Resident billing & receipts
Private-pay, Medicaid, and VA payments tracked per resident, cleanly reconciled.
Adult Family Homes · Seattle & Tacoma
Resident-billing and caregiver-payroll accounting for adult family homes
Adult family homes juggle resident billing (private-pay, Medicaid, VA), caregiver payroll with overtime rules that trigger in weeks 1 and 3 of a shift schedule, and state reporting on top of running a full residential home. We keep the books clean and DSHS-ready so you can focus on residents — not spreadsheets, not payroll disputes, not scrambling before a licensing visit.
Why adult family homes accounting is different
AFH accounting sits at the awkward intersection of small-business bookkeeping, hospitality (room and board), and healthcare (Medicaid billing cycles). Payer mix changes every month as residents move in, transition to Medicaid, or leave — and each payer type has its own timing, deduction rules, and documentation requirements. Generic bookkeeping software doesn't have a concept of a 'resident,' so most AFH owners end up tracking billing in a notebook while QuickBooks stays out of date.
What we hear from adult family homes
- "Resident payments and Medicaid reimbursements tangled together"
- "Caregiver payroll and overtime tracked in a notebook"
- "Personal and home expenses mixed on the same card"
- "DSHS or licensing reports pulled together at the last minute"
What we handle for adult family homes
Fluent in QuickBooks Online, Gusto, industry payroll platforms.
Caregiver payroll oversight
Payroll runs and overtime reviewed, coded, and tied back to the books.
Home expense tracking
Groceries, utilities, supplies, and repairs categorized properly for tax time.
Owner-ready monthly reports
Monthly P&L and cash summary so you know where the home stands.
Numbers we track for adult family homes
Every monthly report includes the metrics that actually drive decisions in your business:
- Occupancy rate (occupied bed-days ÷ available bed-days)
- Revenue per occupied bed (private-pay vs. Medicaid mix)
- Caregiver labor cost per bed-day
- Food and supply cost per resident per month
- Days between Medicaid billing and payment received
Washington-specific for adult family homes
Washington's DSHS ALTSA program pays AFH providers on a state schedule with specific documentation and audit requirements, and Washington requires paid sick leave accrual plus meets-or-exceeds L&I workers' comp for every caregiver. We keep the payroll ledger, resident revenue schedule, and DSHS receipts reconciled monthly so a licensing or Medicaid audit is a quiet event, not a scramble.
Common bookkeeping mistakes in adult family homes
We see these on almost every set of books we clean up. Fixing them is usually step one of onboarding.
- Depositing Medicaid remittances into the same account as personal funds — a red flag in any state audit
- Skipping overtime calculation on split shifts and sleep time — creates real L&I and wage-claim exposure
- Not tracking room-and-board vs. care revenue separately when residents transition payer types
Adult Family Homes accounting — frequently asked questions
What Our Clients Say
74 five-star reviews from construction and real estate businesses across Washington
"Ruvim and his team have been great to work with. They're reliable, responsive, and provide accurate bookkeeping and payroll support. We appreciate their attention to detail and the outstanding work they do!"
"I worked with Ruvim and Ready Accounting for over two years and had a great experience. Ruvim is extremely responsible, reliable, and always on top of things. He built a great system that made reconciling all of our company accounts simple and organized, kept our filings on time, and helped us manage ACH payments to our trade partners smoothly. Ruvim is knowledgeable, responsive, and someone you can trust with the financial side of your business. Highly recommend Ready Accounting to any company looking for dependable and professional accounting support."
"Working with Ready Accounting has been smooth and stress-free. Ruvim is knowledgeable, responsive, and truly cares about your success. Highly recommend!"
"Ruvim is the best bookkeeper there is period. We have used several bookkeepers in the past but no one matched his level. I highly recommend using him."
"We have been with ready accounting for about half a year or so and let me say it's been amazing! Upon opening a business and hiring employees, there was so much things needed to be done where I had absolutely no clue how to do! A friend of mine recommended ready accounting and honestly never looked back! He does an amazing job and best of all, I don't have to do a thing! Thanks ready accounting for being trustworthy and amazing!"
"Ruvim is very organized, thorough and knowledgeable. Excellent communication skills, timely and cares about his clients and their business operations. Highly recommend!"
"Ruvim is an incredibly knowledgeable individual who consistently demonstrates responsiveness and helpfulness. Whenever I have questions, he promptly provides accurate answers, making him an invaluable resource for my business. His understanding of my business accounting needs is unparalleled, and he consistently delivers exceptional results. I wholeheartedly recommend him to anyone seeking reliable expertise and support."
5.0 rating from 74 Google reviews
Want the story behind the stars? Read real client case studies — including a Bellevue remodeler and a Tacoma developer.
Book a call with Ruvim
Tell us about your adult family homes business — we'll follow up to schedule a call, usually the same day.
Prefer to reach out directly? We answer most inquiries within a few hours during business days.
Email us
Info@readyaccounting.coCall us
(253) 367-3672