What does Rosemark cost?

Rosemark publishes $49 per month for its Starter plan, month-to-month with no long-term contract, or $240 for six months. Standard and Enterprise pricing is not published and requires contacting them, and a $250 non-refundable setup and onboarding fee applies to every new Standard and Enterprise account. Figures from their own pricing and Starter pages, verified 2026-08-10.

Is Shoshana scheduling the same thing as Rosemark?

Yes. Shoshana Technologies is the company, founded in 1988; Rosemark, sometimes called The Rosemark System, is its home care management product. People search for both names, and they resolve to the same software.

Does MedAligna do electronic visit verification?

No. We record geofenced clock-ins, which captures where a punch happened, and that is deliberately not the same thing as EVV — our own settings screen says so. If you bill Medicaid for home visits and need verification your payer accepts, that is a real reason to stay on a system built for it.

Can MedAligna replace Rosemark for a home care agency?

For scheduling visits, checking travel time between them and enforcing who is allowed to attend, yes. For EVV, Medicaid billing and client invoicing, no — we do not do those and are not building them. A pure home care agency that bills Medicaid should stay; an organisation staffing more than one setting is the one this page is written for.

What is a good Rosemark alternative if I run home care and a facility?

One roster that holds both. MedAligna schedules facility shifts, on-call rotations and home visits from the same staff list, blocks assignments to expired credentials and OIG-excluded people, holds ratios against census, and produces the quarterly CMS PBJ file — at $99–$249 per location per month with a 14-day trial and no setup fee.

Comparison · verified August 2026

Rosemark alternatives, for agencies that outgrew one setting

Rosemark, from Shoshana Technologies, is home care agency management software: caregiver scheduling, electronic visit verification, Medicaid billing, invoicing and client records in one system. MedAligna is clinical staff scheduling across care settings, enforcing credential, ratio and federal-reporting rules, and it is not a billing or EVV system.

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At a glance

Rosemark publishes $49 per month for its Starter plan, month-to-month with no long-term contract, or $240 for six months (their Starter page, verified 2026-08-10).
Standard and Enterprise prices are not published — those require a call, and a $250 non-refundable account setup and onboarding fee applies to every new Standard and Enterprise account (their pricing page, 2026-08-10).
Rosemark does electronic visit verification and Medicaid billing. MedAligna does neither, and if you bill Medicaid for home visits that is the whole decision.
MedAligna is $99–$249 per location per month, published, with a 14-day trial and no setup fee — and it schedules facility shifts, on-call and home visits in one roster rather than home care alone.
Pick on whether your problem is billing an agency's visits or staffing care that crosses more than one setting.

What Rosemark does well

It has been built for one industry since 1988, and that shows in how completely it covers a home care agency's day. Scheduling, the caregiver app, client records, invoicing, payroll export and accounting integration are one system rather than an integration project, which for a small agency office is the difference between a job and a second job.

Electronic visit verification is native. For an agency billing Medicaid that is not a feature, it is the licence to operate — visits have to be verified in a way the payer accepts, and a product that has done it for years across many states has absorbed a large amount of state-by-state detail that is genuinely hard to reproduce.

The pricing entry point is low and honest about being month-to-month. A small agency can start at $49 without a contract, which is a fair way to sell to a business that may be four people and a phone.

Where an agency system stops short of a clinical roster

None of the following is a criticism of Rosemark for a single-setting home care agency, which is what it is built for. They are the places its model runs out when the same organisation also staffs a building, or employs licensed clinicians whose credentials decide what they may do.

One setting, not several

A home care system models visits to clients. An organisation that also runs a facility — a residential unit beside the home care arm, or a clinic — needs shifts on a grid, on-call rotations and visits in the same roster, staffed from the same people. Running two systems means nobody can see whether the nurse on Tuesday's visits is also down for Tuesday night.

Credential expiry does not block the assignment

Storing a licence and its expiry date is a record. The clinical requirement is that the expiry refuses the work — in MedAligna the check runs in the database under a row lock at the moment somebody is assigned or claims a shift, so a lapsed licence cannot be scheduled around even by two people acting in the same second.

No OIG exclusion screening

Employing a federally excluded person while billing Medicare or Medicaid creates civil monetary penalties per item or service. The list is republished monthly, so a screening done once goes stale; making it structural rather than remembered is a different job from billing a visit correctly.

No census, ratio or HPRD

Home care coverage means the visit has a caregiver. Facility coverage means the unit is staffed against the residents present, weighted for acuity, and reported as hours per resident day. An agency system has no reason to model the second.

No CMS Payroll-Based Journal

The quarterly federal staffing file for skilled nursing, with CMS job codes, built from captured hours. An organisation with a nursing facility files it; a pure home care agency does not, which is exactly why Rosemark has no reason to produce it.

Which one is right for you

These two products barely overlap, which makes the choice unusually clean: it is decided by whether you bill visits or staff clinicians, and an agency that does only the first should not be reading a comparison at all.

Stay with Rosemark if…

You are a home care agency and Medicaid billing is central to your revenue.
You need electronic visit verification your payer will accept.
You want client records, invoicing and payroll in the same system as the schedule.
You are a small agency and $49 a month month-to-month is the right commitment.
Your caregivers are unlicensed or their credentials never gate the work.

Look at MedAligna if…

Your care crosses settings — home visits plus a facility, a clinic, or on-call.
Your staff hold licences and competencies that must gate what they can be assigned.
You file CMS PBJ, or hold ratios against a census with acuity.
You want exclusion screening to be structural rather than a monthly reminder.
You want on-call rotations with an escalation chain in the same roster as everything else.

MedAligna vs Rosemark, row by row

Binary, verifiable facts only. No adjectives; an opinion is not a comparison.

Capability	MedAligna	Rosemark
Published price	$99–$249 / location / mo	$49 / mo Starter; Standard and Enterprise on request
Setup or onboarding fee	None	$250 on Standard and Enterprise
Free trial	14 days, no card	Demo on request
Caregiver scheduling	Yes	Yes
Home visits with travel time between calls	Yes	Yes
Mobile app for staff	Yes	Yes
Geofenced clock-in	Yes	Yes
Electronic visit verification	No	Yes
Medicaid billing and invoicing	No	Yes
Client records and care plans	Client records	Yes
Facility shift grid	Yes	No
On-call scheduling and escalation	Yes	No
Credential expiry blocks the assignment	Yes	No
OIG exclusion screening	Yes	No
Nurse-to-patient ratios against census	Yes	No
Acuity weighting and HPRD	Yes	No
CMS Payroll-Based Journal file	Yes	No

Rosemark is a trademark of its owner. MedAligna is not affiliated with, endorsed by, or sponsored by Rosemark. Comparison compiled from publicly available documentation and pricing pages, verified July 2026. If anything here is out of date or wrong, tell us and we will correct it.

The honest bit

When you should stay on Rosemark

More often than on any other page here. Rosemark does two things we have deliberately not built, and for a large share of home care agencies those two things are the reason the software exists at all. Replacing it with a clinical scheduler would cost you your billing.

You bill Medicaid, and EVV is how you get paid. We do not do EVV — our geofenced punch records where a clock-in happened and is not visit verification.
Invoicing, client records and payroll live in Rosemark and moving them is a finance project, not a scheduling one.
You are home care only, with no facility, no on-call and no ratios to hold.
Your caregivers' credentials do not gate assignments in a way a record cannot handle.
You are on the $49 Starter plan and it is doing the job — that is a good outcome, not a compromise.

We would rather you stayed and told someone we were straight with you than switched and regretted it. This category is small, and reputations travel.

Moving across, or running both

01
Decide first whether this is a move at all
If you bill Medicaid through Rosemark, it probably is not. Plenty of organisations run an agency system for the home care arm and a clinical roster for the facility, and that is a legitimate answer rather than a failure to consolidate.
02
Export the caregiver roster and import it
Same columns going out as coming in, previewed before anything is written. Add contracted hours while you are in the spreadsheet.
03
Set each location's timezone before any shift exists
It decides which day a shift falls on. A visit that starts at 00:30 is filed under the day it starts locally, and changing the timezone afterwards means moving what you already built.
04
Put credentials in and make them blocking
Licences into each person's wallet, competencies imported from your LMS. Until a requirement is marked blocking it only warns — which is the switch that turns a record into enforcement.
05
Keep billing where it is
We capture hours and export them; we do not invoice clients, bill payers or move money. We are not going to pretend a migration includes the part of your business that gets you paid.

Rosemark questions, answered

What does Rosemark cost?: Rosemark publishes $49 per month for its Starter plan, month-to-month with no long-term contract, or $240 for six months. Standard and Enterprise pricing is not published and requires contacting them, and a $250 non-refundable setup and onboarding fee applies to every new Standard and Enterprise account. Figures from their own pricing and Starter pages, verified 2026-08-10.
Is Shoshana scheduling the same thing as Rosemark?: Yes. Shoshana Technologies is the company, founded in 1988; Rosemark, sometimes called The Rosemark System, is its home care management product. People search for both names, and they resolve to the same software.
Does MedAligna do electronic visit verification?: No. We record geofenced clock-ins, which captures where a punch happened, and that is deliberately not the same thing as EVV — our own settings screen says so. If you bill Medicaid for home visits and need verification your payer accepts, that is a real reason to stay on a system built for it.
Can MedAligna replace Rosemark for a home care agency?: For scheduling visits, checking travel time between them and enforcing who is allowed to attend, yes. For EVV, Medicaid billing and client invoicing, no — we do not do those and are not building them. A pure home care agency that bills Medicaid should stay; an organisation staffing more than one setting is the one this page is written for.
What is a good Rosemark alternative if I run home care and a facility?: One roster that holds both. MedAligna schedules facility shifts, on-call rotations and home visits from the same staff list, blocks assignments to expired credentials and OIG-excluded people, holds ratios against census, and produces the quarterly CMS PBJ file — at $99–$249 per location per month with a 14-day trial and no setup fee.