San Diego Home Care

Lauren Reynolds, North County Home Care, San Diego Caregivers, San Diego Home Care, Uncategorized / 11.07.2017

California legislators always act as though they care about protecting the personal information of Californians, unless of course, there's a political or financial reason to go against their core value - which is exactly what's happening to cause a lawmaker and union to propose a new law which violates caregiver privacy. An Article written by Dan Morain of the Sacramento Bee sums it up in the headline, "In the name of helping workers, this bill would strip them of basic privacy." Put basically, Assemblyman Ash Kalra, D-San Jose, has an Assembly Bill 1513 that would "require that employees of private firms, who care for elderly and infirm people in their homes, must divulge their cellphone numbers, mailing addresses and email addresses to unions that seek to organize them." The Assemblyman claims the whole purpose is for the unions to be able to provide more training to the caregivers, but that's a patronizing falsehood. Our caregivers have wonderful and adequate training, at least 12 hours a year ongoing. I can't name a single caregiver who wants more training or less privacy. It's a veiled attempt at using power to support a special interest, the SEIU Union, which gives millions of dollars to lawmakers every year, and helped finance the campaign of Assemblyman Kalra. Home Care agencies across the state are speaking out for their employees, posting comments on the newspaper article and asking lawmakers to do what's right, now what they are paid by special interest groups to do. Our employees have no interest in having their personal information handed out to the highest bidder. The SEIU is the same union which has made 24 Hour Care too expensive for most elderly people, causing caregivers to lose their 24 hour shifts because lawmakers are too afraid to add a "sleep time" deduction that would allow the caregiver to not be paid while they slept overnight. This is what most other states allow, and the Federal Wage Orders allow for sleep time deductions, as well. However, California lawmakers refuse to correct this flaw in our state wage orders, out of fear of upsetting the union. As the minimum wage goes up, caregivers will lose these coveted 24 hour shifts and see their pay drop. That's not union protection. This is what I wrote in response to the Sacramento Bee article. I'm urging state Lawmakers to stop the assault on caregiver privacy. I am not comfortable with personal employee information being shared unless it's for public safety reasons under subpoena from appropriate authorities. That is real protection. To claim that this bill is about training is creating an obviously false sales-pitch. No one really buys that. It's a self serving bill with no true public interest and to insinuate otherwise is patronizing. More elected officials need to take the long view, what's best for California and our workers. No hard working caregiver wants her cell phone,...

Aging Parents, Alzheimer's/Dementia, Lauren Reynolds, San Diego Caregivers, San Diego Home Care / 10.07.2017

Denial is a powerful self-preservation tool - it helps to keep us hopeful and moving forward in bad situations. But denial of a parent's or client's lack of capacity with respect to credit cards and money is the perfect backdrop for financial fraud. Lack of financial capacity requires some sort of action to keep people safe. As providers of in home care, we see it all the time, a lady with "senior moments" in her 80's who is not "diagnosed" with dementia - so her family looks the other way while she pays bills late, uses her credit card to purchase home shopping network items daily or gives large financial gifts to relatives. I've had a client, a wonderful retired Judge who was 93, insist he hadn't paid SDG&E when in fact; he'd paid the same power bill numerous times. His daughter didn't want to interfere with his "independence". We recommend re-loadable debit cards to all of our home care clients, the kind that give daily or weekly spending alerts that can be monitored by a trusted designee. Our agency offers a card to our clients, and for non-clients, I recommend the Truelink Card. I'm always surprised that those who need it most turn it down because "Dad said no." In one case, Dad was a retired physician not diagnosed with Alzheimer's because his fellow physicians simply didn't want to label him with the disease. He carried multiple credit cards, one with a $60,000 limit. He gave gifts as well. It's very hard for a family member, fiduciary or power of attorney to insist that an elderly person is not making good enough decisions to stay in control of their finances. But taking control away from someone who can't monitor money, bills, bank and credit accounts is a crucial step towards protecting those we love and those we are caring for. If taking over entirely is out of the question – consider negotiating with the elderly person to have a second set of eyes on accounts – someone responsible to assist with review of charge card bills, etc. Have a no gift rule unless certain conditions met, including having all gifts in writing signed by the giver, receiver and a witness or responsible party. We have a policy that any gift over $25 must be approved in advance by the agency – to protect our clients, our caregivers and our reputation. If the elderly person uses credit cards, limit the number of credit cards in the house, there is typically no reason that someone elderly needs three or four credit cards. Fewer cards means less to review. Have petty cash in the house, along with a log to track cash expenses. Make sure receipts are kept and reviewed by someone regularly. Finally, never have a caregiver, housekeeper or neighbor help with paying the bills or help with banking. Hire a bookkeeper or...

Aging Parents, Alzheimer's/Dementia, San Diego Home Care / 10.07.2017

During June and July, as in home caregivers logged onto Facebook or Instagram - attorneys used a sponsored ad like this one pictured to lure the potential claimants into exploring their legal options against their employers. The ads ask questions of in home caregivers like, "Are you a home health aide? Are you being paid correctly?" With a simple click of the "Learn More" button, in home caregivers are connecting with attorneys who are aggressively going after companies and household employers who are violating California's often tricky wage and hour laws. It's a reminder to always make sure in home caregivers are paid correctly for all hours worked. This is necessary whether you have one employee, or 100 employees, whether you are working with a full service agency such as ours, At Home Nursing Care, or if you are hiring someone directly. Caregivers are not independent contractors in California, meaning all labor rules apply: sick time, pay for sleep time overnight, overtime after 9 hours in a day, 40 hours in a week, proper documentation on pay stubs, and so on. Make sure you are working with an agency that follows the rules to avoid co-employment liability. Not knowing the rules won't save you or your clients in court. And with social media, bad news travels fast. Give us a call if you are concerned about a private hire or "registry" situation. Our agency has signed meal waiver forms if we need in home caregivers to have paid on-duty meals. We make sure our caregivers don't engage in work that eliminates the personal care attendant exemptions that are very important in California’s Wage Order 15. The exemptions allow caregivers to not get regular meals and breaks if certain conditions are met. Some examples of easy ways to run afoul of Wage Order 15 is to have the caregiver clean an entire house or cook meals for the client and guests. Some registries and private employers still believe it’s okay to have a caregiver stay in a house 24 hours a day, and not pay overtime, or to deduct sleep time from pay. All of those practices will give an attorney a reason to write a demand letter or flle a claim. People who are in positions of influence over the caregiver, such as fiduciaries or accountants who cut checks or set schedules – may face a co=employment liability for any wage order violations, another reason to vet the service providers you engage. At Home Nursing Care is a licensed and accredited full –service in home care company which employs all of our in home caregivers. Our founder, Lauren Reynolds, sits on the board for the California Association for Health Services at home and she stays aware of the latest legal developments and compliance issues. We treat our employees as well as we possibly can, not just that's the law, but because it's the...

Aging Parents, Alzheimer's/Dementia, Lauren Reynolds, San Diego Caregivers, San Diego Home Care / 03.06.2017

Making an educated choice about hiring in home care requires knowing the rules, the risks and how to mitigate them. This applies to families and professionals, such as fiduciaries - advisers hired by clients or appointed by the courts to oversee a person's financial, health and living affairs. Fiduciaries have an added potential liability in that they may be considered "co-employers" if they exercise any supervision or direct any of the care being provided in the home. This was the theme of a presentation given by At Home Nursing Care founder Lauren Reynolds and attorney Elizabeth Murphy at the 22nd Annual PFAC (Professional Fiduciary Assocation of California) Conference in San Francisco. It's a conference dedicated to giving fiduciaries the tools to protect seniors and the vulnerable. [caption id="attachment_2568" align="alignleft" width="224"] Attorney Elizbeth Murphy with AHNC Founder Lauren Reynolds[/caption] The Need: The number of people using nursing facilities, alternative residential care places or in home care services is expected to jump from 15 million in 2000 to 27 million in 2050. Among people who reach age 65, more than two-thirds will need long term care in their life time, and an American turning 65 years old today will incur $138,000 in future long term care costs such as in home care. The most common diagnosis for residents of Nursing homes is Alzheimer's/Dementia. The diagnosis most commonly seen for in home care is diabetes. The Rules: Since January 1, 2016, home care providers have required a license under the Home Care Services Consumer Protection Act. There are two licenses that apply - a non-medical home care license issued by the California Department of Social Services (CDSS), or a home health agency license issued by the California Department of Public Health. Our agency, At Home Nursing Care, has both licenses. Under the CDSS license, home care aides must be registered, which includes a background check that goes backwards indefinitely, in sharp contrast to the more established practice in California of going back 7 years for a criminal clearance. The requirements also include a TB test and initial and annual training. The unintended consequence of this requirement has been a shortage of qualified caregivers to provide in home care. Many aides cannot pass the background test due to mistakes they made 20 to 30 years ago, such as a DUI or shoplifting as a teenager. So far 7,700 in home care aides have requested "exemptions" from the CDSS rules. Home Care Providers have been requesting that the CDSS change their rules because so many aides have now gone underground, working privately under the table with little protections for seniors. Many previous home care companies are now calling themselves "employment agencies" or "referral services" to get out of having a license at all. Also - the CDSS license does not require that home care providers conduct any supervision of the aides that they place with clients. In contrast, under the CDPH...

Aging Parents, Alzheimer's/Dementia, At Home Care Solution, Caring for Elders, Lauren Reynolds, North County Home Care, San Diego Caregivers, San Diego Home Care / 24.08.2016

[caption id="attachment_1886" align="alignleft" width="150"] Client with home care needs and her loyal caregiver.[/caption]   Home care needs are inevitable for most of us, and planning instead of simply reacting helps promote a safer and less stressful home care experience for family members.  At Home Nursing Care is here to help with your home care needs. It's been called the Silver Tsunami, a burst in the number of elderly individuals and as a result, an increase in home are needs.  The Silver Tsunami definition is: a dramatic increase in the number of Americans who are 65 years or older.   Due in part to birth rates (the baby-boom), medical and scientific advancements, and more people are living longer. For the first sixty years of the 20th century, life expectancy grew by about 2.5 years.  But from 1960 to 2007 - life expectancy expanded by a whopping 4.2 years.  Currently, anyone fortunate enough to hit 65 has an average life expectancy of 18.6 more years. Keeping on the statistics train, 1 in 8 Americans is now 65 or older.  That segment currently makes up 12.9% of the population, but it will jump to 19.3& of the population by 2030, according to the US Department of health and Human Services. Many older people live alone.  Since older women outnumber older men and have longer live spans, half of all women aged 75 and older live alone. [caption id="attachment_1211" align="alignleft" width="150"] Loren is the exception - this home care client lived to nearly 103![/caption] In California, 25% of all seniors live by themselves, and about of third of those seniors have some form of disability. Being able to age comfortably, either in place or in a suitable assisted living environment, takes some planning, especially financial planning.   A recent AARP study found that 31.6 % of seniors have experienced a substantial decline in their home's value over the last three years, and a quarter of all seniors have exhausted their personal savings. Paying for in-home care, such as the care offered by my company, At Home Nursing Care, can feel out of reach for some seniors.  Those with good long term care policies experience less stress when hiring in-home help.  I know of a 60 year old man who pays $300 a month for his long term care insurance.  His father had Alzheimer's disease, so this man worries that within a couple of decades he'll need substantial home care.  His policy will currently pay $300 a day for care, an amount that will rise over time.  That amount should cover his needs, whether he chooses a live-in caregiver in his home or a specialized memory care community. Reverse mortgages are another option for seniors with limited cash reserves.  They are available to people 62 or older who own their homes.  The amount of money available is based on age, current interest rates and a home appraisal.  The draw-back is the cost/fees involved, so be sure to consult a financial planner and someone experienced with reverse mortgages.  Beware of potential scams. Home care clients are especially vulnerable to the...

Lauren Reynolds, North County Home Care, San Diego Caregivers, San Diego Home Care, Uncategorized / 23.08.2016

At Home Nursing Care earns accreditation to provide quality home care. At Home Nursing Care  proudly announces it is accredited by the Accreditation Commission for Health Care (ACHC) to provide quality home care services.  Accredited services include; private duty aide, companion/homemaker care, nursing and home infusion.  “We are proud and thank our employees, clients and community partners for helping us reach this goal,” says Lauren Reynolds, Founder/Administrator of At Home Nursing Care. [caption id="attachment_1500" align="alignleft" width="150"] Lauren Reynolds[/caption] Accreditation means a health care agency promotes quality home care by meeting stringent national standards.  As a result, it is awarded accreditation status.  At Home Nursing Care achieved accreditation for both areas it serves, San Diego and Los Angeles. The Accreditation Commission for Health Care is not-for-profit and, as a result, it has independently stood as a symbol of excellent quality home care evaluation since 1986. “I am proud that our caregivers welcomed this challenge and excelled,” says Reynolds, "They cared about meeting this goals, and therefore they have learned extra skills to provide the best care for their clients." At Home Nursing Care provides dementia care, companionship, personal care, light housekeeping, errands, RN case management, medication management and home infusions.   It staffs nurses in hospitals and nursing facilities.  In addition, the agency assigns nurses to work local school districts.  This allows medically fragile children the support needed to attend classes with their peers. Especially relevant, Reynolds understands the challenges of having a loved one who is helpless, in pain, or facing a loss of independence.  Her own mother inspired her to open At Home Nursing Care in 2010.  This was after her mother needed quality home care while battling terminal cancer at the young age of 58.  Prior to opening the agency and becoming a Certified Home Care Manager, Reynolds had a 15-year career as an award-winning Investigative Reporter/News Anchor for San Diego's ABC 10 News. [caption id="" align="alignright" width="127"] Adriana BeischlI[/caption] [caption id="attachment_1969" align="alignleft" width="150"] Culver City Office[/caption] As the need for quality home care services grew, Reynolds expanded At Home Nursing Care to Los Angeles, where she was raised, in 2013.  Her lifelong friend,  Adriana Beischl, manages the LA location.  In addition, she is a Certified Home Care Manager and the  Culver City Rotary named her Rotarian of the Year 2015 in recognition of her community service. The agency has an A+ from the Better Business Bureau and embraces a customer service culture that sets it apart. They want their clients to be 100 percent satisfied. For more information on quality home care services in Los Angeles or San Diego,  visit the At Home Nursing Care website , call San Diego, 760-634-8000, Los Angeles 310-692-9792.    You may also contact At Home Nursing Care by completing the form below. [formidable id="3"]...

San Diego Home Care, Uncategorized / 22.08.2014

[caption id="attachment_1449" align="aligncenter" width="208"] "Bolt" of Sunshine[/caption] At Home Nursing Care is pleased to announce that our puppy, rescued form a shelter in Mexico, is improving in home care services.  He is ready to "Bolt" into action as a "Bolt of Sunshine" for our clients.    This adorable Austrian Sheppard puppy will soon be doing some "saving" of his own - by providing a little puppy love to our in home care services clients. Named "Bolt" in honor of the San Diego Chargers, the puppy's turn in luck from abandoned to "employed" by At Home Nursing Care as an in home care services therapy dog was all thanks to a bet on a Charger's Game. [caption id="attachment_1450" align="alignleft" width="150"] Rescue Dog to the Rescue[/caption] Lynda Clerke, At Home Nursing Care's Community Relations Director, describes how Bolts dog rescue story happened. "It was December 2014 and the Chargers were playing the Kansas City Chiefs.  A win would land the Chargers in the playoffs.  My husband, Dennis, bet the Chargers were going to lose when the Chiefs were within a field goal of a victory.  My son, Chad, said, 'I'll take that bet and if the Chargers win, I get a puppy!' The deal was struck and Charger fans know what happened next - the Chiefs missed the field goal and the Chargers went to the playoffs.  One day after the bet, we had this adorable 4 pound puppy, which my son chose to name Bolt!" Lynda - who heads the Medical Ministry program for the Rock Church in her free time - has a heart for service and she recognized this in Bolt as well.  She wanted to make our in home care services better than ever. This month, Bolt graduated from his first round of training as a therapy dog - earning accolades from his trainer along with his diploma! While at work providing in home care services, he's still a little rambunctious and has a little bit more training and growing up to do - but his future is to be a "Bolt" of sunshine for our clients and our community. [caption id="attachment_1453" align="alignright" width="150"] Graduation Day![/caption] Once his training is complete, Bolt and Lynda will be visiting At Home Nursing Care's in home care services clients who want the companionship and love of a dog, but who can't have pets full time at their in home care services in San Diego. We will also provide visits at no cost to rehabilitation centers, hospitals, or community service groups who request a "Bolt" of sunshine. Welcome to our staff Bolt! [caption id="attachment_1454" align="alignleft" width="150"] Lynda Clerke and her Bolt[/caption]             At Home Nursing Care is a licensed and accredited provider of in home care services. We offer in home care services such as bathing, dressing, incontinence care, constant safety monitoring, light housekeeping, errands and incidental transportation.  At Home Nursing Care is licensed by the California Department of Public Health to provide nursing services at home, such as medication management, geriatric care management, assistance with feeding tubes and infusions.  All care is supervised by a registered...

Health Care Reform, Lauren Reynolds, North County Home Care, San Diego Caregivers, San Diego Home Care / 08.02.2012

On February 21, 2011, hundreds of employees and owners of home care agencies will gather in Sacramento to lobby against harmful home care legislation that threaten to drastically increase the costs seniors pay for in home care. One bill, SB411, co-sponsored by the SEIU, the Service Employees International Union, and Senator Cullen Price,(D- Los Angeles) calls for licensing home care in California and also certification of home care aides. While reputable home care companies, who are members of the California Association for Health Services at Home, support licensing the growing home care industry, they oppose this bill unless two very harmful provisions are amended. First, in this home care services act, SB 411 will require that employers pay for training for their employees, and then pay an annual fee of up to $180 per employee. This is an exorbitant fee and it’s higher than any other fee we can think of imposed on companies in California.    This added expense to have an “annual” certification will cost the average home care agency an estimated $20,000 to $50,000 per year, an expense that will have to be passed onto consumers who already struggle to be able to afford care to stay in their homes. Secondly, the bill will require all home care aides to have their names and where they work posted publicly on a website, which invades their privacy and threatens their personal safety.  In addition, it provides a launching pad for identity thieves who will already be able to gather a great deal about the home care workers. One employee, Georgetta, a former nurse, said “that’s not safe; I don’t want anyone who goes online to know where I am working.” Home care agency owners and their employees instead want to support licensing, but to have home care workers names and employers not posted publicly. Also, it’s a waste of time and money to force companies to renew the certification of their employees “annually”.  A much better plan would be to have the certification revocable if there was any crime, similar to what happens with Certified Nursing Assistants and nurses. On top of those two harmful provisions, SB 411 would cost the state an estimated $25 million dollars, at a time when the state is cutting services and grappling with a massive budget deficit. A much lower cost option is AB 899.   The California Association for Health Services at Home is supporting AB 899 by Assemblywoman Mariko Yamada (D-Davis), chair of the Assembly Committee on Aging and Long Term Care.  It would license home care agencies and would not post employees names and placed of work online. As the elderly population is expected to double over the next 20 years, costs must be controlled or seniors will be forced to find care in the underground economy, or worse, they'll end up in nursing homes paid for by Medicaid.  We urge those who are concerned about these issues to contact their State Senator or Assembly member and urge no on SB 411, unless amended until it makes common and economic sense.  ...

Caring for Elders, Lauren Reynolds, North County Home Care, San Diego Caregivers, San Diego Home Care / 31.01.2012

Many people are wondering how a proposal to end a federal "exemption"for personal care attendants and home care aides will end up affecting the costs for clients and employment home health care laws for employers. In a presentation to home care employers, attorney John Gilliland tried to stress that while major changes may be in store, agencies will be able to adapt. "This wont put you out of business," he said, clients will still need help.   A sad, unintended consequence is that the higher costs associated with the changes will force some seniors into skilled nursing homes rather than aging in place at home. A proposal by the U.S. Labor Department would end an exemption that allows employers to not pay overtime to "companions" who provide care in someone's private home.   This exemption has allowed longer shifts, such as 12 hour shifts and "live-in", where the caregiver spends 24 hours in the home, but generally sleeps eight hours a night. The proposed change would also mandate that caregivers be paid minimum wage, something that's already law in California. Gilliland said that there are 17 states across the country which have already eliminated the exemption and companies and clients have adjusted. For live in care, he said, clients will be given a choice:  Do they want continuity of care with one caregiver for most of the week at a higher rate, or do they want costs lowered by having multiple caregivers in the home working less than 40 hours total? Archana Acharya, an attorney with Murphy Law Group in Los Angeles, said of the proposed changes, "It's a grey area right now." Hypothetically, in California, here is how the rule change for live in care may play out. Right now families are charged a basic rate for 16 hours of work, provided the caregiver gets 8 hours of sleep, five of those hours uninterrupted. The average rate in San Diego County is $200 - 240 per day for that service. Under the new plan, if a family wants more continuity of care, for a 24 hour "live-in" shift, they could expect to pay a regular rate for the first 8 hours, time and a half for the second eight hours, and double time for the last four hours, adding up to sixteen hours per day of work.  Eight hours of sleep time could be deducted from the employee's pay and the client's costs, if the employee actually got 8 hours of sleep.  The costs to the client would likely be as much as $300 a day. Another requirement of the proposed rule change is that records must be kept of any interruption of sleep time.   Employees would have to keep a time sheet noting any reason for waking up overnight.  In California, if an employee gets less than five hours of uninterrupted sleep, they must be paid for all 24 hours.    It's at that point that the costs would skyrocket for clients, and it would probably be less expensive to move into a nursing facility.  Worst case, the client would...

Aging Parents, Alzheimer's/Dementia, At Home Care Solution, Health Care Reform, North County Home Care, San Diego Caregivers, San Diego Home Care / 13.01.2012

A recent USA Today article states that there is an increase in seniors living over the age of 90.  According to author Haya El Nasser “The number of people living to age 90 and beyond has tripled in the past three decades to almost 2 million and is likely to quadruple by 2050”. Seniors who live longer generally have some sort of disability or need help at some level of living. Sandy Markwood, CEO of the National Association of Area Agencies on Aging, indicates that the focus needs to be on being able to help these seniors live at home as long as possible as nursing home cost could rise to average $72,000 a year. Long Term Care at any level, in the home, assisted living or nursing home can add a tremendous cost to seniors and their families. Government Programs Only Pay For About 16% Of Long Term Care Government programs such as Medicare, Medicaid and the Veterans Administration will cover the cost of long-term care under certain conditions. Medicare will cover rehabilitation from a hospital stay or limited care at home if there is a skilled (medical) need. The Veterans Administration will cover the cost of nursing home care indefinitely if the veteran is at least 70% service-connected disabled. The VA will also cover other forms of home-based or community-based care if there is a medical need. Medicaid will cover both medical and non-medical related long-term care but in order to qualify for Medicaid a person has to have less than $2,000 in assets and income that is insufficient to pay the cost of care. Funding Long Term Care with your Life Insurance Policy Drawing cash from life insurance or changing a life insurance policy should only be done after reviewing with an expert advisor.  Loss of the policy and death benefit could prove to be a detriment.  If, however you have accumulated cash in a life insurance policy and no longer need the coverage you may consider using the cash for long term care or purchasing a LTC rider to your current policy. New insurance products are being developed to cover both life insurance and long term care insurance. ElderLawAnswers reports: “A new law makes the purchase of products that combine annuities or insurance policies with long-term care insurance more attractive. These "hybrid" products are gaining in popularity due to a law that went into effect January 1, 2010, making distributions from life insurance and annuities tax-free when used to pay for long-term care. The same law also allows owners of annuities or life insurance policies to exchange their old policies for insurance for long-term care or hybrid policies without being taxed.” Combination sales which include life insurance, annuities and traditional long-term care coverage are becoming popular with insurance companies and may prove a method of financing long term care.  Investigate closely, however to find what exactly will be covered.  Some policies do not cover home care costs or complete costs of nursing homes. Long Term Care Insurance Funding for All Long Term Care Needs The first long-term care...