A generic chart of accounts hides everything that matters in home care. Build one that splits revenue by payer and puts caregiver labor in its own cost-of-service line, and your P&L starts answering real questions — which payers pay, and what care truly costs.
Out-of-the-box charts lump all income into “Sales” and scatter labor across the statement. For an agency whose economics are payer rate minus cost of care, that’s the two most important numbers made invisible. You end up with books that satisfy a tax return but can’t run the business.
Give each payer type its own income account — Medicaid, waiver programs, MCOs, VA, private pay. Now the P&L shows your payer mix and revenue concentration at a glance, and you can watch a program’s share (and its margin) move over time. That single change turns the income statement into a management report.
NavSuccess does this for home care & healthcare agencies — see Bookkeeping for home care.
Detailed enough to answer your real questions — revenue by payer, direct care vs overhead — but not so granular that categorizing becomes a chore. Structure beats sprawl.
Yes, and it’s worth it. A careful re-map (with prior periods restated where possible) gives you comparable reports; a bookkeeper who knows home care can do it without breaking your history.
No — billing runs off authorizations and payer rules. The chart changes how you see the results, so you can manage payer mix and margin.
Book a free 30-minute consultation. We’ll look at where your books and compliance stand and show you exactly what we’d take off your plate.