If you manage Family-Managed Home Care (FMHC) funding for yourself or a loved one in Ontario, you already know the care is only half the job. The other half is the paperwork: a dedicated bank account, payments to care providers, payroll taxes and a monthly report to Ontario Health atHome. This guide explains what FMHC bookkeeping involves, what records to keep and how to avoid the mistakes that cause problems at reporting time.
What is Family-Managed Home Care?
FMHC is an Ontario Health atHome program. Eligible patients, or their substitute decision-makers (SDMs) such as a parent or spouse, receive funding to purchase home care services or employ their own care providers instead of receiving services through a contracted agency.
Before joining, a patient must be assessed, meet the eligibility criteria for traditional home care and have a care plan developed by Ontario Health atHome. Every FMHC patient then signs a contract with Ontario Health atHome that sets out the care plan, the monthly reporting requirements and the financial details. Under the current contract, funding is flowed on the first day of each month.
Your financial responsibilities under FMHC
Ontario Health atHome describes the patient or SDM as responsible for managing the financial side of the program, including:
- Running the dedicated FMHC bank account
- Paying care providers or agencies, and the related taxes
- Securing the required insurance
- Keeping accurate records
- Meeting Ontario Health atHome’s reporting requirements and payment schedules
One guiding principle matters for bookkeeping: FMHC is designed to be equivalent to traditional home care, so you cannot fund more services than your care plan allows. Your records need to show that the hours and services you paid for match what was approved.
What goes into a monthly FMHC report
Your contract specifies the exact format and deadline, so always follow it first. In practice, a clean monthly FMHC report rests on these building blocks:
- Bank reconciliation — every deposit and payment in the FMHC account matched to your records, with a closing balance that agrees with the bank statement.
- Funding received — the monthly amount from Ontario Health atHome, recorded on the date it arrived.
- Payments to providers — each payment supported by a timesheet or invoice showing dates, hours and the service delivered.
- Payroll and remittances — if you employ caregivers directly, the wages paid and the CPP, EI and income tax remitted to the Canada Revenue Agency.
- Care plan check — total hours delivered compared with the hours authorized in your care plan.
Records every FMHC family should keep
- Monthly bank statements for the FMHC account
- Signed timesheets and agency invoices
- Pay statements and payroll registers for each employee
- CRA remittance confirmations, T4 slips and Records of Employment
- WSIB registration and premium records, if they apply to you
- Insurance certificates
- Copies of every report submitted to Ontario Health atHome
Keep these organized month by month. If Ontario Health atHome asks a question, you should be able to produce the supporting document in minutes, not days.
Common FMHC bookkeeping mistakes
- Mixing personal and FMHC money. Pay only FMHC-approved costs from the FMHC account, and never use it for household expenses.
- Paying for more hours than the care plan. Track hours weekly so you catch overages early.
- Missing timesheets or invoices. A payment without support is the hardest item to explain.
- Treating employees as contractors. Caregivers you hire and direct are usually employees, which brings payroll deductions and remittances.
- Late reports. Ontario Health atHome works to a set reporting schedule, so build your month-end routine around it.
Should you hire an FMHC bookkeeper?
Many families choose to work with a professional bookkeeper so reports are accurate and on time, especially when they employ several caregivers. Ask your Ontario Health atHome care coordinator how bookkeeping costs are handled under your agreement before you start.
At Carnation Consulting, our CPA-led team prepares FMHC bookkeeping and monthly reports for families across Ontario, fully remotely. Learn more about our FMHC bookkeeping services in Ontario, or book a free consultation.
Frequently asked questions
Who do I report to for FMHC?
You report to Ontario Health atHome, which sets the reporting requirements and payment schedule in your FMHC contract.
When does FMHC funding arrive?
Under the current Ontario Health atHome contract, funding is flowed on the first day of each month.
Can I use FMHC funds for anything outside the care plan?
No. FMHC funds the services in your approved care plan. Speak to your care coordinator if your care needs change, as Ontario Health atHome reassesses needs regularly.
This article is general information, not legal or tax advice. Your FMHC contract and your Ontario Health atHome care coordinator are the final word on your program’s requirements.
Sources: Ontario Health atHome — Family-Managed Home Care · FMHC Fact Sheet (PDF) · FMHC contract overview