Bookkeeping and tax for medical businesses • Personal tax returns for individuals

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What does your payroll setup include for an agency with hourly caregivers?

The setup gives you a working payroll system built for how home care agencies actually operate. Most agencies run hourly caregivers across multiple clients and schedules, with overtime that needs to track correctly and turnover that means you’re onboarding new employees regularly. The system handles all of that without creating extra work every pay period.

I configure the payroll system, typically Gusto, with your agency’s specifics. This includes pay schedules, overtime calculations, and the correct federal and state withholdings for where your caregivers work. Home care agencies often have employees in different counties or even different states, and the system needs to handle withholding requirements accordingly. I make sure the tax filing settings are correct so federal and state payroll taxes get deposited and reported on schedule.

Employee records get set up with the information you need to run payroll: pay rates, hire dates, direct deposit details, and tax withholding elections from W-4s. If you’re growing and hiring regularly, I build out the onboarding workflow so adding a new caregiver takes minutes instead of becoming a project every time.

Overtime handling is configured correctly from the start. Most caregivers are non-exempt hourly workers, so weekly hours over 40 must pay at time-and-a-half. The system calculates this automatically, but only if it’s set up right. Some states have daily overtime rules or other requirements, and those get built into the configuration.

The reporting ties back to your books. Labor is usually the biggest expense for an agency, and accurate medical practice accounting depends on clean payroll data. The setup ensures the system feeds the right numbers into your bookkeeping each pay period, so your monthly reports show labor costs correctly.

You also get hands-on training so you or an office admin can run payroll confidently on your own. The training covers entering hours, reviewing the pay run before it processes, approving payroll, onboarding new employees, and understanding the reports. The goal is for you to handle payroll independently after the setup.

This is a one-time engagement starting at $300. There is no ongoing payroll processing contract with our firm. You run payroll yourself going forward, which keeps your costs predictable and under your control.

If you need payroll configured correctly for your caregiver team, or if you have a system that was never set up for hourly workers in the first place, book a consultation and we can walk through what your agency needs.

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More Questions

Can I hire you for one project before committing to monthly service?

Yes. Standalone project options include catch-up bookkeeping, tax returns, payroll setup, tax strategy, and audit support. Each is scoped and priced on its own with no ongoing commitment required.

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Why does my profit and loss look fine while my bank account feels empty?

Your profit and loss statement and your bank account measure different things at different times. The gap usually comes from insurance receivables not yet collected, inventory purchased but not used, loan principal payments, prepaid package cash already spent, owner draws, and taxes never set aside.

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How long do I need to keep receipts and financial records?

Keep most business financial records for seven years to cover the IRS's standard audit window and extended periods for income understatement. Payroll records need at least four years. Cloud bookkeeping with digital receipt storage makes retention automatic rather than a filing cabinet project.

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My injectors want commission. How do I keep that from wrecking my margins?

Define your commission base precisely because paying on gross revenue versus net of product cost changes everything. Track provider-level margin so your most popular injectors are also your most profitable ones.

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What separates a profitable therapy practice from a busy one?

The difference is per-visit economics. A profitable practice tracks collected revenue, clinician cost, and overhead per visit by clinician and service type. A full schedule at weak rates is busyness, not profit.

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I am a mobile therapist working out of my car. Do I even need real bookkeeping?

Yes, but scaled to your operation. Simple books that capture per-visit revenue, mileage documented the way the IRS requires, and quarterly estimates handled. Small operations lose the most to missed vehicle deductions and April surprises.

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Hunter Green CPA provides bookkeeping, tax preparation, and tax strategy for medical business owners across the United States. Alongside its business services, the firm prepares personal tax returns for individuals and families. Based in Oak Park, Illinois and led by Mason Hunter, a CPA with 10 years of tax experience and a background in corporate tax management.

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