How would I best document care given under a care contract?

Follow
Share

Mom's elder lawyer says that Medicaid doesn't require the documentation of care to be "super comprehensive", nor does it need to include how much time is spent on EACH task. He wants me to just use a simple check-box system to document what tasks are done on what day. He maintains that my time spent is holey & completely documented with the check-box labeled "24/7 Supervision". In other words, it doesn't matter if it took me 30 min to bathe her or an hour-and-a-half because I'm "on duty" 24 hours per day regardless supervising her & preventing her from "getting into trouble" or wandering off and we have a physician's statement testifying to the effect that she can't be on her own due to her stage of dementia. He maintains that you want "just enough" proof to show Medicaid but "not too much". In his words, "over-documenting makes it look like you were trying too hard to 'pump up' what you were doing & makes Medicaid more tempted to pick you apart & deny payments".

Has anyone else used just a check system & not recorded their actual time per task? How did Medicaid respond to such a simple system?

This question has been closed for answers. Ask a New Question.
11

Answers

Show:
I worked Elder Care and had to acct for my time each day. Nothing fancy, just had to state what we had done, where we had traveled, my mileage (if it was my car) and sometimes a general "take" on her mood or state of health. It took about 10 minutes at the end of each working day. Someone in the family was supposed to co-sign this and rarely did. My company would occasionally ask for the book and they'd take it and just check the hours I'd stated against the hours I'd "called in". Also kept receipts if I had spent my money, for which the family always just personally reimbursed me. Never had a problem, as I recall. Anything I did for her (tailoring, running errands that she couldn't go on with me) we settled up between the two of us, with her POA son's full knowledge. It was my JOB, so if you look at this as your JOB, you may get a different perspective.
Helpful Answer (0)
Report

Whatsagipper: Thank you. My mom passed away, but I still kept the list. List EVERYTHING. It can be done while you're eating dinner and does not have to be elaborate.
Helpful Answer (0)
Report

The checklist idea mentioned above is good. If you're actually providing 24/7 care, you would rather get a nap than spend time writing and checking time in and time out for each task. And as another has stated, "If they want more info, they can ask"
Helpful Answer (0)
Report

When I was living out of state providing care for my mother, I took the time to write down every single task. It turned out to be 18 full pages for my 6 month stay.
Helpful Answer (2)
Report

For my own records (to try to see how much time I wss caring, and see what if it were someone else we would pay) I downloaded a free time sheet like app on the phone. Created two clients, one for mom, and one for the house upkeep. Each time I do something I can record it there, up to the minute if needed or desired. I can set the pay rate, so if its time that we would otherwise pay someone else, I track it w one rate, if its more like im really just visiting, I still track it, but no $ amount. This has been pretty easy, I can print out invoices if needed too. I'm doing the larger share of the siblings, so this helps me keep perspective when I really need help in doing something or to take time for me.
Helpful Answer (1)
Report

I sure do find my times differ from day to day! Days when she's in a good mood & feeling cooperative, i can cue her to get dressed in as little as a half-hour. But when she's being argumentative & picky...it can take an HOUR & a half!! I can't really say there's anything fun about dementia but it sure makes each day its own bucket of caregiving surprises!
Helpful Answer (1)
Report

I haven't done this specifically for providing care, but did keep detailed records for trust management, generally using the same methods law firms use to record billable time.

Time was recorded for phone calls, research, trips to the post office, cost of mailing and overnight deliveries and probably a few categories I've now forgotten. I charted time as we did in law, in tenths of an hour, but these were typically entries that weren't longer ones such as the time that might be spent cleaning house or going to a medical appointment.

I had a separate sheet for out of pocket expenses, with columns for date, destinations for travel, mileages, costs of trips, etc. (the first sheet was for time, the second was for expenses, so there was some overlap but it helped me remember everything I did).

It's been over a decade so I don't remember exactly how I set up the sheets; they're still on my older computer.

If I were to do this, I think I'd list all of the chores that you do, ranging from meal prep, dishes, household tasks, etc. to driving to medical appointments, ER, etc.
I'd make a chart, with frequently repeated tasks listed horizontally as column heads, and dates listed vertically along the side. I would do it this way because the dates will be more numerous and ongoing, obviously changing, but the tasks would probably generally remain the same.

You can select the method of measurement - fractions of an hour (such as 1/4 hour, 1/2 hour) or write the specific number of minutes. But make it easier to tally by using the same mode - i.e., all fractions, all specific minutes, etc.

Leave a column for miscellaneous and/or new items.

Actually, if you have Excel, you could do it on computer; it will be easier to tally the hours spent. Using the formula function, you just insert the "sum" formula, and the minutes and/or hours will be tallied for you. You can use the multiplication function to calculate mileage costs.

It's also easier to print out if you need to to provide detail for anyone.

If any of this doesn't make sense (and sometimes it's hard to describe in words), let me know. I'll see if I can do a better job of explaining!
Helpful Answer (2)
Report

We set up a caregiver account that I now use for his expenses and I do keep receipts when I make a purchase exclusively for him out of my own pocket.
Helpful Answer (0)
Report

Try to also keep all receipts. I know from experience, I use my own money sometimes when I buy her Depends pads or special shampoo. Try to change this behavior asap. There is no reason for you to go broke, as she approaches the month/year she will be 100% on Medicaid.
Helpful Answer (1)
Report

We kept a note book with each day listed, who worked that day, what time meds were given and moms bp and pulse rate. Also she had to use machine to help leg swelling so we recorded when we did that. Its just a plain notebook nothing fancy with just the basics. Since my mom needed 24/7 like your mom we felt this was enough info, afterall we had to be there even if every minute we were not tending to her, we were keeping her safe.
Helpful Answer (2)
Report

This question has been closed for answers. Ask a New Question.
Related
Questions