Senior care & aging services
Books and taxes for geriatric care managers.
Hourly coordination fees, a monthly retainer that has to actually cover the hours, money fronted for clients, and out-of-town families who pay on their own schedule. Your own bookkeeper keeps it straight, an accountant checks every transaction, and you get one clear number each month.
- From $197 a month
- An accountant on every transaction
- Cancel whenever
January netted $8,400. A pharmacy reimbursement came back from a client this month, so I kept it out of your actual fee income.
- Family retainer paymentRetainer fee
- Initial assessment feeAssessment fee
- Reimbursement, client pharmacyClient reimbursement
- Aging Life Care Association duesAssociation dues
- Mileage and gas, client visitsVehicle and mileage
Why your books are different
A geriatric care manager's books go wrong in the same four places.
A generalist sees invoices and mileage. Your business is a retainer that has to actually cover the hours, money fronted for clients that is not yours to keep, and out-of-town families who pay on their own schedule. When the books do not know that, a good month of work can look thin, or a light one can look better than it was.
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1
Money advanced for a client gets mixed with your own income
A care manager who pays for a client's groceries or a co-pay out of pocket and gets reimbursed later can end up with that reimbursement landing in the same account as fee income, making it look like extra revenue instead of money owed back.
What we doKeeps client reimbursements separate from fee income, so what you earned and what you were paid back never get confused. -
2
Retainer fees get spent before the month's work is done
A monthly retainer is often paid at the start of the month for work performed across the whole month, and if it is booked as fully earned the day it lands, a month that runs long on hours can look more profitable than it was.
What we doTracks retainer income against the hours it is meant to cover, so the real profitability of a retainer client is visible. -
3
Out-of-town family billing lags behind the work
Families who live far away and hire a local care manager sometimes take weeks to pay an invoice after the visit or coordination call happens, so a busy month of care management can show up as a thin one in the bank account.
What we doTracks what has been billed against what has actually been paid, so a slow-paying month does not read as a slow work month. -
4
Mileage and coordination time disappear into a flat rate
A single visit to a client's home might include driving time, a stop at the pharmacy, and a call with a doctor's office, and without tracking those pieces, it is hard to know if the rate actually covers the real time spent.
What we doKeeps mileage and time separate in the books, so you can see if your rates are keeping up with the real time a visit takes.
Your categories
The categories Gus keeps for a geriatric care manager.
Set up once for how you get paid and what you spend. You never pick a category. He does, and an accountant checks it.
Money in
- Hourly coordination feesBilled to the family, often monthly, for ongoing care coordination.
- Initial assessment feesA flat fee for the first in-depth evaluation of a new client.
- Retainer feesA standing monthly fee some clients pay for ongoing oversight.
- Client reimbursementsMoney advanced for a client's groceries or supplies, paid back by the family.
Money out
- Professional liability insuranceCoverage for the advice and coordination you provide.
- Association dues and certificationMembership and renewal fees that keep your credentials current.
- Mileage for client visitsDriving to homes, doctor's offices, and facilities.
- Case management softwareKeeping client notes and coordination organized.
- Continuing educationTraining that keeps your practice current.
- Marketing to referral sourcesElder law attorneys, hospitals, and financial advisors who send clients.
What we watch for you
- Billed hours versus paid hours
The gap between work done and invoices actually collected, since family billing can lag.
- Retainer coverage
Hours worked against what a retainer is supposed to cover, so pricing stays fair to you.
- Reimbursements outstanding
Money advanced for clients that is still owed back to you.
- Referral source mix
Which attorneys, hospitals, or advisors are actually sending you clients.
Ask Gus
Things geriatric care managers 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.
No, that is money owed back to you. I keep it separate from your fee income so it is clear it is a reimbursement, not extra revenue.
I track your hours against what the retainer is supposed to cover, so you and the accountant can see if the arrangement is actually working for you.
Not necessarily. I track what you have billed against what has been paid, so a slow-paying family reads as a collections issue, not a work problem.
The tax side
The tax side of a geriatric care manager's practice.
Most of what goes wrong here is separating true income from money you were only ever holding for a client.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Self-employment tax for a solo practiceMost geriatric care managers work as a sole proprietor or single-member LLC, paying 15.3 percent self-employment tax on net earnings unless an S corp election changes that.
- Mileage for client visitsMiles driven to a client's home, a doctor's office, or a facility can be deducted at 72.5 cents through June 2026 and 76 cents after, when not reimbursed separately by the family.
- Client reimbursements are not incomeMoney a family pays back for something you fronted, like a co-pay or a prescription, is not business income and should not be taxed as if it were a fee.
- The pass-through deductionSolo practitioners can often deduct up to 20 percent of business profit, though the deduction can be limited once taxable income passes $201,750 single or $403,500 joint.
Deductions geriatric care managers miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Professional liability insurance
- Aging Life Care Association dues
- Certification renewal fees
- Mileage for client visits
- Case management software
- Continuing education
- Phone plan for client calls
- Office or co-working space
- Marketing to elder law attorneys
- Business cards and materials
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
A geriatric care manager's year, kept every month.
New clients can call any week of the year. Your taxes and your referral relationships come on a schedule. Your team keeps you ahead of both. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.
- January
Referral relationships renewed
The team reconnects with elder law attorneys, hospitals, and financial advisors who send clients your way, while this year's set-aside gets planned.
- April
Books closed, return filed
Your return is filed and signed while retainer clients keep going. The set-aside built since January already covers what is owed.
- July
Halfway on retainer fit
A look at whether retainer hours match what clients are actually using, and whether pricing still makes sense.
- October
More calls after the holidays
Adult children who visit for the holidays and notice a decline often reach out to a care manager for the first time in the weeks after. The team looks at capacity before that wave of inquiries hits.
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 geriatric care managers. 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 geriatric care managers ask first.
I paid for a client's prescription out of pocket. Is that a business expense?
No, it is money owed back to you. Gus keeps it separate from your fee income so a reimbursement is never mistaken for extra revenue.
Did I actually earn the full retainer if a family barely used any hours?
Gus tracks your hours against what the retainer is meant to cover, so you and the accountant can see whether the arrangement still makes sense.
An out-of-town family is slow to pay. Is my business struggling?
Not necessarily. Gus tracks what is billed against what has been paid, so a slow-paying family reads as a collections issue, not a work problem.
Should I bill mileage separately or build it into my rate?
Either can work, but Gus keeps mileage and time tracked separately either way, so you can see if your rate is actually keeping up with real visit time.
Do I need malpractice or professional liability insurance for this work?
Most care managers carry it, and Gus keeps that premium visible as a real cost of the practice, not an afterthought.
My books are disorganized from years of doing this myself. Can you still help?
Yes. Send whatever bank statements you have. Gus separates client reimbursements from your fee income as he works through them, and most practices see where they stand within a week.
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.
More in senior care & aging services
We keep books for the business next door too.
- Adult day care centers
- Medical alert system dealers
- Residential care homes (board & care)
- Respite care providers
- Senior dental & mobile care
- Senior home safety assessments
- Senior living placement advisors
- Senior move managers & downsizing specialists
- Companion care services
- Memory care communities
- Small assisted living facilities
- Home health agencies (skilled)
- Hospice providers
- Non-medical home care agencies
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