June 25, 2024

Unpacking Home Health vs. Home Care: What You Need to Know

Show Notes
Transcript

In this episode of “Let’s Talk About Scams,” host Joyce Petrowski, founder of R.O.S.E. Rose Resources / Outreach to Safeguard the Elderly, welcomes Laurel Smith, a seasoned professional in the senior care industry, to discuss the differences between home health and home care. They discuss the essential details of what each service entails, the importance of using reputable agencies, and the potential pitfalls of hiring private caregivers. Laurel shares valuable insights on safeguarding the elderly from unregulated home care practices in Arizona and highlights the role of the Arizona in Home Care Association (AZNHA) in maintaining high standards in the industry. Episode Takeaways

Difference between Home Health and Home Care: Home health involves medical services prescribed by a doctor, such as physical therapy and wound care, whereas home care includes non-medical assistance with daily activities.
Importance of Using Reputable Agencies: Reputable home care agencies conduct background checks, provide necessary training, and ensure caregivers are properly insured, unlike some private caregivers or registries.
Risks of Hiring Private Caregivers: Private caregivers might lack proper training, insurance, and background checks, posing risks to the elderly.
Consumer Protection Tips: Verify the credentials of home care providers, ask for workers’ compensation and theft insurance certificates, and understand the legal implications of hiring private caregivers.
Role of AZNHA: The Arizona in Home Care Association monitors and ensures its members adhere to best practices in the home care industry, providing a safer option for families seeking care for their loved ones.

Resources

Arizona in Home Care Association (AZNHA)): (http://www.aznha.org)
Family Home Care: (https://www.familyhomecare.com)
Arizona Caregiver Coalition: (https://www.azcaregiver.org)

Remember, knowledge is power—subscribe to “Let’s Talk About Scams” podcast to stay updated on ways to safeguard your well-being against scams. Share what you’ve learned with your loved ones and stay vigilant. Stay safe and informed! Visit https://www.roseadvocacy.org/ for additional resources and newsletters to safeguard against scams. Disclaimer: The information contained in this podcast is intended for informational purposes only and is not a substitute for individual professional / legal advice. The podcast information was carefully compiled from vetted sources and references; however, R.O.S.E. Resources / Outreach to Safeguard the Elderly cannot guarantee that you will not fall victim to a scam.

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Welcome back to Let's Talk About Scams. I'm your host,

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Joyce Petrowski, founder of Rose Resources Outreach to Safeguard the Elderly.

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You can find more information and resources on our website

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at Roseadvocacy dot org. You can sign up for our

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monthly newsletters. We send one out via email and in

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don't forget you're going to want to click subscribe so

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you don't miss an episode of Let's Talk About Scams.

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So today I have a guest, Laurel, who is going

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to talk to us about the home health and home care.

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We're going to get the difference on what the differences

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are on that, and then she's going to go into

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a lot more detail on home care and some things

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to look out for, some things to consider when you

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are looking to hire somebody for in home care. Laurel

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Smith has worked in the senior care industry for over

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twenty years. She did marketing, sales, installation of service of

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personal emergency response systems for ADT Security Services. She included

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in her role there was quiet Care, which is a

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motion monitoring system used to monitor seniors as they moved

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throughout their home to detect if there was a fall

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or no movement. She also worked as an inside and

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outside marketing and sales represented for representative for an assisted

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living community. Laurel is currently the community Liaison for Family

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Home Care and is entering her tenth year. She is

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also serving her third year as a board director of

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OSNAHA Arizona in Home Care Association. So let's welcome Laurel. Well, Hi, Laurel, welcome,

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and thank you for coming and doing this PODCAS cast

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with me today. Thank you for inviting me, Joyce, I'm

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happy to be here. Yeah, I am excited to talk

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about in home care. I'm sure you have a lot

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of knowledge on that. So first question, what's the difference

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between home health and home care?

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I'm so glad you asked that because there are many

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people that don't understand the differences. So when a company

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has home health in their name, generally speaking, that's medical.

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So it has to do with home health is prescribed

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by a doctor. That is things like physical therapy a

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lot of people refer to it as PT, occupational therapy OT,

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respiratory therapy, speech therapy, wound care, and all of those

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types of services require a physician's order for someone to

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receive those services, and then those are covered by medical

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insurances and medicare and those kinds of things. Home care,

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that's what the word says, is just care, and so

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those are activities of daily living that a company would

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provide in someone's home wherever they call home, because sometimes

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home is in a retirement community, sometimes home is with

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their children. Sometimes home is an apartment, sometimes it's an

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assisted living building. So that activities of daily living are

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things that help people get through their day, like it's dressing, bathing,

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helping them ambulate, lighthouse keeping, meal prep, changing the bed linens,

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and then doing the laundry because oftentimes that's a trip

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hazard as people get older, you know, the sheets are heavy,

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and doing those kind of things. So it's activities to

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help them remain independent and safe in their home.

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Home health, you said, was the doctor's order, So they

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probably have to have nurses on staff to do certain things.

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It depends. So sometimes they're physical therapists, sometimes they're CNAs. Yeah,

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those kind of things, so it doesn't necessarily take a nurse.

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It all depends on what the need is of that patient.

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Those are provided in the home as well. Sometimes it's

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outpatient though, so someone would go to a little physical

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therapy location for those services. And again that is something

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well and a lot of times that cover that follows

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an injury or a long illness, and so they need

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to get their strengths back. So they have to have

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the PT and the OT occupational therapy to be able

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to function in their home.

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Again, the people that are working for home care companies,

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they're not necessarily nurses. Would they have any specific like

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background training. Are they certified nursing assistants?

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That all depends as well. It depends on the agency.

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But something that I would like to caution people about

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is there is a difference right now in Arizona. Anybody

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can start a home care agency. They don't have to

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be honest or ethical. There's no regulation, so they can just,

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you know, hire some teenager and send them into somebody's

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home to provide services without knowing their background, without doing

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a criminal background check, without knowing if they even have experience.

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So is that older adult going to be at risk

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because of the lack of experience that that person might

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have going into the home. So in Arizona, there are

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two models right now, and one is using an agency

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that actually has caregivers as employees. The other model is

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hiring through a registry or you know, looking somebody up

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online because there's a lot of different websites out there

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or places to go to find a caregiver, and so

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you look at their picture, you look at their background,

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or their their bio or what they like, and you're

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inviting this person into your home and that can be

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very scary without knowing has anybody done a background check

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on them. So hiring someone like this or companies that

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even have caregivers, but they're referred to as independent contractors,

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which is a ten ninety nine model, meaning that they're

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not an employee. So for your public a W two

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employee is someone who is actually employed by the agency

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that they take out taxes on employment Insurance workers COMP

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is paid on that employee take out all the taxes

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and everything. But if you hire a private caregiver or

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someone from one of the other ones that I already mentioned,

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then that person receiving the services becomes the employer and

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they are supposed to take unemployment Insurance workers COMP, liability, state,

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federal taxes and they don't realize it. I'm happy to

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give you an example of a situation that happened that

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opened up a whole big ball of.

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I think that would be great help people understand it.

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Yeah, so there are several different stories, but this is

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one that actually has some numbers attached to it so

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people can understand it. So there was a person that

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hired a caregiver to care for their spouse and they

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worked there for a couple of years. Then the spouse

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passes away. The caregivers let go, thank you, You've been wonderful.

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You've done a great job. We really appreciate it. And

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they were working their full time. So now they're unemployed.

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What am I going to do? So they go down

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to the unemployment office and they file for unemployment and

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the person helping them said, I'm gonta show you any

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I don't show any income for you. How can we

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pay you unemployment? And so, in brief, what happened is

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it went back to that person that hired that caregiver directly.

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It ended up costing that homeowner ten thousand dollars because penalties,

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late fees, and things that weren't paid, et cetera. So

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people think they're going to save money by hiring somebody

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privately for lower money, and you they had no thought

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that this person was going to go and hire or

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file for unemployment.

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It's just not something you think about, right, No.

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No, So that's a prime example.

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Wow, and I'm sure that happens, right, it does. The

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person giving the care is like, well, I'm no longer employed,

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so I should get unemployment for a while until I

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can find another job. That's kind of like the natural

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thought process. But then the person that hired them, you know,

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or I should say hired in quotes, right, because they're

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not an employee, you know, it was is all that's

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on their mind is I need somebody that can come

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in and care for my spouse because I either am

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not home enough to do it, or I'm home, but

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I can't do it, you know, for whatever reason. And

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so that's their main concern. They're not thinking about, well,

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what if when they leave they claim unemployment or what

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if you know, they get hurt, What if they slip

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and fall in my house? Then there's no worker's comp

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So now that person can file a claim against me

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to pay for their injury, and it has to go

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against my homeowner's policy.

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That isn't enough to cover it because I heard of

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another case that that caregiver then sued saying that they

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couldn't work or whatever. They ended up the people had

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to sell their house to pay for the settlement. So

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it's like, I understand it, and there's some Now with

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that being said, there are some good private caregivers out there,

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but they do it as a business and they do

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pay their taxes, and they do have training and that.

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So it's just they have your own workers comp insurance

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and exactly, and all that stuff needs to be discussed

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because people don't realize it ahead of time when they

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when they get into this the ramifications that can happen,

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well exactly because you know, like we just said, they're

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not thinking about all that, right they have the one

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goal is to get themselves or their loved one help

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to be able to recover from an injury, recover from

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an illness, you know, whatever it is. That's their main goal,

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and so they're not even thinking about down the road.

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But you know, it's it's always good to talk about

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this because then people have the information. Is there some

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place that people can go to that they could maybe

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get like a list of questions that they could add

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ask like if they're interviewing different, whether it's a person

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or whether they're interviewing like a company. For some in

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home care that there are questions that they can ask.

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That's a great question. I don't know if the Arizona

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in Home Care Association has that on their website or not,

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but they may have, and I don't know, I don't

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know all the FAQs that are on there, but going

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through an association like OSNAHA AZNHA dot org, which is

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an association that was started back in two thousand and

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seven by family home cares owners and a couple of

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other concerned people because they fought for legislation to become

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regulated and to no avail. So they started this association

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to bring regulation to an unregulated industry and to help

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safeguard our elders. So on that site, there are many

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companies that adhere to the guidelines that have been put

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in place, and people can find a list of caregiver companies.

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They can also if they click on the button that

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says printable PDF, it will also have a column that

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shows all techs, altcs or those kind of services, because

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not all home care agencies out there take all techs

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or government programs. Because that is for low income or

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Arizona long term care insurance. And I hope I'm not

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getting ahead of maybe some questions you might have asked, but.

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Because that was going to go right into my next

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question is, so somebody's looking, probably the best thing they

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can do is get on to osnaha's website, which is

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a z as in nancyha dot org rg and they

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can kind of look down through the list of the

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different home care agencies that are members of OSNAHA and

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then look and see, you know, if they take long

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term care insurance, if they take all techs, if they

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take VA benefits. So that brings us into outside of

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just privately paying, you know, just writing a check out

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of your personal checkbook each month or every two weeks,

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whatever it is for the care and paying the agency.

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What other is there anything else? So we talked about

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a few of them that can kind of help pay

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for this.

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Yeah, so if someone is low income or they're afraid

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they're going to run out of money, they can only

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have a certain amount of assets. They can apply for

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all techs, Arizona long term care insurance policies. There may

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be affiliate members on the OSNAHA site too, that can

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help people with that. It's very important to go to

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a reputable company that knows what they're doing. Also, if

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they are a veteran or the spouse of a veteran

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applying for VA EID and attendance, you know it's due

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to them. Again, there are criterias that surround that. But

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going right to the VA can be daunting, it can

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be frustrating, it can be a lot of work. There

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are accredited agents in the valley that work nationwide that

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are accredited by the VA to do this paperwork on

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behalf of people.

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And are there any of them that are affiliate members

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of OSNAHA that might be listed there.

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I don't know that off the top of my head.

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I do know that we're going to have a couple

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at our conference coming up in August. But that's something

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that if they become affiliate members then their information would

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be there, or.

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Maybe maybe somebody could send an email into OSNAHA. I'm

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sure they have the info at osnaha dot org that

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they could ask if if there's any recommendation that OSNAHA

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would have or you know, any affiliate member that would

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help VA.

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Now, the website itself does show affiliate memberships, but I'm

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racking my brain right now to know if they're even

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on there. And the one is a brand new contact,

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so but she's been doing via accredited business for many,

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many years.

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Okay, so it might be a little bit of time,

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I think. I think the affiliate members are listed on

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there because I found myself on there because I am

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an affiliate member of OSNAHA. Yeah, and we appreciate that. Yeah.

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So another way that people can pay is also on

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long term care insurance policies. So that's generally speaking for

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people that got into that years ago. So it's your

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things like jen Worth Banker's Life, MetLife John Hancock long

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term care insurance policy that pay for home care services. Also,

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the Arizona Caregiver Coalition offers rest bit vouchers for family

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members so they can get a break, but it's with

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a limited yearly benefit and that is also something that

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has to be applied for on their website.

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Well, that's good to know that if family members are

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caring for their loved ones that they could apply for

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that to get to I'm guessing what that is is

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then they give you the money to then pay for

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somebody to come in and relieve you.

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I think it has to be paid ahead of time,

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and it's like a six hundred, twelve hundred and twenty

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four hundred dollars voucher, and they it's for different things.

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I don't work for them. I don't know. I don't

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know the details. But Arizona Caregiver Coalition.

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Arizona Caregiver Coalition, Okay, we will get the websites for

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OSNAHA for Family Home Care because Don the owner of

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Family Home Care is one of the founders of OSNAHA,

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and then also for the Arizona Caregivers Coalition. We'll have

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those all in the in the show notes so people

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can look those up and see. I always thought long

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term care policies were more geared for, like nursing homes

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and skilled nurse.

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Are But the insurance company is going to save money

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if someone is getting services in their own home. And

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every insurance policy is different, so you know, it all

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depends on what they signed up for. Is there a

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writer to it, is there you know, some kind of

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a condition to it or whatever. So so I'd like

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to go back to something you brought up, because when

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you were talking about having the private private caregiver coming

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in the home and if they quit, they go down

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for unemployment or so there's another thing. It's like what

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if they get sick. So I want to I want

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to kind of go over the things that are important

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for people to think about if they are thinking about

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hiring somebody, so agency versus some kind of a registry

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or a private caregiver who is really liable. So when

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you utilize an agency model, those that have caregiver employees,

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all of the following things are done by the agency.

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They find and hire the caregivers. They screen the caregivers

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for experience. They do criminal background checks, whether or not

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they have CPR and first Aid training. They employ the caregiver.

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They directly pay the caregiver. They manage the schedule and

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monitor the performance of the caregivers. They and pay and

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file reports so state and federal payroll taxes on the

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caregivers that include Social Security, Medicare tax, federal unemployment. They

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also pay workers compensation and insurance for in case of

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illness or injury, either one while they are on the job,

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and they pay theft insurance to cover theft issh and

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they provide a replacement caregiver if that caregiver gets sick

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or quits so and communication, So how does the family

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member even know how well that caregiver is doing if

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it's just a private caregiver. Where do they put their notes?

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Where do they have a binder? Do they have a

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portal or anything like that? And these things are important.

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So when someone's using a private caregiver registry, all of

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the points that I just mentioned are the responsibility of

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the consumer and they become the employer. And the other

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issue is if they have a living and they want

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to fire them, do they have to evict them?

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Or if they're only there for a certain amount of

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time and the times up the person they're caring for

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is better and they don't need the care, do they

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have to evict him as well? Right because they've invited

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them into the home, told them here's your space, you know,

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And that's a valid.

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Point and other things that people don't think about. Another

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issue is if number one, it's illegal to pay somebody

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under the table. It's done all the time, but it

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is illegal. And if the caregiver gets paid under the table,

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obviously no taxes are being taken out or paid. So

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in addition to no money going towards social Security. What

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happens when they are retirement.

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Age and they show no income, right, they don't have

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any Social Security paid?

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Yeah, so yeah, wow, important things to think about. And

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you know a lot of times so a private caregiver.

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So I have heard of these situations too. So they

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have a private caregiver. It's like, oh, my baby is sick,

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so can I bring my baby with me today? You know,

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two year old whatever? You know, it's a Petri dish.

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So it's you know, you're exposing a vulnerable adult to

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a child that can be carrying a lot of different

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things if they were in daycare, and now they can't

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go to daycare, so I'm going to bring them with me.

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Oh and my boyfriend, he had to drive me here

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today and he's just gonna wait for me to be done.

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So can he just sit here in the room, Well,

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I'm taking care of you. And then he goes down

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the hall to the restroom and that's usually by the

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master bedroom with valuable. So there's a I hear about

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all these things.

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Yeah, it's unfortunate. And I've actually heard of some people

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that will specifically target retirement communities. They will get jobs

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within the retirement community. And then they start befriending. And

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it could be a male or female befriending a male

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or female who might have recently lost their spouse or

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their partner, or maybe it's been a while, but you know,

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they're by themselves, and they start befriending them. And then

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the next thing, you know what I heard. It was

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a man and it was a woman who then all

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of a sudden moved into his home, you know, because

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she was going to care for him. Well, she finaggled

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her way in and got him to turn the house

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deed over to her, put her on the bank accounts

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a whole bunch of stuff, and he couldn't a victor

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right and on the d exactly right, and she could

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have evicted him right, But then she was basically had

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access to all of his money. And by the point

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by the time they talked to some independent person, you know,

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and that independent person was trying to explain to them,

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you need to you need to get her off your house,

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you need to you know whatever. By that time, she's

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got him into this absolute trust and he's just so

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emotionally spent and psychologically spent with this, it just seemed

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easier for him to just go along, right, to continue

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to go along with it. So, and I'm not saying

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that happens at all retirement community and people need to

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be worried about that. It doesn't. I mean, this was

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just one case that I had heard about. And there

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are tons of retirement communities in Arizona and they're all,

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you know, really good. But these are things that you

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have to just be careful of. Is you know, whether

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it's somebody that works at that community or somebody out

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of the blue that you know, just all of a

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sudden wants to be your friend and they're trying to

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get in even closer. You know, it's a whole romance

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scam thing coming up, right, except it's happening in person

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and not over the computer. So you have to be

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very careful about that. And yeah, so have you heard

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of any other quote unquote scams that happened like and

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I don't want to, but we are talking about home

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whether it's home health or home care. You know, anybody

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that might have been trying to scam the the people

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they were caring for. I mean, I guess it would

383
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happen a lot if they were a private caregiver, right.

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More so. Now that's not to say that agencies haven't

385
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had problems, because I'm privy to a lot of information

386
00:24:14.759 --> 00:24:17.039
from a lot of different companies. I've read a lot

387
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of different articles in publications, and so yeah, they've They've

388
00:24:22.839 --> 00:24:27.759
had employees that have gotten into a sticky finger situation,

389
00:24:28.559 --> 00:24:32.599
or they they play up to the piers because they've

390
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become close to the person they're caring for. So they

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talk about, you know, baby needs new shoes, but it's

392
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really beyond that. It's you know, my baby needs medical

393
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help and whatever. And before you know it, that person

394
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is feeling really bad because this caregiver is caring for

395
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them and so they want to help, so they're giving

396
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