When recording care given, do you time everything each and every time you do it or do you find an average time?
Mom's elder lawyer said that I didn't need to record the time it takes me to do tasks...just the tasks themselves...because, where she requires 24 hr supervision & I have a physician's statement to that effect, my notation that I gave 24 hrs or supervision "covers" and "proves" care is given round the clock & by simply listing the tasks I do (without times), it further backs up my case.
I have every faith that her lawyer knows what he is doing. I also have every faith that he has her best interests at heart, as well as mine. BUT...I have an overpowering fear of Medicaid. I know how government agencies work & how it always seems that the dishonest get an easy pass & the completely upright & honest get hammered & harassed. Spiders, snakes & clowns are NOTHING compared to my fear that we will reach the end of Mom's money & Medicaid won't like something we did (or didn't) do, document, etc. & will demand I pay for Mom's care/nursing home fees out of pocket. There is just absolutely NO way I can do that!
So....I've decided that I'd like to keep 2 sets of records - the simple, check-off sheet the lawyer advised AND one that includes time spent on each task. I'm going to record in intervals of 15 min. since I can't think of anything that I do for her that takes *less* than 15 min.
Now, onto my actual question....do those of you that record times under a care contract time everything out each day, eg. making breakfast took 15 min today, but 45 min the following day & 30 min the day after? Or do you look and see that most days cooking breakfast takes 30 min and just use that time every day, figuring those days that you spend only 15 min but record 30 and up evening out with those days where you recorded 30 and actually spent 45?
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.
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.