An oversight environment where financial records face scrutiny from Medicare, state regulators, and accreditation bodies on a regular basis.
What We Handle
Clean financial records matter more in hospice than in many other businesses. Between Medicare cost reports, state surveys, and accreditation reviews, your books need to tell an accurate and complete story. They need to hold up when someone outside your organization examines them. Full-Service Bookkeeping keeps your transactions categorized correctly, your accounts reconciled, and your monthly reports current so you always know where things stand.
Tax preparation for hospice organizations requires familiarity with the structure and operations of healthcare providers. Whether you operate as a for-profit entity, a taxable subsidiary, or another structure, your Business Tax Returns need to be prepared accurately and filed on time. The Bookkeeping and Tax Package bundles monthly bookkeeping with your business and personal tax returns, all handled by the same CPA who knows your numbers throughout the year.
Clean Books for Compliance
Clean Books for Compliance
Every transaction categorized correctly. Bank and credit card accounts reconciled each month. Reports that make sense to you and to anyone who needs to review them. Financial records that support your cost reports and hold up during surveys, audits, and accreditation visits.
Tax Return Preparation
Tax Return Preparation
Business tax returns prepared by a CPA who understands healthcare organizations. Returns are stronger when prepared from books that have been maintained all year, and the Bookkeeping and Tax Package ensures the same person handles both. No handoff between a bookkeeper and a separate tax preparer.
Common Problems
Hospice providers often start with a mission and figure out the financial systems later. The clinical work and family support take priority, and that is as it should be. But over time, the books fall behind or grow messy. Someone handles billing and payroll, but nobody maintains the kind of accurate, organized financial records that could withstand a regulatory review without scrambling.
The result is that owners and administrators often lack visibility into the real economics of their organization. What does it actually cost to care for a patient at each level? Are staffing hours aligned with patient census? When Medicare requests documentation, a lender asks for financial statements, or a surveyor needs records, can you produce clean reports that match your bank accounts?
Books That Cannot Hold Up
Books That Cannot Hold Up
Financial records that have not been reconciled in months. Expense categories that are inconsistent or unclear. When an audit or survey arrives, you find yourself reconstructing information from bank statements and old invoices instead of handing over organized records. This creates stress and takes time away from patient care.
No Visibility Into True Costs
No Visibility Into True Costs
You know what Medicare pays per day at each level of care. You may not know what each patient day actually costs your organization in staffing, supplies, mileage, and overhead. Without that visibility, you cannot tell whether your operations are sustainable or where adjustments might help.
What Changes
The financial side of the business stops being a source of worry. Your books are current and accurate. When a surveyor asks for documentation, when a bank needs statements for a line of credit, or when your board wants to see where things stand, you have what they need. The records reflect reality and can be explained clearly.
You also gain clarity on the economics of your organization. You can see staffing costs in context. You can track trends month to month. Tax returns are prepared from books that were maintained throughout the year. The important work your team does for patients and families continues. The difference is that the financial foundation underneath that work is solid. If you would like to talk about how Hunter Green CPA can help your hospice or palliative care organization, reach out to schedule a consultation.
Confidence During Oversight
Confidence During Oversight
Clean books that are ready when someone needs to see them. Financial records that match your bank accounts and tell a clear, accurate story. Less stress when audits, surveys, or accreditation visits happen because the documentation is already organized and current.
A Clear Picture of the Organization
A Clear Picture of the Organization
Monthly reports that show where things stand. Staffing costs tracked and visible. Tax returns prepared accurately and filed on time. Financial records that support the meaningful work your team does every day, allowing you to focus on patients and families instead of paperwork.
Your Trusted CPA
Next Step:
A Short Conversation
Tell us about your business and what you need help with. We'll ask a few questions, explain how we can help, and tell you exactly what it will cost.