When recording care given, do you time everything each and every time you do it or do you find an average time?

Pamstegma...since this is an all-inclusive care contract (meals, housekeeping, bill paying, laundry, grocery shopping, pet care, transport, medicines, actual medical care, etc) Medicaid WILL care about cooking, housekeeping, etc. Any services she spends her money on needs to be documented in ordee to prove that she got something for her money vs just giving it away.

Nope. No OCD & no masochistic desire to torture myself. My reasons were plainly expressed in my posts but I don't mind stating it again in different, possibly clearer terms....its called fear of financial ruin. Been there, done that. Don't plan to do it again. I spent all of my retirement AND my savings saving my farm in 2010 when the economy crashed & I lost my job. It tooks months to find a new job...and I had to take a $12,000/yr paycut to do it. It's taken me 5 years but I have scraped & scratched & squeezed every penny until Lincoln cried, but I just made the final payment on my farm the week prior to Thanksgiving & I've managed to put back a very modest savings. I bust my a$$ on this farm caring for the crops & animals that lighten the monetary load by supplying food as well as the time I spend supervising & assisting my elderly mother. I'm lucky that she's still ambulatory & "good enough" to follow me around while I do my farm chores but with the Alzheimer's making her like a giant, 100 lb child, it's certainly not without it's challenges. I run this entire farm, pay the utilities, buy the food we can't grow, pay for medications, put gas in the vehicles & generally support the TWO of us on less than $1000/mo. So, yeah, I worry about money. I worry that Medicaid won't like something & will deny x-number of months nursing home payment when the time comes that mom needs admitted. And, if Medicaid won't pay, where do I find the money? How do I provide for us? THAT is why I'm overly cautious.

Olly, I haven't recorded for purposes of a care contract, but have for management of a trust. And as I wrote in your earlier post, I've done this for years as part of timekeeping required by law firms. I always err on the side of being more detailed, especially if there's a possibility of outside scrutiny later.

I never, never averaged. We had daily time sheets which I also used for trust record keeping, noting starting and stopping times. It really isn't that difficult once you get used to it.

What you could also do is develop standardized modules, such as for breakfast, with something like (a) made scrambled eggs, x minutes; (b) cooked sausage, y minutes (c) made toast, z minutes. Then you can add x & z if that's what breakfast was that day, or may just y & z on another day. I don't think you have to be that detailed though; this was just an example.

But I would definitely time from start to finish, including when you're doing other things inbetween, such as folding laundry while some of it is still drying.

Medicaid doesn't care about time cooking, they care about time feeding, dressing, bathing, wound care, medications, transport, assisting with toileting and transfers from bed to wheelchair. Look up ADL's (activities of daily living) and what Medicare/Medicaid allows for a patient.

OzarkOlly, caregiving is a complicated and often stressful role, with routine tasks and lots of the unexpected. I can't understand why you want to make it even more complicated by tracking something the lawyer you allegedly trust says is not necessary to track.

If this is a little harmless OCD and you really want to do it, well, OK. Track from the beginning to the end of each task, and don't average.

When we had a PCA (from a Medicaid-approved agency) I signed her timeslip every day. It contained her hours for the day (9 to 3:30) and a list of tasks she checked off. For example, she assisted with a bath, provided lunch, assisted with exercise. No amount of time was recorded for these activities. She was there and she monitored his safety for the full time. In addition she did certain specific tasks, which she checked off a list. Even if my husband wasn't up to walking or exercise and there weren't many tasks to check off, she still got paid the full amount. Being there to ensure his safety, encourage his hydration, and generally to be available was worth it!

So why you think anyone would later question that you earned your pay if you "only" record the tasks you did, without exact times? If the house is filthy and the patient is malnourished and neglected, you are in trouble, whether you wrote down "mopping floors, 45 minutes" or not.

If your mother needs to apply for Medicaid later, they look for instances of giving money away. You have a care agreement in place. That money is not a gift. Medicaid is not so stupid and unfair as to think the applicant should have lived off nothing for five years before applying. They expect that she bought her groceries and paid her rent and paid medical bills, and bought clothes, and paid to have tasks done, such as snow shoveling and yard maintenance (if applicable). They expect that she paid for some in-home care. That is all legitimate.

What would raise red flags is if the going rate for the care in your area is $900 and you are charging $3500. Then some of the money would be considered a gift. But you have had an attorney involved in drawing up the agreement. There should be no red flags.

Keeping track of the tasks done each day is probably above and beyond the documentation needed. Listen to your lawyer.

Tracking your time in 15-minute increments is simply not needed. If you do it, know that you are doing it because it gives you psychological comfort. And that's OK.