Senior care & aging services
Books and taxes for medical alert system dealers.
Device sales split from monthly monitoring fees, a monitoring center's cut, and active subscribers tracked month over month. 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
July netted $14,000. A batch of new subscribers signed up this month, so I split their device sales from the recurring monitoring fees that will keep coming in.
- New device sale, hardwareDevice sales
- Monthly monitoring subscriptionsMonitoring fees
- Monitoring center wholesale feeMonitoring center cost
- Device inventory restock orderDevice inventory
- Google and TV ad spendMarketing and advertising
Why your books are different
A medical alert dealer's books go wrong in the same four places.
A generalist sees a sale and a subscription. Your business splits every customer payment with a monitoring center behind the scenes, mixes one-time hardware sales with recurring fees, and lives or dies by how many subscribers stay active. When the books do not know that, your real margin stays hidden.
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1
The monitoring center's cut gets confused with your own revenue
A customer pays you a monthly monitoring fee, and a chunk of that goes straight to the monitoring center behind the device, so if the whole customer payment is booked as your income, the real margin on each subscriber is hidden.
What we doSplits what the customer pays from what goes to the monitoring center, so you can see your actual margin per subscriber, not just the sticker price. -
2
A device sale and a subscription get lumped into one number
A new customer often pays for the hardware and the first month of monitoring at the same time, and if that single payment is booked as one lump of income, it is hard to tell how much came from selling a device once versus recurring revenue that repeats every month.
What we doSplits the one-time device sale from the recurring monitoring fee, so you can see how much of your income is repeatable and how much is a one-time sale. -
3
Returned devices sit as inventory nobody accounts for
When a subscriber cancels, often because a loved one has passed away or moved into a facility, the device usually comes back, and if returned units are not tracked against inventory, it becomes unclear how many devices are actually available to send back out.
What we doKeeps returned and refurbished devices in the inventory count, so you know what you actually have on hand to sell or lease again. -
4
Cancellations quietly shrink recurring revenue
A subscription business's real health is in how many monitoring subscribers stay active, and a slow trickle of cancellations can erode monthly revenue for months before a spreadsheet total makes it obvious.
What we doTracks active subscriber count and cancellations month over month, so a slow erosion in recurring revenue shows up early, not after it has already cost you.
Your categories
The categories Gus keeps for a medical alert dealer.
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
- Device salesThe one-time hardware purchase or lease fee for a pendant or base station.
- Monthly monitoring feesThe recurring subscription customers pay for 24/7 monitoring.
- Installation and setup feesFor dealers who offer in-home setup.
- Accessory and add-on salesFall detection add-ons, wall buttons, or extra pendants.
Money out
- Monitoring center feesThe wholesale per-unit cost paid to the monitoring center behind the branded device.
- Device inventory purchasesBuying pendants, base stations, and accessories to keep in stock.
- Shipping and fulfillmentGetting devices to customers and back when returned.
- Warranty replacementsRefurbishing or replacing units under warranty.
- Sales commissionsFor dealers with a sales team paid per unit sold.
- Marketing and advertisingDirect mail, television, and online ads aimed at families.
- Merchant and card processing feesMonthly subscriptions run through recurring card billing.
What we watch for you
- Active subscribers
The number your recurring revenue is actually built on, tracked month over month.
- Margin per subscriber
What a customer pays each month against what the monitoring center and overhead cost.
- Device inventory on hand
What you can ship or install right now against what has been sold or returned.
- Cancellation rate
How many subscribers leave each month, the number that erodes recurring revenue if it is not watched.
Ask Gus
Things medical alert dealers 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.
I split the payment so you can see your real margin per subscriber, not just what the customer sees on their bill.
As two separate things, the device sale once and the monitoring fee as recurring revenue. That way you can see how much of your income repeats every month.
I track your active subscriber count every month, so a run of cancellations shows up early instead of only becoming obvious months later in a bigger drop.
The tax side
The tax side of a medical alert dealer.
Most of what goes wrong here is separating a one-time sale from recurring revenue, and knowing which staff are employees.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Device sales versus a lease modelWhether you sell the hardware outright or lease it as part of the subscription changes how the revenue and the equipment cost are recognized. The accountant sets this up to match how you actually price it.
- Section 179 for equipment and vehiclesWarehouse shelving, packing equipment, or a company vehicle used for installs can usually be expensed the year purchased, up to $2,560,000, with 100 percent bonus depreciation for property acquired after January 19, 2025.
- Sales commissions and 1099sA commissioned salesperson who is genuinely independent, paid $2,000 or more in 2026, gets a 1099-NEC by January 31. One who works set hours under your direction is usually an employee instead.
- Sales tax on device salesSome states tax medical alert device sales while others exempt them as durable medical equipment. The accountant checks how your state treats it.
Deductions medical alert system dealers miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Device inventory purchases
- Shipping and fulfillment costs
- Warranty replacement units
- Merchant and card processing fees
- Marketing and advertising
- Sales commissions
- Install technician mileage
- Warehouse or storage costs
- Packaging supplies
- Customer service phone lines
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 medical alert dealer's year, kept every month.
A new subscriber can sign up any week of the year. Inventory planning and your taxes 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
Inventory and pricing reset
The team checks device inventory levels and reviews monitoring center pricing for the new year, while this year's set-aside gets planned.
- April
Return filed
Your return is filed and signed while new subscribers keep signing up. The set-aside built since January already covers what is owed.
- July
Halfway on subscriber count
A look at active subscribers, cancellations, and margin per subscriber against the year's plan.
- October
Before the holiday gift season
Adult children often buy a medical alert system for a parent as a holiday gift. The team looks at inventory and staffing before that seasonal demand 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 medical alert system dealers. 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 medical alert dealers ask first.
A customer pays a monthly fee, but the monitoring center takes a cut. What do I actually keep?
Gus splits the payment so you can see your real margin per subscriber, not just the number on the customer's bill.
How does Gus handle a new sale that includes the device and the first month together?
As two separate things: the device sale counted once, and the monitoring fee counted as recurring revenue. That way your repeatable income is clear.
We had a run of cancellations this month. Should I be worried?
Gus tracks your active subscriber count every month, so a run of cancellations shows up early rather than becoming a surprise later.
Do returned devices from cancelled subscribers count as inventory again?
Yes, once refurbished. Gus keeps them in the inventory count, so you always know what is actually available to sell or lease again.
Does my state charge sales tax on the devices I sell?
It depends on the state. Some tax medical alert devices and some exempt them as durable medical equipment. The accountant checks how yours treats it.
My books mix device sales and monitoring fees together right now. Can you fix that?
Yes. Send the bank statements you have. Gus separates them going forward, the accountant checks the setup, and most owners see it sorted 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
- Geriatric care managers
- 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