Mental & behavioral health
Books and taxes for addiction treatment centers.
A per-diem insurance payment for a client's residential stay, food and supply costs for a full house, overnight staff payroll, and a bed sitting empty for a week. Gus sorts all of it, an accountant checks every transaction, and you get one number a month.
- From $197 a month
- An accountant on every transaction
- Cancel whenever
November came in at $34,000. Occupancy dipped for a week when two clients discharged early, so I flagged the per-diem drop before you saw the bank balance and wondered.
- Insurance per-diem batchResidential billing
- Overnight staff payrollClinical and support wages
- Food service supplierFood and household
- Facility leaseFacility costs
- Private pay client balancePrivate pay
Why your books are different
An addiction treatment center's books go wrong around beds and around-the-clock staffing.
A generalist sees a deposit and a payroll run. Your facility bills insurance per diem for a residential stay, staffs around the clock regardless of how full the house is, and runs food and household costs for everyone under one roof. When the books flatten all of that, occupancy problems hide until the bank balance says so.
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1
Empty beds still cost the same in staffing and food
A facility staffed and stocked for full occupancy does not save much when two beds sit empty for a week, but the revenue drop shows up immediately while the cost side barely moves, and an owner watching only the bank balance cannot see why.
What we doTracks residential billing against a rough occupancy note, so a revenue dip reads as an occupancy problem, not a mystery. -
2
Per-diem billing lags behind admissions and discharges
Insurance per-diem payments for a residential stay often land weeks after a client is admitted or discharged, so a month with strong admissions can still look thin on paper.
What we doBooks the per-diem batch as income when it lands and keeps a note on the payer, so a lagging deposit does not read as a slow month. -
3
Clinical and support staff wages blend into one payroll line
A facility running clinicians, house managers, and overnight support staff around the clock often books all of it as one payroll number, which hides what clinical care actually costs against facility operations.
What we doKeeps clinical wages and support staff wages in their own lines so the real cost of care versus operations is visible. -
4
Food and household costs swing with occupancy but get booked as flat
A full house eats through groceries and supplies fast, and a slow month with fewer residents can look like savings that are really just fewer people in the building.
What we doKeeps food and household costs in their own line against occupancy, so a swing reads as a resident count change, not a surprise.
Your categories
The categories Gus keeps for an addiction treatment center.
Set up once for how the facility gets paid and what it spends. Nobody hand-sorts a category. Gus does, and an accountant checks it.
Money in
- Residential billingInsurance per-diem payments for a client's residential stay.
- Outpatient or aftercare billingSessions or check-ins billed apart from residential per diem.
- Private payClients or families paying directly for stays insurance does not fully cover.
- Grant or contract fundingCounty or state contract revenue, kept apart from client-pay income.
Money out
- Clinical and support wagesCounselors, nurses, and house staff, kept apart from administrative pay.
- Facility costsLease or mortgage, utilities, and maintenance for the residential space.
- Food and householdGroceries, supplies, and linens for a full house.
- Medical and clinical suppliesMedication management supplies and clinical materials.
- Licensing and accreditationState facility licensing and accreditation renewal fees.
- Malpractice and liability insuranceCoverage for clinical staff and the facility itself.
What we watch for you
- Occupancy trend
How full the facility is running, tracked against billing, so a revenue dip reads as an occupancy issue right away.
- Insurance lag
Weeks between a client's stay and the per-diem deposit, so a strong month does not look slow on paper.
- Clinical labor share
Clinical and support wages against billing, so staffing decisions are based on real numbers.
- The set-aside
What the facility will owe, tracked every month, so April is a number already known.
Ask Gus
Things addiction treatment center owners ask Gus.
Text him like you would text anybody. He answers in plain English, and when a question is above his pay grade, an accountant looks and gets back to you.
Two clients discharged early and left beds empty for about a week. Staffing and food costs stay close to flat either way, so a short occupancy dip shows up fast on the revenue side.
Yes, and I already keep it in its own line. It often comes with its own reporting requirements to the funder, which is outside what this subscription covers, but the books stay clean either way.
It is common in this trade. I book the batch as income when it lands and keep a note on which stays it likely covers, so a lagging deposit does not read as a slow month for the facility.
The tax side
The tax side of an addiction treatment center.
Most of what goes wrong here is timing and labor visibility, since staffing runs around the clock and billing lags behind the actual work.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Worker classification for clinical and house staffCounselors, nurses, and house managers who work set shifts under the facility's supervision are almost always employees, not contractors. This is a high-stakes area for a staffing-heavy residential facility.
- Payroll tax obligationsOnce staff are properly classified as employees, the facility owes its share of payroll taxes and needs state unemployment insurance registration. Gus does not run payroll but keeps the books ready for whoever does.
- Contractor 1099sAny consultant, medical director, or contractor paid $2,000 or more in 2026 who is not on payroll gets a 1099-NEC by January 31.
- The pass-through deductionMost owners can deduct up to 20 percent of business profit before it is taxed, though this often shrinks for a personal-service business at higher income.
Deductions addiction treatment centers miss
Your bookkeeper knows what to look for in your statements. You never have to.
- State facility licensing fees
- Accreditation renewal fees
- Malpractice and liability insurance
- Medical director fees
- Clinical and medical supplies
- Staff continuing education
- Facility maintenance and repairs
- Vehicle costs for client transport
- Background check fees for new hires
- Food service and kitchen supplies
- Linens and household replacement items
- Business insurance beyond malpractice
General information about 2026 federal rules, not advice for your business. Your accountant looks at your actual numbers before anything gets filed.
All year, not just April
An addiction treatment center's year, kept every month.
Occupancy can swing with referral patterns more than the season itself. Gus keeps the facility ahead of both the calendar and the tax deadlines. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.
- January
Plan the year
Last year's return gets started, licensing renewal dates are on the radar, and the monthly set-aside is planned.
- April
Filed. Done.
The business return is filed and signed. No surprise bill, because the set-aside has been running since January.
- July
Halfway check
Where the facility stands, what it will owe, and whether occupancy swings this year changed the number.
- October
Before year-end
Gus looks at any equipment or facility moves worth making before December, alongside accreditation renewal timing.
What you get
What you pay depends on what your business needs, and it does not move after that, busy season or slow. No hourly bills, no surprise invoices, no setup fee.
Book a call- Monthly bookkeeping
Every transaction sorted into categories set up for addiction treatment centers. You never categorize a thing.
- An accountant checks every transaction
Real review, every month, before your books close. Not a spot check.
- Your business tax return, filed
Prepared, reviewed, and signed by that same accountant every year.
- The monthly number
What you made, what you spent, what to set aside for taxes.
- Your own bookkeeper
A real person assigned to your business, in the app whenever you need them. No hold music.
- On your books all year
Every month, not just in April. Your team speaks up whenever something is worth your attention.
- Cancel any time
No contract. No cancellation call. Your books are yours.
Straight answers
Questions addiction treatment center owners ask first.
Can Gus track occupancy alongside our billing?
Gus books your revenue and can keep a rough occupancy note alongside it if you provide census data, so a revenue dip is easy to explain rather than a mystery.
We take both insurance and county contract funding. Can the books separate those?
Yes. Grant or contract funding is kept in its own category, apart from insurance and private-pay revenue, so you can see which side of the facility is self-sustaining.
Does Goatkeeper handle our state facility licensing or accreditation paperwork?
No. That stays with your compliance staff or consultant. Gus keeps the books and flags the fees as costs, but does not manage licensing or accreditation itself.
Our staff work rotating overnight shifts. Does that complicate payroll?
It does not complicate the bookkeeping. Gus keeps clinical and support wages in their own lines regardless of shift pattern, and flags any contractor whose schedule looks like an employee's.
Our per-diem insurance payments are often weeks late. How does that affect our numbers?
Gus books the deposit as income the day it lands, not the day of the stay, and keeps a note on the payer so a lagging batch does not read as a slow month.
Our books have never separated food and household costs from general facility expenses. Can that be fixed?
Yes. Point Gus at a few months of grocery and household supplier statements and he will pull those costs out of the general expense line and keep the split going from there.
Is a real accountant checking my books?
Yes. You get your own bookkeeper, Gus does the first pass on every transaction, and an accountant checks every one before your month closes. That same accountant prepares, signs, and files your business return. Goatkeeper is not a CPA firm, and we never pretend a person looked when they did not.
What does it cost, and can I cancel?
It starts at $197 a month, depending on what your business needs. No setup fee, no hourly bills, no contract. Cancel any time from the app, and your books go with you.
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What makes a bookkeeper worth paying for Every business we keep books for
Book a call
Pick a time. That's the whole signup.
Fifteen minutes with a real person on our team. They look at where your books are, tell you straight what it takes to get caught up, and get you set up on the spot if it fits.
- $197 a month to start
- An accountant on every transaction
- Cancel whenever