Growing home healthcare provider replaces fragmented intercompany accounting and manual reporting workflows with connected financial management across six entities.
Health & Social Care
Rapid growth across multiple healthcare entities created increasing intercompany accounting complexity, manual reporting workflows, and growing pressure on the finance team.
Sage Intacct automated intercompany accounting, consolidated financial reporting, and replaced spreadsheet-driven workflows with connected multi-entity financial management.
For the people American River Healthcare serves—patients receiving home health, hospice, and infusion care across the Sacramento region of California—the quality of care depends on an organization that can keep growing without losing operational control.
Behind every service line is a finance function that must scale with it.
When Daniela Sawin joined American River Healthcare as Controller six years ago, the organization ran three entities on QuickBooks. She built the accounting function from scratch, a team of one that grew to eight, and watched the complexity multiply faster than the headcount.
Today the organization has six entities and the intercompany accounting burden that came with that growth nearly broke the operation. Sage Intacct is what made scaling it possible. "I'm never going back," Daniela says.
"I went from making six journal entries to one."
Daniela Sawin
Controller
The break point wasn't a single failure. It was cumulative: the slow accumulation of friction that comes when a system built for small business bookkeeping is asked to manage six related entities, shared cost allocations, and growing transaction volumes.
QuickBooks was crashing mid-session. The team was getting logged out without warning. Billing runs with high line-item counts would bring the system down entirely.
But the deeper operational problem was intercompany. American River Healthcare's management services organization allocated shared costs across all entities—and when allocation percentages changed, the entire team had to stop what it was doing and manually update each set of books individually.
"Everyone would kind of divide and conquer," Daniela says. "At that point I was like, this is not feasible. We cannot live like this anymore."
The cost of staying put was becoming visible in headcount terms too. Daniela did the math: remaining on QuickBooks across six entities, while continuing to add staff to manage the manual workload, meant an additional $60–80k in annual payroll costs.
"If my boss would have just been like, no, we're not spending that on accounting software," she says, "he would have been spending way more on an additional employee."
American River Healthcare selected Sage Intacct over NetSuite and Oracle on the strength of its intercompany functionality—and the people behind it. "Sage was our favorite," Daniela says. "We liked the people and we liked the product."
The operational change was immediate. Where a single intercompany transaction previously required separate journal entries across every entity, Sage Intacct consolidated the entire process into one. "I went from making six journal entries to one," Daniela says. "So when it's an intercompany transaction that includes all five other entities, it just hits everything."
The intercompany close, which had previously taken more than a day, now takes minutes because transactions are tracked and reconciled continuously throughout the month rather than in a manual burst at period end.
Reporting changed just as dramatically. Previously, Daniela would pull raw data from QuickBooks, export it to Excel, and manually reformat it to match the profit and loss structure management needed—a process that could take hours. Now custom reports are built once inside Sage Intacct and pulled in seconds. "It doesn't even take 10 minutes," she says. "It takes two minutes."
The efficiency gains compounded in an unexpected direction. Sage Intacct's controls—role-based access, dual approval requirements, locked reconciliation periods—forced the team to work differently. Transactions that had previously been corrected by going back and changing entries now require proper adjusting of journal entries.
"They would say, 'I just want to be able to change it,'" Daniela says. "And I'm like, technically that's not real accounting. You're not supposed to be going back and changing it." The result is a team that is more technically capable, not just less burdened.
When Sage Intacct was first demonstrated to the team, one employee had a different concern entirely. She turned to Daniela and asked: "Am I going to have a job after you get Sage? Because I don't think I'm going to have anything to do." Daniela told her the job wouldn't disappear, but it would change.
That employee still works at American River Healthcare. She went from spending her days processing intercompany transactions to reconciling the general ledger, amortizing prepaids, and taking on broader accounting responsibilities. "I was able to level her up," Daniela says. "She didn't have the time to do all of that before because she was doing all of the intercompany stuff."
"She didn't have the time before—she was doing all the intercompany stuff. I was able to level her up."
Daniela Sawin
Controller
American River Healthcare continues to grow, with more entities, more service lines, and more patients depending on the organization to deliver. For Daniela, the question she's focused on now is how to use the data foundation Sage Intacct has built to make the next leap—faster decisions, better visibility, and AI tools that are only as good as the data underneath them.
"AI is only as good as the data that's being put into it," she says. "We're excitedly cautious, we trust but verify. But we can see how it's changed the way we work, and we're excited to see what's next."
For any controller navigating the same growth pressures, her advice is direct: "If you're in a company that is growing and you're feeling pain points in your current software, switching to Sage is one of the best things you're going to do for yourself and for your accounting team."
