Home care agency audits
Greywood CPA audits and reviews financial statements for home care and in-home services agencies that receive state Medicaid, waiver or Department on Aging funding. We are a licensed CPA firm (Virginia Board of Accountancy firm license #134961) working with agencies nationwide, and every engagement is quoted at a fixed fee before work starts.
Which report you need depends on your state, how much state and federal money your agency spends and what your provider contract says. Nonprofit agencies spending $1,000,000 or more in federal awards need a Single Audit in every state. Illinois requires a CPA audit from $500,000 in state awards, while New York and Texas audit Medicaid cost reports themselves. We confirm the exact requirement before we quote.
Last reviewed: November 2026
Most home care agencies don't choose to get audited. Someone they depend on for revenue requires it. The most common sources of the requirement are:
Your provider agreement or grant agreement usually states the requirement and the deadline. If yours doesn't say clearly, send it to us and we'll tell you what applies.
There is no single national rule. States handle home care agency finances in three different ways, and many agencies face more than one of them:
| Where | What's required | What it means for you |
|---|---|---|
| Illinois | A CPA audit or review set by how much state and federal money you spend, under the Grant Accountability and Transparency Act (GATA). Community Care Program providers fall under it. | You need an independent CPA report filed with the state. See the Illinois detail below. |
| New York | Medicaid-funded LHCSAs, CHHAs and fiscal intermediaries file an annual Home Care Cost Report. It doesn't need CPA certification, but the Department of Health has a contractor audit the submissions, and agencies upload trial balances, general ledgers and financial statements as support. | Clean, reconciled financial statements are what the cost report audit tests. Agencies also need audited statements when a lender, buyer or contract asks. |
| Texas | Medicaid long-term services providers file cost reports with HHSC, generally due 90 days after fiscal year-end. HHSC runs its own field audits and desk reviews, and costs that can't be documented are disallowed. | The state audits you, not a CPA. Your records and financial statements have to support every reported cost. |
| Every state | A Single Audit once a nonprofit agency spends $1,000,000 or more in federal awards in a year (fiscal years beginning on or after October 1, 2024). Provider contracts, managed care plans and lenders can also require audited or reviewed statements. | Check your provider agreement, grant agreements and loan documents. They state the report and the deadline. |
Operating in another state? Send us your provider agreement and we'll confirm what applies before we quote.
Illinois raised the GATA thresholds effective March 20, 2025:
| If your agency spends in a fiscal year | You need | Due |
|---|---|---|
| $1,000,000+ in federal awards | Single Audit For-profit agencies receiving federal pass-through funds from a state agency need a program-specific audit instead | Earlier of 30 days after the report or 9 months after year-end |
| $750,000+ in state awards | Audit under Government Auditing Standards | Earlier of 30 days after the report or 6 months after year-end |
| $500,000 – $749,999 in state awards | Financial statement audit (GAAS) | Earlier of 30 days after the report or 6 months after year-end |
| Under $500,000 | No audit under GATA. File the Consolidated Year-End Financial Report (CYEFR) in the Grantee Portal | Per your grant agreement |
Audits that your program or contract requires for other reasons, sometimes labeled an "other audit" in the GATA portal, still have to be submitted for review. If your agency was flagged as high risk, extra procedures may apply.
The level is set by whoever relies on your statements. Picking a lower level than required gets the report rejected; picking a higher one costs more than you need to spend.
We present your numbers as financial statements. Rarely accepted by state programs; sometimes enough for a lender.
Analytical procedures and inquiry. Accepted by some state programs and lenders below audit thresholds.
Testing, confirmations and controls work, ending in an opinion. What most funded agencies need, including Single Audits.
Not sure? Read audit vs. review vs. compilation, or send us your contract and we'll tell you in one reply.
We quote one fixed fee in writing before any work starts, so the number in the proposal is the number you pay. No hourly billing and no surprise invoices. Send us your last year's financials and your provider agreement, and you'll have a fixed-fee proposal within 1–3 business days.
If your books need work before the audit, our bookkeeping and cleanup team can handle it separately. We keep it independent from the audit team.
Most audits take 4 to 8 weeks from the day your records are complete. Tell us your filing deadline up front and we'll plan backward from it.
A 30-minute call about your programs, funding and deadline. Send your provider or grant agreement if you have it.
Scope, report type, timeline and one fixed fee, in writing.
Everything we need, uploaded through a secure portal.
Testing of revenue, payroll, receivables and compliance, done remotely.
You review the draft, a CPA partner signs, and you submit to your program.
We send one tailored list at the start, so there are no surprise follow-up requests. For a home care agency it usually includes:
Auditors compare service units billed to the program against payroll and electronic visit verification (EVV) records. Reconciling the two every month is the single best way to avoid a finding.
Denied, adjusted or unpaid claims left in receivables overstate revenue. Write off or follow up on old balances before year-end.
Grant-funded programs limit what you can charge to them. Keep invoices and allocation methods for every cost charged to a program.
Rent or management fees paid to an owner's other companies must be disclosed. Tell your auditor about them early.
Missing the program deadline can put your contract at risk. Start the audit at least three months before it's due.
It depends on your state, funding and contracts. Nonprofit agencies that spend $1,000,000 or more in federal awards need a Single Audit in every state. Illinois requires a CPA audit once you spend $500,000 or more in state awards under GATA. New York and Texas instead require Medicaid cost reports that the state audits. Lenders, buyers and managed care contracts can also require audited statements. Your provider agreement states the requirement.
Not for the Medicaid cost report itself. New York's Home Care Cost Report does not need CPA certification, but the Department of Health has a contractor audit submissions and agencies upload their trial balance, general ledger and financial statements. Texas HHSC audits provider cost reports directly and disallows costs that can't be documented. Agencies in both states often still need audited or reviewed statements for lenders, buyers, managed care plans or federal funding.
We charge one fixed fee, quoted in writing before any work starts. The fee depends on your revenue, the number of payer programs, the condition of your books and whether a Single Audit or Government Auditing Standards apply. Send us last year's financials and your provider agreement and we will send a fixed-fee proposal within 1–3 business days.
Most home care audits take 4 to 8 weeks once your records are complete. Tell us your program deadline and we will plan the work backward from it.
Yes. Many home care agencies are for-profit companies. The audit standards are the same; what differs is which program rules apply. Federal Single Audit rules apply to nonprofits, while for-profit agencies are usually covered by their state program's or contract's audit terms instead.
Yes. We work with agencies across the country, remotely, and register with a state's board of accountancy wherever that state requires it before we issue a report.
Independence rules limit this. We can help clean up records before an audit through a separate team, but we won't audit numbers we prepared in a way that impairs independence. We'll tell you up front what we can and can't do for an audit client.
Send us your provider or grant agreement. A senior CPA will confirm what report you need and send a fixed-fee proposal within 1–3 business days.