We were looking for a bookkeeper and found so much more. Cianna worked in a CPA firm before opening her business and because of this she had a plethora of knowledge and background. With this foundation, she has helped our practice grow by making projections and financial forecasts. Not only is she a wealth of knowledge, but she is constantly networking and has made introductions to other resources, such as our billing company, insurance company, payroll company and medical lawyer.  

We started working together when our practice was in its infancy, and she has been with us through our business’s growing pains. Her team’s drive, dedication and moral compass is unparalleled.  They do not shy away from a challenge, and they make it their mission to make small businesses flourish and dreams come to fruition. We started as a small practice with one provider and 4 staff and we are looking to add more providers with the hope of selling the practice one day.  Cianna and her team have been an integral part of our growth.  Their expertise and services beyond bookkeeping have served as a beacon of light and given us peace of mind. We are extremely blessed to have the privilege of working with Keane.  Simply the best!



I knew it was time to sell my business but worried I would not maximize the 30 years of hard work I had invested.  Thanks to the proactive approach of Cianna & her team, we developed a plan to optimize the financials over a specified period to increase shareholder value.  By the time the sales process began, we had a history of sound financial statements showing robust growth.  As the sale progressed, the buyers requested many additional documents which Cianna produced in a professional & timely manner.  I would highly recommend Keane to companies thinking of selling or to those which require accounting services.



Cianna and her staff at Keane Management have been refreshing to work with and understand the value of a relational client experience over a transactional experience.  I appreciate her attention to detail and her authentic way of communicating and following up.  She is also focused on ensuring her clients are poised for success well into the future and is helping us build a foundation for long term sustainability.  



I met Cianna when my company was just starting to grow to the point where I could no longer run everything at once. Not only did she and her associates come in and get my books and finances into shape, but she quickly recognized other inefficiencies in areas of my work and billings that I was able to correct, and I was able to offload so much more to her team to manage for me than I had thought possible.

I often joke that I found Cianna at the perfect time because now she might not work with such a small business like my own, but I’m so glad to have “locked” her in. As I look towards steps of growing and restructuring my company, Cianna is usually the first person that I call for advice. And on a day-to-day basis, I can pick up the phone and call Nicole to get a quick answer on any accounting issues. From dealing with AR, 401K, payroll, and the countless other forms that come in throughout the year, I know that I can just pass them along to Nicole and they’ll get taken care of.

Working with Cianna and Keane feels so much more personal than other larger account management organizations. There are so many times when I refer to Cianna as my business coach, as she has helped me work through areas of staffing, client acquisition, and so much more. It is clear that her interest in her own clients is to see them operate smoothly and grow.



I have had the pleasure of knowing Cianna for many years, she has consistently demonstrated her kind-hearted and compassionate nature. When I found myself in need of financial assistance, I reached out to Cianna for guidance, and her response was nothing short of remarkable. She swiftly devised a clear and effective financial plan, providing me with the strong financial structure I needed.

Thanks to Cianna’s expertise and support, my company was successfully sold. The new owners were quick to praise our well-structured accounting system, stating, “We have never acquired a daycare business with such meticulously organized finances.” I wholeheartedly recommend business owners to consider integrating Cianna’s services into their operations. Her services not only provide invaluable education to you and your management team but also establish a robust framework for a successful business.

For those contemplating the sale of their business, my advice is simple: establish a solid partnership with Cianna. Share your financial concerns and weaknesses, as well as your strengths, with her. Cianna has the unique ability to create a tailored plan that aligns perfectly with your goals. Stay committed to the plan she formulates and maintain open and consistent communication with her as your company navigates the substantial changes ahead. She has always proven to be a reliable source of wisdom for any financial question or concern. Her encouragement and guidance were a constant source of motivation for me.

In sum, Cianna is the kind of asset that any business owner would dream of having. Her expertise, support, and unwavering dedication make her an invaluable addition to any team.



At the end of 2019, I was faced with the daunting challenge of venturing out on my own as a solo practitioner after being in a group practice for the preceding 12 years.  I was in essence starting over. I began by reaching out to a close friend who has decades of medical practice management experience and is very involved with MGMA. She had no hesitation in recommending Keane.  From our first meeting, I felt very comfortable with Cianna.  She made the overwhelming task of starting a practice far more manageable and compartmentalized for me.  She was able to outline every step from accounting to staffing, medical management, and human resources. Even when posed with the challenges of COVID, Cianna was always present and available with plans for maintaining the finances of the practice and managing human resource issues. Cianna is so extremely integral to the functioning of my practice. She has far exceeded her original task of “bookkeeping” and has become more of an off-site invaluable practice manager.  There is no question I sleep better at night knowing Cianna is on my team. 



I started using Keane based on the counsel from my business coach as we were scaling quickly and needed a higher level of financial accounting and business forecasting than we were able to do in-house. Cianna was highly recommended by our tax accounting team and we decided to wait a few months for her to have an opening instead of taking a chance elsewhere. 

She is like a small business CFO and was able to help us set budgets, forecasts and align our business to best industry benchmarks. Within the year, we had an unsolicited offer to purchase majority stock in the company and it was a great offer and path. Cianna was a rockstar at getting all the financials in order for the purchase and both the CEO and CFO of the large acquiring company were quite impressed, commenting that “usually the books of independent healthcare practices aren’t so well organized and clean- we usually get a mess and shoeboxes with receipts”. 

Cianna worked very well with us, and with the acquisition team. She was able to find some calculation errors that were overlooked during due diligence, and she helped make the financial transition smooth.  Because my financials and forecasts were so well organized, along with Cianna’s thoroughness and ability to present the information so completely, I’m certain this assisted in our ability to maximize the value of the sale.



For many years I had a long-standing accountant who diligently filed my personal and corporate taxes, but I longed for a dynamic consultant who could help me with the big picture of finance, cash flow and regulation. Since then, I have been blessed to have Cianna as part of my team. First off, she spends a good amount of time with each of her clients and becomes very familiar with their needs and growth potential. If there are problems or issues with business function, she will quickly seek solutions and in this regard, I have always heeded her advice. 

Infrastructure-wise, she knows the terrain of daily business strategy and there is really no question she cannot answer. I have come to understand that she is highly respected in Boston among major accounting firms.  Cianna is worth her weight in gold to any small or medium size business where cash management is a strategic factor in success.