Healthcare Practices
Retirement Plans for a Home Care Agency with Caregiver Staff
SEP, SIMPLE IRA or 401(k)? For a home care agency, caregiver payroll decides which plan works. Coverage rules and the SIMPLE IRA, SEP and 401(k) adoption deadlines.
RTW.ai · Resources
Practice accounting, explained.
CPA-authored guides for healthcare practice owners. S-corp structure, quarterly tax planning, retirement strategy, cash flow — the specifics your current CPA probably hasn't explained.
By Askia Roberts, CPA · GA License #CPA038784
Healthcare Practices
QBI Deduction for Home Care Agency Owners: Is Your Agency a Specified Service Business?
Whether a home care agency's owner can claim the 20% QBI deduction above the income threshold turns on one question: are the services medical? How the IRS health-field test treats non-medical and skilled-care agencies, and what to check before an October 15 extended return.
Professional Services
Which 1099s Should a Consultant Expect for 2026?
Clients report consulting fees on Form 1099-NEC at $2,000 for 2026, and payment apps report on Form 1099-K above $20,000 and 200 transactions. Neither form limits what you report. Forms arrive by February 1, 2027.
Trades & Contractors
Contractor 1099s for Subs: The $2,000 Threshold for 2026
For payments made in 2026, a contractor files Form 1099-NEC for each subcontractor paid $2,000 or more, up from $600. Forms are due February 1, 2027. Get a W-9 before paying, or backup withholding at 24% may apply.
Trades & Contractors
Deducting Tools Under $2,500: The De Minimis Safe Harbor for Contractors
A contractor can generally expense tools and equipment costing $2,500 or less per invoice or item in the year of purchase by electing the de minimis safe harbor. It needs a written policy from January 1 and an election with the return.
Professional Services
S-Corp Owner Health Insurance: Get It on the W-2 by December 31
For a consulting firm owner taxed as an S corporation, health insurance premiums have to run through the company and onto the owner's W-2 for the above-the-line deduction. The year-end payroll is the deadline.
Healthcare Practices
How Much Does a CPA Cost for a Medical Weight Loss Clinic?
Actual price ranges for clinic accounting — compliance-only tax prep, bookkeeping plus tax, and CFO-level advisory — what each tier includes, and why most clinics are paying mid-market rates for the tier that answers the fewest of their questions.
Healthcare Practices
How Should a GLP-1 Clinic Account for Medication Inventory?
Medication a clinic buys and dispenses is inventory, not an expense — and treating it as an expense overstates deductions, hides gross margin, and misstates taxable income. How to structure cost of goods sold for a weight loss clinic.
Healthcare Practices
Accounting for a Home Care Franchise
The initial franchise fee is an intangible amortized over 15 years, not a deduction. How franchise fees, royalties, ad fund contributions, and required software change the books — and the margin question a franchise P&L has to answer that an independent's does not.
Healthcare Practices
What Is a Home Health or Home Care Agency Worth?
How buyers actually value home health and home care agencies — normalized earnings, payer mix, licensure and certificate-of-need value, caregiver retention — and the diligence findings that reduce a price after the letter of intent is signed.
Healthcare Practices
LLC vs. S-Corp for a Medical Weight Loss Clinic: The Breakeven Math
When the S-corp election starts paying for itself in a weight loss or GLP-1 clinic, what it actually changes, the ownership complication specific to clinical practices, and the costs that determine the real threshold.
Healthcare Practices
Accounting for Medicaid Waiver Home Care
HCBS waiver revenue is authorization-capped, rate-fixed, and electronically verified — which makes unbilled hours, authorization overruns, and EVV mismatches the three places waiver agencies lose money without seeing it.
Healthcare Practices
The Tax & Accounting Guide for Medical Weight Loss Clinic Owners
What a medical weight loss or GLP-1 clinic owner needs to understand about the financial side: membership revenue, drug inventory and cost of goods, cash-pay economics, entity structure, provider compensation, and the reporting a generic bookkeeper will not produce.
Healthcare Practices
How Should a Weight Loss Clinic Recognize Membership and Program Revenue?
A patient who prepays for six months has not generated six months of revenue. How deferred revenue works for medical weight loss clinics, why booking cash as revenue makes growth unreadable, and what it does to a clinic that spends against it.
Healthcare Practices
Accounting for a Medicare-Certified Home Health Agency
PDGM 30-day periods, the Notice of Admission clock, revenue recognized across period boundaries, and the cost report — what makes Medicare-certified home health accounting different from non-medical home care, and where agencies lose money in the gap.
Healthcare Practices
What Happens If Your Practice Misses the September 15 Deadline?
The per-owner, per-month penalty, what it costs by month, why filing immediately is cheaper than filing correctly later, what relief is actually available, and how a missed practice deadline puts every owner's October 15 return at risk.
Healthcare Practices
The October 15 Deadline for Practice Owners: What Is Still Possible
October 15 is the extended personal return deadline — and the last date several tax moves remain available. What can still be done, what closed on December 31, and the retirement-contribution deadline practice owners most often get wrong by a month.
Healthcare Practices
What Is the September 15 Deadline for a Physician Practice?
September 15 is the extended due date for calendar-year S-corp and partnership returns — and the Q3 estimated payment date. There is no second extension. What is due, what the per-owner penalty costs, and why every owner's October 15 return depends on it.
Healthcare Practices
Tax Deadlines for Physician and Dental Practice Owners: The Full Calendar
Every tax deadline a practice owner actually has to hit — March 15 and September 15 for the practice return, April 15 and October 15 for the personal return, four estimated payment dates, and the payroll deadlines in between. What each one covers, and what missing it costs.
Healthcare Practices
Starting a Home Care Agency: The Financial Setup
What to get right in the first ninety days — entity and payroll before the first caregiver, a chart of accounts built for payer mix and hours, the working capital nobody budgets for, and the classification decision that is hardest to undo.
Healthcare Practices
Bookkeeper vs. CPA for a Home Care Agency: What Each Actually Does
Where a bookkeeper stops and a CPA starts for a home care agency — payer-level margin, caregiver payroll compliance, S-corp strategy, and quarterly taxes — and the questions to ask before hiring either one.
Healthcare Practices
How Much Does a CPA Cost for a Home Care Agency?
CPA and accounting costs for a home care agency range from $2,500/year for tax prep only to $25,000+/year for full-service bookkeeping and CFO advisory. What drives the price, what each tier should include for an agency specifically, and how to tell whether you're buying transactions or judgment.
Healthcare Practices
Why Home Care Agencies Run Out of Cash While Growing
Home care agencies pay caregivers weekly but collect from the VA, insurers, and Medicaid waiver programs in 30–60 days. The working-capital math of that gap, how to size a cash reserve, when a line of credit is the right bridge, and the forecast that makes growth fundable.
Healthcare Practices
Caregiver Payroll for Home Care Agencies: Overtime, Classification, and the Margin Math
Caregiver payroll is 60–75% of a home care agency's revenue. How the 2015 Home Care Rule changed overtime, why 1099 caregiver classification is a compliance trap, what payroll burden actually costs, and how to keep overtime from eating the margin.
Healthcare Practices
The Complete Tax & Accounting Guide for Home Care Agency Owners
What a non-medical home care agency owner needs to understand about taxes and accounting: entity structure, caregiver payroll and overtime, margin by payer, VA and long-term-care billing cycles, quarterly estimates, and the reporting most agencies never see.
Healthcare Practices
LLC vs. S-Corp for a Home Care Agency: The Breakeven Math
When an S-corp election starts saving a home care agency owner real money, what a reasonable salary looks like for an owner-administrator, how the QBI deduction interacts with the choice, and the compliance costs that set the breakeven point.
Healthcare Practices
Accounting for VA-Contract Home Care Agencies: Authorizations, Billing Lag, and Margin
How VA community care changes a home care agency's accounting: authorization-capped revenue, CCN billing through regional administrators, 30–60 day payment cycles, timely-filing risk, and the payer-concentration question every VA-heavy agency should be able to answer.
Professional Services
1099 Consulting Income: What You Owe and How to Reduce It
When you receive 1099 income from consulting, you owe income tax plus self-employment tax on every dollar of profit. Most new consultants are surprised by the total tax rate. Here is what you owe, when you pay it, and the specific steps that reduce the bill.
· Updated July 14, 2026
Trades & Contractors
1099 Contractor Taxes: What You Owe and How to Reduce It
If you're a 1099 contractor or sole-proprietor tradesperson, your tax burden is significantly higher than a W-2 employee's — but most of it is reducible with the right structure. Here is what you actually owe, five ways to reduce it, and when to make the move to an entity.
· Updated September 28, 2026
Professional Services
Bookkeeper vs. CPA for a Consulting Firm: Who Does What
Most consulting firm owners either pay CPA rates for bookkeeping work, or run without a CPA and miss the planning they actually need. Here is how the roles divide, when you need each, and what good coordination between them produces.
· Updated July 14, 2026
Trades & Contractors
Bookkeeper vs. CPA for a Contractor Business
Contractors typically either have one without the other — or pay CPA rates for bookkeeping work. Here is how the two roles divide for trades businesses, what each function costs and covers, and what the integrated model looks like.
· Updated September 28, 2026
Healthcare Practices
Bookkeeper vs. CPA for a Physician Practice: Who Does What, and When to Hire Each
Most physician practice owners are either paying a CPA to do bookkeeping (expensive) or using a bookkeeper without CPA oversight (risky). Here is how the roles divide, when you need each, and what happens when the wrong person is in the wrong seat.
· Updated July 14, 2026
Professional Services
Why Consulting Firms Have Cash Flow Problems Despite Strong Revenue
A consulting firm billing $600K per year should not struggle to make payroll. But cash flow problems are common in professional services — and they have predictable causes that have nothing to do with how much you bill.
· Updated July 14, 2026
Professional Services
How Much to Pay Yourself From a Consulting S-Corp
The salary you pay yourself from your consulting S-corp is one of the most consequential tax decisions you make each year. Too low, and the IRS audits you. Too high, and you eliminate the tax benefit. Here is how to find the right number.
· Updated July 14, 2026
Professional Services
Retirement Accounts for Consulting Firm Owners: More Than a SEP-IRA
Most consultants open a SEP-IRA and call it done. That leaves money on the table. A Solo 401(k) allows significantly higher contributions at the same income level — and a cash balance plan can shelter six figures. Here is how each option works.
· Updated July 14, 2026
Professional Services
Consulting Firm Tax Deductions: The Complete List
Consulting firm owners routinely miss deductions in the categories that require active decisions — retirement, home office, vehicle, and health insurance setup. This checklist covers every deduction available and which ones most consulting firms are leaving on the table.
· Updated July 14, 2026
Professional Services
Year-End Tax Planning for Consulting Firm Owners
Most tax planning opportunities for consulting firms expire on December 31. By April, the year is over and you can only calculate what you owe — not reduce it. Here are the specific decisions that must be made before year-end, and when to make them.
· Updated July 14, 2026
Trades & Contractors
Cash Flow Problems in Contractor Businesses: Causes and Fixes
High revenue doesn't mean strong cash flow in contractor businesses. Retainage, slow-paying GCs, change order disputes, and tax payments create cash gaps that look like business problems but are actually billing and planning problems. Here is how to diagnose and fix them.
· Updated July 14, 2026
Trades & Contractors
Retirement Accounts for Contractors: Solo 401(k), SEP-IRA, and Cash Balance Plans
Contractors can shelter $24,500 to $300,000+ in pre-tax retirement contributions depending on income and plan type. Here is which vehicle is right for your situation, contribution math at different income levels, and the deadlines that matter.
· Updated July 14, 2026
Trades & Contractors
How Much to Pay Yourself as a Contractor S-Corp Owner
Your S-corp salary as a contractor determines payroll taxes, retirement capacity, workers' comp premiums, and quarterly withholding all at once. Here is the framework for setting it correctly and the four variables it controls.
· Updated July 14, 2026
Trades & Contractors
Home Office Deduction for Contractors: The Job Site Exception
Many contractors believe they can't claim a home office because they work on job sites. That's wrong. If you manage your business from home — scheduling, estimating, invoicing, client communication — you may qualify. Here is how the rules apply to trades businesses.
· Updated July 14, 2026
Trades & Contractors
Contractor Tax Deductions: The Complete Checklist
Every deduction available to contractor and trades business owners — tools, vehicles, materials, insurance, home office, retirement, and the ones most contractors miss. With documentation requirements and year-end deadlines.
· Updated September 28, 2026
Trades & Contractors
Contractor and Trades Business Tax Guide (2024)
The complete tax guide for contractor and trades business owners — plumbers, electricians, HVAC, roofers, general contractors, and more. S-corp structure, vehicle deductions, retirement accounts, quarterly taxes, QBI deduction, and year-end planning. Everything you need to keep significantly more of what you earn.
· Updated September 28, 2026
Trades & Contractors
Vehicle Tax Deductions for Contractors: Work Trucks, Vans, and Trailers
Vehicles are one of the largest deductions available to contractors. Section 179, bonus depreciation, actual expense vs. standard mileage, and the specific rules for heavy SUVs and work trucks. Here is how to maximize the deduction and what documentation you need.
· Updated July 14, 2026
Professional Services
How Much Does a CPA Cost for a Consulting Firm?
CPA fees for consulting firms vary widely — from $1,500 for basic compliance to $12,000+ for full advisory with S-corp and business return. Here is what drives the cost, what you should expect at different engagement levels, and how to evaluate whether you're getting value.
· Updated July 14, 2026
Trades & Contractors
Year-End Tax Planning for Contractor Businesses
Most contractor tax planning opportunities expire on December 31. Equipment purchases, retirement contributions, salary adjustments, and entity elections all have hard deadlines. Here is the Q3–Q4 sequence every contractor business should run.
· Updated July 14, 2026
Trades & Contractors
How Much Does a CPA Cost for a Contractor Business?
CPA fees for contractor and trades businesses range from $1,500 for a basic return to $10,000+ for full advisory. Here is what drives the cost, what you should expect at each price point, and how to evaluate whether your current CPA is delivering value.
· Updated July 14, 2026
Professional Services
Home Office Deduction for Consultants: What Actually Qualifies
Most consultants either skip the home office deduction (leaving money on the table) or claim it incorrectly (creating audit risk). The rules are straightforward once you understand the exclusive use requirement and how S-corp owners claim it differently than sole proprietors.
· Updated July 14, 2026
Healthcare Practices
How Much Can I Take Out of My Physician Practice S-Corp?
Distributions from an S-corp are not the same as salary — and taking too much or too little has real tax and legal consequences. Here is the framework for calculating what you can safely pull from your practice each month.
· Updated July 14, 2026
Healthcare Practices
How Much Does a CPA Cost for a Physician Practice?
CPA fees for physician practices range from $2,500 for a basic tax return to $80,000+ per year for full advisory. Most physicians are paying mid-market rates for compliance-only service — and don't realize there's a tier between the two.
· Updated July 14, 2026
Trades & Contractors
Late S-Corp Election for Contractors: How to Get Relief
Missed the March 15 deadline to elect S-corp status for your contractor business? In most cases, relief is available. Here is the IRS procedure for late elections, the requirements, and what happens when you qualify.
· Updated July 14, 2026
Professional Services
Late S-Corp Election for a Consulting Firm: What's Still Possible
The S-corp election deadline is March 15 — or 75 days after entity formation. If you missed it, IRS relief procedures may let you elect retroactively. Here is what's available, what it costs, and when it's worth pursuing.
· Updated July 14, 2026
Professional Services
LLC vs. S-Corp for a Consulting Firm: The Decision Framework
Every consulting firm owner eventually faces the LLC vs. S-corp question. The answer is almost always: form an LLC, then elect S-corp taxation when income supports it. Here is the framework, the timing, and the specific situations where the standard answer doesn't apply.
· Updated July 14, 2026
Trades & Contractors
LLC vs. S-Corp for Contractors: What the Terms Actually Mean
Most contractors who ask 'should I be an LLC or S-corp' are asking the wrong question. An LLC and an S-corp are not mutually exclusive — they answer different questions entirely. Here is the correct framing and the right structure for contractors at different income levels.
· Updated July 14, 2026
Healthcare Practices
Physician With Both 1099 and W-2 Income: How Taxes Actually Work
Employed physicians who also moonlight, run a side practice, or work locum tenens face a tax situation most CPAs don't explain clearly. Here is exactly how the two income streams interact, why the penalty risk is higher than most realize, and how to fix it.
· Updated July 14, 2026
Healthcare Practices
Why Physician Practices Have Cash Flow Problems Despite Strong Billing
Billing $1.2M and running short on cash is more common than most physician practice owners want to admit. Here is why it happens, what the actual levers are, and how to run the practice so the bank balance reflects what the business has actually earned.
· Updated July 14, 2026
Healthcare Practices
Missed the S-Corp Election Deadline? Here's How to Fix It Retroactively.
The IRS allows late S-corp elections up to 3 years and 75 days after the intended effective date. If your physician practice should have elected S-corp status and didn't, the fix exists — and it can recover years of overpaid taxes.
· Updated July 14, 2026
Healthcare Practices
Physician Practice Quarterly Estimated Taxes: How Much to Set Aside
Quarterly estimated taxes are the most common source of unexpected tax bills for physician practice owners. Here is the calculation framework, the safe harbor rules, and a reserve percentage by income range — so April never surprises you again.
· Updated July 14, 2026
Healthcare Practices
Physician Practice Retirement Accounts: The Options Most CPAs Don't Surface
A Solo 401(k) is a good start. A cash balance plan stacked on top of it is where physicians over 45 find the largest single available tax deduction — often $150,000 to $275,000 per year. Here is how each option works and who should be using which.
· Updated July 14, 2026
Healthcare Practices
Physician Practice Tax Deductions: The Complete Checklist
A comprehensive list of every deduction a physician practice owner should be capturing — from the obvious (retirement, health insurance) to the ones most CPAs miss (Section 199A, vehicle basis, home office safe harbor, continuing education timing).
· Updated July 14, 2026
Healthcare Practices
The Complete Tax Guide for Physician Practice Owners
Everything a physician practice owner needs to understand about taxes: entity structure, S-corp salary, quarterly payments, retirement accounts, distributions, and the gaps that cause most practices to overpay. With links to the full analysis on each topic.
· Updated July 14, 2026
Healthcare Practices
How Much Should I Pay Myself as a Physician S-Corp Owner?
Most physicians either overpay FICA by setting their S-corp salary too high, or risk an IRS audit by setting it too low. Here is the framework — including specialty-specific benchmarks and the actual tax math — for getting this right.
· Updated July 14, 2026
Professional Services
Professional Services Firm Owner Tax Guide (2024)
The complete tax guide for consulting firm and professional services firm owners. S-corp structure, salary optimization, retirement accounts, quarterly estimated taxes, QBI deduction, home office, cash flow — everything you need to pay significantly less than the default tax bill.
· Updated July 14, 2026
Professional Services
The QBI Deduction for Consulting Firms: Is Your Business an SSTB?
Many consulting firm owners are told they can't take the QBI deduction because 'consulting is an SSTB.' That's often wrong. Whether your consulting firm qualifies depends on the nature of your work — not just the label 'consulting.'
· Updated July 14, 2026
Trades & Contractors
QBI Deduction for Contractors: Why Most Trades Qualify in Full
The 20% qualified business income deduction is one of the most valuable tax breaks available to pass-through businesses — and most contractors qualify for it in full because construction and trades are not Specified Service Trades or Businesses. Here is how it works and how to maximize it.
· Updated July 14, 2026
Healthcare Practices
The QBI Deduction for Physician Practices: What You Can Actually Claim
Medicine is a Specified Service Trade or Business, which means the QBI deduction phases out at higher income levels. But the phase-out is not a cliff, and retirement contributions can push many physicians below the threshold. Here is exactly how it works.
· Updated July 14, 2026
Professional Services
Quarterly Estimated Taxes for Consultants: The Calculation Most Get Wrong
Consultants who miss quarterly estimated tax payments face penalties and a large tax bill in April. The calculation isn't complicated — but most consultants are either overpaying safe harbor or underpaying because they're using the wrong income figure.
· Updated July 14, 2026
Trades & Contractors
Quarterly Estimated Taxes for Contractors
Contractors with self-employment income or S-corp K-1 distributions have no employer withholding on that income. Here is how to calculate quarterly payments, when they're due, and how to avoid underpayment penalties when income is seasonal.
· Updated July 14, 2026
Professional Services
Should My Consulting Firm Elect S-Corp? The Break-Even Math
The S-corp election saves consulting firm owners real money on self-employment tax — but only above a specific income threshold. Here is the calculation, what it costs to run an S-corp, and how to know if the numbers work for your firm.
· Updated July 14, 2026
Trades & Contractors
S-Corp Election for Contractors: The Break-Even Math
When does the S-corp election make financial sense for a contractor? Here is the break-even analysis, the costs you need to account for, and the situations where the standard advice doesn't apply to trades businesses.
· Updated July 14, 2026
Healthcare Practices
S-Corp vs LLC for Physician Practices: The Breakeven Math
The S-corp versus LLC decision comes down to one calculation: do the payroll tax savings exceed the compliance costs? Here is the actual math at different income levels, and when each structure makes sense for a physician practice.
· Updated July 14, 2026
Healthcare Practices
Why Is My Physician Practice Tax Bill So High?
If your tax bill came back larger than expected, it is almost never random. There are five specific reasons physician practice owners overpay — and most of them were preventable before you filed.
· Updated July 14, 2026
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