Senior care & aging services
Books and taxes for memory care communities.
A private-pay rate built for higher staffing ratios, agency coverage when turnover hits, and a secure door system with its own monthly fee. 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
November netted $32,000. Two weeks of agency coverage after a caregiver left pushed staffing costs up, so I kept that separate from your regular payroll.
- Resident monthly rate ACHPrivate-pay rate
- Level of care fee billingLevel of care fees
- Agency staffing invoiceAgency staffing
- Payroll, memory care staffCare staff wages
- Door alarm monitoring feeSecurity monitoring
Why your books are different
A memory care community's books go wrong in the same four places.
A generalist sees payroll and a facility bill. Your business runs on a staffing ratio tighter than general assisted living, security systems with an equipment cost and a monthly fee, and turnover that gets expensive fast. When the books do not know that, a rough staffing month looks like a wage problem instead of what it is.
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1
Agency staffing fills gaps at a premium
High turnover means shifts sometimes get covered by an outside staffing agency at two or three times the hourly cost of a regular employee, and if that expense gets buried in general wages, a staffing crunch looks like a payroll problem instead of what it is.
What we doKeeps agency and temp staffing costs in their own line, so a rough month is visible for what it actually was, a staffing gap, not a wage increase. -
2
Security technology gets treated as a one-time cost
Door alarms and wander management systems carry both an equipment purchase and an ongoing monitoring fee, and if the whole thing is booked as one expense the month it is installed, the recurring cost disappears from view after that.
What we doSplits the equipment purchase from the recurring monitoring fee, so both show up correctly, this month and every month after. -
3
Level of care fees rarely match staffing intensity
Memory care residents often need more hands-on help than the flat level of care fee accounts for, and without a clear view of care fees against actual staffing hours, a community can be underpricing care for months before anyone notices.
What we doSplits room and board from level of care fees, so you can see whether what you charge for care is keeping up with what it costs to staff it. -
4
Turnover cost hides in the hiring line
Background checks, training, and onboarding for a caregiver who leaves within a few months is a real cost that is easy to miss when it is scattered across several categories instead of tracked together.
What we doKeeps hiring and training costs visible against how long new caregivers actually stay, so the true cost of turnover is not hidden.
Your categories
The categories Gus keeps for a memory care community.
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
- Private-pay monthly rateTypically higher than general assisted living given the staffing it requires.
- Level of care feesAdditional tiers based on behavioral or physical support needs.
- Move-in or community feeA one-time fee collected at move-in.
- Second-person feesAn add-on when two residents share a unit.
Money out
- Care staff wages and overtimeStaffing ratios run tighter here than in general assisted living.
- Agency and temp staffing feesCovering shifts when turnover leaves a gap, usually at a premium rate.
- Payroll taxes and workers compThe cost of employing care staff, not just paying them.
- Security monitoring and hardwareDoor alarms and wander management systems, both equipment and a monthly fee.
- Dementia-specific programmingActivity supplies and training built for memory care.
- Medication management suppliesCosts tied to closely tracked medication schedules.
- Facility rent, mortgage, and utilitiesThe cost of the building itself.
- Liability insuranceTypically higher here given fall and wandering risk.
What we watch for you
- Agency staffing cost
What temp coverage costs against regular payroll, the clearest sign turnover is getting expensive.
- Caregiver-to-resident ratio
Staffing hours against residents, the number memory care pricing depends on getting right.
- Occupancy
Residents filled against capacity, since a memory care unit runs mostly fixed costs regardless of a few empty rooms.
- Care fee coverage
Level of care fees collected against what that staffing intensity actually costs.
Ask Gus
Things memory care 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.
Agency coverage runs two to three times a regular caregiver's rate. I kept it separate from base wages, so you can see it was a staffing gap, not a raise nobody approved.
The install is one cost, but the monthly monitoring is ongoing. I split them so the recurring fee shows up every month, not just the one you bought it.
That is exactly what I track. Room and board is separate from care fees, so you and the accountant can see if pricing is keeping up with staffing.
The tax side
The tax side of a memory care community.
Most of what goes wrong here is separating equipment from ongoing fees, and separating your own staff from an outside vendor.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Security equipment versus monitoringDoor alarms and wander management hardware can usually be expensed as equipment the year purchased, while the ongoing monitoring fee is a regular operating cost, not part of the equipment write-off.
- Section 179 for facility equipmentSecure door hardware, call systems, and furnishings bought outright can usually be expensed the year purchased, up to $2,560,000, with 100 percent bonus depreciation for property acquired after January 19, 2025.
- Agency staff are not your 1099sA staffing agency you pay to cover shifts is a vendor, not a contractor you issue a 1099 to. Your own care staff working scheduled shifts remain employees.
- 1099s for outside specialistsA programming consultant or music therapist who works independently for more than one community, paid $2,000 or more in 2026, gets a 1099-NEC by January 31.
Deductions memory care communities miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Wander management monitoring fees
- Door alarm and security hardware
- Dementia-specific activity supplies
- Staff dementia care training
- Background checks per hire
- Liability insurance
- Medication management supplies
- Facility maintenance and repairs
- Staff uniforms
- Licensing and survey fees
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 memory care community's year, kept every month.
A new resident or a staffing gap can arrive any week of the year. Rate changes 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
Rates and staffing plans reset
Annual rate increases and the staffing budget for the new year get set, so the team confirms the numbers before billing continues.
- April
Filed, staffing steady
Your return is filed and signed while the care team keeps its routine. The set-aside running since January already covers it, no scramble needed.
- July
Halfway on staffing cost
A look at agency staffing spend and caregiver-to-resident ratio against the year's budget, and whether pricing has kept pace.
- October
Before winter turnover season
Caregiver turnover and flu-related absences often climb heading into winter. The team looks at staffing plans and anything worth buying before December.
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 memory care communities. 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 memory care owners ask first.
Why did payroll spike when we had to bring in agency staff?
Agency coverage runs well above a regular caregiver's rate. Gus keeps it in its own line so a staffing gap reads as what it was, not an unexplained payroll jump.
We bought a new door alarm system. Is the whole cost written off this year?
The hardware usually can be. The ongoing monitoring fee is a separate, regular cost that keeps showing up every month after, and Gus keeps the two apart.
How do I know if our level of care fees actually cover our staffing costs?
Gus splits room and board from care fees so you and the accountant can see whether pricing is keeping up with what staffing that level of care actually costs.
Our caregiver turnover feels expensive but I can't point to why.
It usually is. Gus keeps hiring, training, and background check costs visible against how long new hires stay, so the real cost of turnover shows up instead of hiding in scattered categories.
Does Medicaid ever help pay for memory care?
In some states a Medicaid waiver covers part of the cost, though most memory care residents pay privately. Gus tracks whichever payers your residents actually use.
My books are behind from a rough staffing stretch this year. Can you still help?
Yes. Send the bank statements you have. Gus works through the backlog and separates agency staffing costs from regular payroll as he goes, usually 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
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- Senior home safety assessments
- Senior living placement advisors
- Senior move managers & downsizing specialists
- Companion care services
- Small assisted living facilities
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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