When the need is present, we all want to find the most effective way to provide care solutions for a loved one. Whether the need is age, accident or illness related providing the best care giving possible is foremost in our minds. Should you be new to the world of care giving know that there are numerous options to provide needed care. In many states there are wage and employment provisions designed for situations where the caregiver lives in the home or when a caregiver is a relative. Residing and receiving care in the home is preferred by most people particularly seniors. There are agencies which will provide care giving services in the home. These agencies handle the legal aspects of being an employer. A few agencies, like Platinum Eldercare, can employ individuals designated by the family, whether a relative or a known good friend.

You need not gamble everything when you hire a caregiver to work in the home. Investigate how to protect your interests. In this article together we will look at the contrasting advantages of direct employment of caregivers versus using an agency and how you can protect your money, your property and your estate.

Let’s start with the scenario where Joann Smith has decided to hire (directly employ) a caregiver to assist with the daily living activities of her aging and now disabled father, Harold. There are three significant areas to be addressed when hiring a caregiver, (1) the quality and dependability of the caregiver, (2) the legal and practical risks, and (3) the related costs and expenses. Most of us focus on the costs, how much per day to pay the caregiver, but be sure to weigh the expense in dollars and time of managing the caregiver and the associated risks.

(1) Thinking of the caregiver, we all know the axiom, “You get what you pay for.” True here too, generally the lowest paid caregivers are the least trained and skilled. Depending on your care needs and the quality of your care management skills, you needn’t spend too much on a caregiver. That being said, elder abuse and financial abuse are like the skull and cross bones in the medicine cabinet. Every individual (and agency) must be vigilant and screen for the prevention of abuse. Joann will need to carefully screen her potential caregiver (her new employee), checking references and background looking for indicators of potential problems – before the caregiver is enters home! Joann also needs to access the care giving abilities of the new caregiver taking into consideration personal disposition, experience, duties, physical stature and ability to lift and transfer. It is also becoming prevalent in more states that caregivers have a minimum training and in some minimum certifications.

Now think about what will need to be done to provide oversight and management of the new caregiver. How much does Joann want to be involved in the daily management and care giving of her father? Joann will need to plan for employee absences and the rest of the household needs for her father.

The quality and dependability of the caregiver is paramount. Yes, Joann has the ability and can dedicate the time to providing and managing a caregiver. Does she want to?

Now let’s look at what an agency might do for Joann. Recognize that instead of selecting and hiring a caregiver the task is now to select and engage an agency to provide all of the employer services for Joann. Selecting an agency is frequently easier than an employee. Agencies have public records, client referrals, and verifiable relationships with lawyers, trustees, and fiduciaries. It is a straightforward process to select solid agencies for the purpose of care giving. Agencies are knowledgeable of care giving practices and the regulations regarding the same. Most agencies screen and train to reduce the potential of abuse. Agencies provide oversight and management, validate experience and training, and assume the duty of providing consistent and constant care.

(2) Before talking more about care giving agencies, let’s look the legal and practical risks of Joann being an employer.

To protect the corpus of family estate (possibly a trust) and the house Harold lives in from possible lawsuits from her employees, Joann will need purchase Workers’ Compensation coverage for her employee. Joann should also look to adding an Umbrella Liability Insurance Policy from the insurance company providing her homeowner’s policy. She should consider buying as much liability insurance as the carrier could possibly sell her, at least $5 million dollars of coverage. Liability insurance is typically not expensive.

The legal liability exposure is tremendous when hiring employees directly or through a trust. Insurance is the most cost effective way to mitigate this liability exposure.

Should a trust be involved, as a matter of policy many commercial institutions (Banks), acting as managers or trustees for the trust, will not allow their trust clients to direct hire due to the fiduciary liability exposure it places on the institution. There has been some very large litigation for this very reason.

The temptation is there, to go “BARE” with respect to workers compensation insurance (the insurance term used when someone is not covered by insurance and open to the liability). States don’t like that and if they determine there are employees at work without WC coverage they will come down very hard with HUGE fines and then force the purchase of the coverage and until done will not allow employees to work. Thinking about hiring caregivers as independent contractors? The IRS regulations are very specific as to who can qualify as an independent contractor. Most individual caregivers will not qualify as independent caregivers.

To employ caregivers as an employer Joann must contact the IRS and the State to get Employer ID numbers and begin the payroll withholding process including unemployment and disability assessments. The exposure here is if not done the penalties are stiff and the resolution process time consuming.

In most locales employees are limited in the number of hours and continuous days they may work (be expected to provide care / restricted from coming and going freely / provide oversight during sleeping hours). Minimum wage, days off, and overtime regulations must be observed

As a note, Joann will need to satisfy The Department of Homeland Security by validating the employee’s eligibility to work in the United States through the Form I-9 process.

In many situations, caregivers are asked to transport or shop for the person receiving care. Because the caregiver is doing this as part of being employed Joann needs to mitigate the potential of liability to her, the employer and the estate. Adding named employees who will be driving the family automobile on the family auto insurance policy will provide protection at the lowest possible cost. Consider increasing the policy’s liability insurance amounts to the maximum. Of course, the background screen verified the employees’ driving record and license status, right? Using the family vehicle allows the family to insure there is a safe automobile ready for use. Should it be decided the employee would use their personal automobile, Joann should consider obtaining the protection of non-owned automobile insurance for her employees.

Illness is the nemesis of the ill and aging. Tuberculosis is very contagious. Anyone working with the person you care so much for should be screened for TB. Observing practical steps to limit infection and illness only makes sense. Hand washing is the norm, limiting contact of an ailing employee with the care recipient.

Wow! Seems like a lot but the effort is a design to being compliant with Federal and State Law as well as provide some level of protection and mitigate risk for the family, the individuals, the trust, and the estate assets.

Now many of these steps mentioned to limit risk and liability are provided by care giving agencies but not everything everywhere and the levels of protections vary. This is a real point of comparison when Joann is looking for an agency to provide services. What are easy ways to get a feeling for what protections to expect? Agencies (and individuals) join professional associations and obtain certifications which promote and require levels of protections for the care recipient and their estate. Though not a requirement for business, it is a visible measure. When investigating agencies, obtain form the agencies policy holder’s proof of insurance and the coverage levels. It takes a bit of time but worth the investigation.

(3) Let’s talk about the costs of care. When Harold was self sufficient living at home there was the typical expense: mortgage or rent, utilities, groceries, property upkeep, etc. Now that Harold needs assistance there are additional expenses. By far the largest expense will be the cost of care giving labor. The cost of labor is directly related to the wage paid plus the cost of employee related expenses (overhead), e.g., taxes, social security, insurance etc. Hourly wage rates are reflective of the current local market and the level of care giving skills needed.

Yes, Joann can reduce the administrative total cost of a direct hire employee by managing and filing the appropriate reports and payments herself. The questions to answer are, ”Is the labor worth the return on the effort?” and “Do the costs of private insurances and liabilities protection offset any cost saving?”

Should Joann decide in favor of live-in care then the costs of room and board for the additional person needs to be considered. Joann will also need to investigate whether the live-in facilities will be deemed as wages by the government and therefore subject to withholding and taxation.

Care agencies can be a good way to manage the entire employee and a substantial portion of the care giving needs for a loved one. There are frequently addition care needs like doctors ad therapists. Depending on the agency these too may be addressed.

At some point the cost of living at home with care giving assistance will exceed the cost of living in a board and care facility, a few thousand dollars a month. It can be a difficult decision to leave the home and careful consideration of emotional well being as well as finances needs to be considered. It is relatively easy to see the financial case. A board and care makes use of one or two care givers to provide assistance to up to six people in need (1:6 ratio) whereas in the home there is typically a 1:1 care giver to recipient ration.

The monthly payments or cash flow requires special attention whether care is in the home or in a facility. It is not uncommon for the monthly costs to spiral as the needs of a loved one are better determined and addressed. Even without accelerating costs the base cost of care giving can be a challenge for those not prepared. As with most things advance preparation is the best defense. Long-term disability/accident insurance and long-term care policy can go a long way towards managing the needed monthly cash flow. Just like planning for retirement, planning or extended care, a plan for cash management requires the estimation of the rate of expense, knowledge of what assets are available and what it will take, if necessary, to convert assets to cash.

Depending on the financial situation, employer history, affiliations made over the years, and locality where one resides; there are social and benefit programs designed to provide home health care and care giving assistance. Joann may want to look to senior centers and local social welfare agencies as good resources to finding opportunities. Veterans and their wives may find benefits through the Veterans Administration. And, do not forget the local libraries for pamphlets and postings.

Conclusion, care giving costs. While it may be suitable for Joann (you?) to privately employ and manage caregivers, it is a complex world of regulations, risk management, and care management. It may be appropriate to engage an agency to reduce and mitigate the potential risks and provide the oversight and management of employees as caregivers. The financial aspects bear a great weight on the scope and breadth of care giving possibilities. A firm understanding of the cash flow requirements and how it will be meet is certainly a requirement.

We have discussed three significant areas to be addressed when hiring a caregiver, the quality and dependability of the caregiver, the legal and practical risks, and the related costs and expenses. Where to go next? If this is your entry into care giving seek out a reliable experienced professional to provide their wisdom and to assist with making the right connections to agencies, programs and other resources. Due diligence is a must when caring for a loved one.

Platinum Eldercare, a California based corporation serving all 50 states, provides discreet premium In-Home private care and products for individuals, their parents and dependents. And specializes in professional In-Home Care and Care Management services for the trust industry: personal trusts, special needs trusts or conservatorships. The client is relieved of the burden of managing services, given shelter from unlimited liability, and given back control without worrying about all the details. Witness our extreme success working with banks and trust companies across the nation since 1991. www.platinumeldercare.com

We all feel the desire a bit of extra help… a helping hand… now and then. Perhaps someone to work in the yard, wash windows, walk the dog, a bit of deep cleaning. Think of the value of this to someone not as apt as you or someone tasked with 24 hour caring for his or her spouse.

In home care is not always about personal care –dressing, feeding- though for a growing number it is exactly that need. Perhaps all that is need is a few hours of cleaning and pick up, sitting with Dad for a bit of free time, over night watch so I can sleep, a trip to the doctors.

All of these things and more is what home care is about.

Here at Platinum Eldercare we have provide and manage gardeners, repairmen, respite givers, full time personal assistants, personal caregivers and transportation providers.

Do you need a helping hand?

Quality in home care begins with the staff caring for your family member. Its not the agency that matters, but instead the reputation the in home care agency has earned for the quality of the care giving staff.

I cant tell you how many times I’m spoken with families telling me their horror stories about the care staff that cared for a family member and what a fiasco it was.

So when youre picking an in home care company take the following unusual step.

Find out how much the care agency pays the employees (hourly rate), that will be caring for your family member. Compare that to the wage rate charged you for there services. If they are paying their staff minimum wage that should set off a red flag. Especially if you are being charged 2 to 3 times the wage rate paid the staff.

Take care, till next time, John

Click play and enjoy!

(Extending Care and Comfort beyond Your Means)

People work diligently and purposefully to secure their future. So many people have visions of peace and prosperity but in reality have their dreams it interrupted by the nightmare of outliving their means to provide for themselves. Who do they turn to — family, friends, and YOU their professional advisor?
For those clients who are outliving their money or soon will outlive their money……….what are you, their professional advisor, going to advise them.
Before answering, let’s look at what we know…
First, Realize that more and more of us should consider the fact that over 10% of all our clients will live past there expected longevity. Since the 19th century, common prolonged existence or longevity is increasing. No longer is, the average male expected to live up until the mid forties, and the average female expected to live until the late forties. Many of our older generation of people born in the 1900s are surviving today. Now, experts find people were living beyond the 70 and 80s. We can now anticipate that most people can live past 90 providing they have quality medical care and their hereditary makeup is healthy.
Second, In keeping with that we can expect that at least 10 percent of our clients needing assistance with their health conditions will run out of money. Financial planning and actuary tables have been to conservative and we could argue the investment too speculative to provide sufficient funds for even longer extended are needs.
Third, expect that in the future government payments i.e. Social security will have later and later qualifying age limits for eligibility, smaller funding levels as a percentage of living wage and thus reducing the amount of available cash flow to the client.
The professional advisor should provide suggestions to manage and budget cash flow, to provide well being care in the most cost effective manner without compromising care, to select appropriate service to meet the immediate need, to preserve the dignity and satisfaction of life.
We take note that some of the services provided by home health agencies may , just may be unnecessary. For instance, “A client wants to remain at home and doesn’t need one on one care giving during the daytime hours.”
Adult day care facilities are available that would be happy to provide supervision at their facility where the client would be in a group setting during the daytime hours along with other clients and can make new friends.
The cost is minimal and a facility can be found close by but the savings are dramatic as compared to a caregiver’s cost during those daytime hours when she/he really is needed as much for activities of daily living but more for companionship.
Some agencies require that their care managers make frequent visits to the client site.
Often a significant expense in addition to the normal costs of hourly care, periodic, necessary, cost containing schedules can be used to achieve the desired results of professional care management.
The use of friends, acquaintances and relatives to provide or supplement care giving can enhance the quality of live providing more than a warm body. With appropriate planning compensation can be provided that is budget minded and satisfies the wage and labor laws.
So, again let’s consider, “What are you, their professional advisor, going to advise the client?” “Better what is your plan today and going forward?” Find your resource make alliances with skilled, competent consultants and provider. Be prepared. Evaluate your client’s situation regularly and listen and watch for signs of pending needs and demands on the financial resource available t your client. For some, we may not be able to avoid a living nightmare but for all we can raise the curtain and let in light. And for many we can provide wisdom, compassion and effective planning to preserve and extend quality of life and care received.

Good Day!

Examine our care giving Platinum Eldercare the ONLY NATIONAL COMPANY WITH “UNBELIEVABLE PRICING” guaranteed not to be undercut with the ability to ensure that the client does not outlive their money – if and only if they use US!

In-Home/In-Facility Care Giving – Platinum Eldercare™ provides professional, private duty care and companionship for your elderly or disabled loved one, whether in the home or at a residential facility, and either on a short or long-term basis. Platinum Eldercare™ also offers additional care management and concierge services. We accept insurance, workers compensation, and payment from trusts and conservatorships as well as private payment arrangements.

Cost Saving Products – Platinum Eldercare™ offers products that can reduce the costs of caring for the elderly and disabled, while at the same time, allowing them to live independently and securely at home, rather than in a care facility.

Free Referrals – Platinum Certified companies are the best recommendations for families in need of quality care. Platinum Eldercare™ screens companies in the home health care and assisted living industries, carefully reviewing their qualifications, insurance coverage, licenses, accreditations, and the services they offer. If they meet our exacting standards, we award them as Platinum Certified care giving companies.