Do you have problems with retaining a caregiver from a company if your parent's caregiving is paid for by Medicaid? - AgingCare.com

Do you have problems with retaining a caregiver from a company if your parent's caregiving is paid for by Medicaid?

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If your parent has caregiving hours from a caregiving company paid for by Medicaid, does anyone have the same problem I do with retension of the caregiving company's caregivers due to the caregivers' vacations, minimum hours they need to work, distance they need to drive to your household, poor pay from they receive from their company, and/or transcience and other obligations they may have. My father has had over 100 caregivers since he moved to my house in September, 2014 and I've been told if I could afford to pay private pay I wouldn't run into this same problem.

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Medicaid Long Term Care has definitely NOT been phased out in NY State and covers Level II personal care, home health aides, nursing services, adult day health care, therapies in the home, and consumer directed personal assistance services as well as nursing home care.Medicare DOES NOT pay for LTC services. Most dual eligible (people on Medicaid and Medicare), must enroll in MLTC plan to receive services. Criteria: Program for dual eligible adults who need more than 120 days of LTC, LTC and other Medicaid services are provided through health plans. Medicaid pays the plans to provide services and it is mandatory in all counties statewide, each county must have at least two MLTC to provide services. Long term care and additional services include: nursing services at home, therapies in the home, home health aides, personal care, adult day health care, consumer directed personal assistance nursing home, social adult day care, home modifications, medical equipment & supplies, non-emergency transportation, personal emergency response system, home delivered meals, podiatry, optometry, audiology, and dental. The amount of coverage is governed by the need.
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Yes as the ICAN Ombusman for ACR Health I have run into a variety of problems with home health agencies however, not with the Medicaid coverage. Medicaid is fine with providing the coverage. The problem arises with complete coverage of hours approved. I've been told HHA agency refuses to pay for any hours over a 40 hour week. They charge the Client $25 per hour for the aide and the aide gets paid $9.00, very reminiscent of temporary agencies here in New York State. Also have met with resistance when trying to advocate for a raise for HHA upon client request for retention, insurance refused to reveal criteria used to obtain said raise.
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If your full-time senior caregiver is employed independently by you and your family, operate under the one-week-salary bonus rule or two weeks for caregivers that have been with your family for multiple years. If he or she is employed through an agency or works at your senior's facility, be sure to check with the management regarding policies on tipping. If you know that the caregiver has really gone out of their way to make your aging parent or loved one as happy and well-cared for as possible, give a little extra – check out The Gift of Relaxation section from last week.
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Luvawgs...good genes...I'd say. Bodes well for you. I feel your pain on the caregiver issue. I do think a lot of the problem in turnover is simply low pay issues. Perhaps if you "tipped" his agency caregivers a decent amount from time to time, special perks now and then, you'd get them stay longer, as OhMyGod suggested... To help make up for the low pay.... you can call these gifts and as I'm sure you know, you can gift up to 10,000.00/yr to anyone without having to claim it on taxes.
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Luvdawgs: Unless you hire a private individual, I believe you will run into inconsistencies. And in general, off the subject, people DO NOT want to perform their job, e.g. fast food worker, office staffer, et al.
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Agencies work on a Tier system and self pay is tier 1 and will always get care. Tier 2 is a private insurance or medicare picking up the cost. Medicaid is tier 3. The needs of a client in tier 3 is taken into account so if your father is relatively healthy compared to other clients, they will be the priority.
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Luvdawgs hit the nail on the head!! As a former paid caregiver, when I was treated as an important part of the family dynamic, I felt much more inclined to do a better job (though I always did, anyway). Treating a paid caregiver as a piece of furniture or worse, an indentured servant is a sure way to lose them.

My "family" respected that I had a personal (and at the time, VERY stressful homelife). We spoke each Friday about the upcoming week, what was needed by the client and what was needed for me to be the sole caregiver at home to a very, very sick husband and also to a daughter who still lived at home.

They DID give me Christmas and birthday gifts and actually treated me as one of the family. That was not necessary, but it made me feel that I was cared about...and honestly, the pay was so bad, if they had been a difficult family I would have gone FT at my 2nd job.

You MUST respect the caregiver. But you must also do your own background checks and such. I was bonded by my company, but the fact that I was of the same religious background as my client and we actually knew a lot of the same people...didn't hurt. I told them to please, check me out.

Any problems that arose were dealt with swiftly and in a professional manner. I was not an 18 yo kid, I was a 50 yo woman with a lifetime of caregiving behind me.

Not to say the younger people have a disadvantage--but they did tend to be much less serious about their jobs, they'd talk on their phones all day...etc. My phone was OFF while I was at work. Maybe being older I had more respect for my client, I don't know. It just worked well for the family and for me for almost 2 years. I'm sure I'd still be with her if she hadn't declined to the point she could not live at home.

Sometimes it takes a long time to find that good fit. Hang in there.
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Lassie, they at least say that Medicaid will pay here but since hub's aunt and uncle never qualified I'm not sure
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Hi Luvdawgs,
I have had the same problem for about 10 years. I finally get it fixed more or less. It doesn’t matter who is paying. We had private pay. So here is what I recommend:
Find a local agency and ask about their turnover rate. Review their rating on the internet. Also ask the agency about hiring practices. Where and how they hire? If it’s a collage or school forget about them and find someone else. Why: Students schedules change at a maximum of every 3 months. Students also graduate and usually get better jobs. We have had many student caregivers and they all have left in a very short time. Find an agency that hires locally and people like housewives and retirees looking to supplement their income. They may not be as capable as someone younger but they will stay longer. Don’t be afraid to ask the agency to send someone else if they send someone who can’t do the job and be sure to let the agency know so they don’t send them to another client. Believe me the agency doesn’t know about these people.
If a care giver needs to be off for whatever reason ask how the agency will backfill for them. When this occurs don’t let the agency off the hook but be reasonable. Have then start early to find a backfill and make them send them to you to get them up to speed and yourself confident in them before they really need to be there for you.
Get the agency to train 2 or 3 care givers for backups before they are needed. Even if you have to add some hours to do this. It just gives you some peace of mind.
Once you get a care giver assigned to you, talk to them about their personal life. Are they taking care of any children? The more the less reliable they will be. If they are of school age they will most likely leave when the summer break starts. Married or single? If married ask about their spouse. Are they working and where? Try to determine if the marriage is stable or not. I have had care givers leave because the spouse got a new job and they were moving, they got devoiced or the spouse graduated and got a job somewhere else. Is the care giver taking any classes (a student)? Where are they are living and how far or long they have to drive to get to you. This is a big indicator of how long they are going to stay! Is the schedule OK for them? If not what would be better for them (maybe you can be flexible). Ask them if they like the agency they are working for? If not they will most likely leave soon and you will have an indication about how good the agency is.
I schedule the care givers when the work load is greatest. For me it’s the AM. It’s a lot of work getting my wife up and out of bed in the morning. I also give them some time each shift to be social. It's a lot harder for a care giver to leave if they have formed a relationship with you and you have shown how much you appreciate them. I always thank the person for all they do for us at the end of each shift. I don’t care what the agency policy is I give Birthday and Christmas gifts directly to the care givers.
I address small problems with the care givers. For example, putting thing away in the wrong place. Big ones like doing something unsafe go directly to the agency. For example, sitting in their car smoking while my wife is taking her shower.
I have found texting to be a problem. Make sure the agency knows this. My policy is the care giver can have the cell phone on them for emergencies but phone conversations need to be kept short 1 to 2 minutes. If they abuse this the phone must be kept in their car. Even if the care giver is just standing by waiting for my wife to complete something I don’t want the focus on them texting. If they do the quality of care is affected.
This is mostly trial and error but don’t feel locked to and agency. I did and it cost me a lot of money, time and grief.
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I've never heard of Medicaid paying caregivers here in NYS, despite being LIED to by several people who assured me this was so. Medicaid would pay for a few hours a week of day care and that was it. Home care through Medicaid was being phased out.... What I wouldn't have given for paid caregivers sent, even with a big turnover rate!
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