For those of you under contract as family caregivers, how do you bill hours? Do you bill for driving to and from their home? How about sitting with them while they eat a meal, and that kind of thing?
I will be contracted to care for my parents full time and need to prove at least 30 hours of work for my divorce settlement (with a child) and am trying to figure out what I can and can't bill them for.
- Your parents' income and assets
- Their specific care needs
- How your state deals with Medicaid
I would talk to an elder attorney (on the parents' dime - this is about figuring out their care plan) whose specialties include personal care contracts, state employment law as pertains to family caregivers, Medicaid spend-down and planning specific to your state. Depending on a lot of factors, you may want to either:
1) Set your parents up as a business (or one of them as a sole proprietorship) and utilize a payroll service to pay you on an hourly basis under a formal employment contract. This can ensure that your wages are not looked at as a gift for Medicaid and tax purposes, provide you with formal employment experience and social security history, offer a framework to obtain insurance to cover injuries/damages that occur within the employment, and provide you with access to unemployment benefits in the future. You'll need to track your hours as you go, submit them to the payroll service, and you'll operate as a W2 employee for your income taxes.
2) Establish a lump-sum personal care contract. With this option, you do some math to calculate the amount of time you'll provide services multiplied by a realistic wage for those services and predict forward based on your parents' life expectancy per actuarial tables to come up with a single estimated amount. You could drill down to different pay rates by type of duties, an expected increase in care level over time, etc. This too would be considered payment for work vs. a gift for Medicaid and income tax purposes. To avoid one ginormous tax bill to you, typically the lump sum could be set up in a trust that would pay out on a regular basis like a paycheck.
With either approach (or a combined approach or something else the attorney figures out) you need to do some research on ADLs (mostly about physical needs) and IADLs (includes shopping, meal prep, financial mgmt, etc) to come up with a detailed breakdown of their current and projected needs.
Prior to living together, I would treat everything spent together as working time and their home as your job. You don't get paid for travel time to and from your office, but you do get paid for time (and expenses/mileage) for any transport related to them while "on duty." Your employment contract should detail exactly how to calculate hours spent sleeping over if you occasionally do so for their benefit vs. yours.
When living together, you're going to have to do some projections (and maybe some trial runs) of how to calculate your hours. And are they moving into yours, or you moving into theirs? Will you be cooking the same foods? Is someone going to pay rent? You might consider counting time you spend supporting BOTH yourself/your child and your parents at a 50% level (i.e., one hour making dinner for both = 0.5 hr paid time). On the other hand, time you spend at home that you could otherwise be elsewhere (like when kids are in school) because they MIGHT need help is caregiving time whether you're specifically engaged with them at any given moment or not.
As you noted, it's more difficult to figure out while cohabitating, but keep in mind that companionship, housekeeping, outings, entertainment -- all of that can fall under paid caregiving. Perhaps it's more difficult to consider the value of your time when you have a history as an unpaid parent and home manager, but there are time/energy/opportunity costs to being present to support your parents vs. time that could otherwise be spent being paid as an employee elsewhere. Don't give up too much simply because you're under the strain of not having a work history you can leverage outside the home -- your time and energy is finite and valuable.
It does seem like more than half of the answers on this site are "see an elder attorney" and "it depends on your state" but those are all too often the correct responses :)
AND…..
also the amount of care a person needs has to have a resonable assessment of the type of care they need. Like each of your parents doctors do on their letterhead or on their prescription pad a listing of ADLs that mom or dad each are “at need” for. Having this just establishes that it’s all legit. If your hubs or his atty wants to go all pit bullie on the divorce settlement they can tear apart any document that was just done DIY by your placing the # of hours and why it was supposedly necessary. If this is an antagonist divorce, his atty is being paid to make you look like a fool or to be foolhardy or to be a conniving scheming witch of a spouse and parent. None of these are good looks for you. Get your attorney to do this.
When I submitted cost of care for my Husband (when doing taxes) The time and travel to doctors and hospital were counted. (check the IRS for billing travel) So if you take them anywhere you can count that towards your hours. You can't count the time it takes you to get from your house to theirs. (If you stop to pick up a prescription though then you are "on the clock".
If you are sitting with them while they eat to ensure that they are eating safely? Chewing, swallowing, not "pocketing" food..then that is part of their care.
If you are sitting with them while they eat and you are folding laundry then that is part of your task as a caregiver.
I would say from the time you arrive at their home until the time you leave that is "billable" as part of their care.