Home health care is health care that is provided to patients inside their home, and usually by either health care professionals or family and friends. The term “home care” suggests that the care provided is non-medical and more of a custodial nature, whereas “home health care” may suggest licensed staff members. The differences here are similar to the differences between assisted living facilities and nursing homes. Much like assisted living facilities, home health care lets seniors enjoy a good measure of independence. An elderly individual or couple will appreciate having privacy as well as assistance in daily living needs.

What Home Health Care Provides

What kind of services does home health care provide? Home health care may help seniors with daily living needs such as bathing, dressing, house keeping and cooking and dining preparation. Depending on the needs of the resident, there may be special provisions such as transportation services and errands, volunteer programs, exercise and walking, and toileting assistance. More extensive forms of home health care would also provide rehabilitation programs, including visits from physical therapists and nurses. Other qualified home health care professionals may include respiratory nurses, occupational nurses, social workers, mental health workers and physicians.

Who pays for home health care? This type of outside assisted living program can be paid by private resources from the resident or family, by public payers such as Medicare and Medicaid or by employer-sponsored health insurance plans. Medicare will usually not pay for home health care on a long term basis while Medicaid is more likely to help low-income families with little or no assets. Employer-sponsored home health care is likely to be on a short term basis unless the insurance plan is very generous. Most of the time home health care will be paid for by a family’s own resources.

Comparing Home Health Care with Assisted Living

How does home health care compare with in-house stays at nursing homes and assisted living facilities? Most seniors would prefer home health care, of course, as people always do value their privacy. However, there are also circumstances that would necessitate constant supervision of the resident at an assisted living facility, and not only occasional visits. Home health care is basically assisted living, but with even more independence. Therefore a resident that cannot be left alone for long periods of time would be better suited in a nursing or board and care type home.

It might appear that home health care would be cheaper than a stay in a nursing home. However, home health care costs can be just as expensive, depending on the number of hours aides work. Some residents have admitted that full time home health care usually costs twice as much as a stay in a board and care or assisted living home. Most home health care agencies will charge about $20.00 an hour or over. If the resident is relatively independent then the fees associated with the service can be controlled. However, don’t forget that if your needs are minimal to begin with, you could hire a trusted individual to perform the same tasks and save money from paying an agency fee.

Home health care is ideal for seniors who feel well and can easily get around but who need occasional doctor visits and help with housekeeping. It is also a preferable choice if a senior needs full time care but does not want to become a resident in a public nursing home. Full time home health care provides the most privacy and personal attention possible. If you are looking for this type of senior assistance, you should always be mindful of the qualifications of workers, as opening one’s home to a stranger could always be a security risk. The best home health care agencies have screened workers who are well qualified in their field.

How We Can Help You

ElderHomeFinders is a company dedicated to helping seniors locate assistance in the southern California area. We inspect assisted living facilities and retirement communities in the area so that our clients will find the perfect home at a price they can afford. Can ElderHomeFinders also help seniors find home health care? Yes. Our company can put you in touch with the right home health care agency, according to your special needs and budget limitation. We can also advise you on the differences between home health care services and assisted living and board and care facilities and which choice would better work for you. Seniors have worked hard all their life and surely deserve the best health care possible – whether in a senior living facility or in their own home

General Health Management like administration of medication or other medical treatments
Personal care such as bathing, oral hygiene, dressing, and shaving
Nutrition help like preparing meals, assisting eating, and grocery shopping
Homemaking services including laundry, dishwashing, and light housework
Companionship for example reading to the senior or taking them on walks
Recruiting and Interviewing Applicants
There are many avenues for hiring a home health care employee. Generally, home health care workers can be hired directly or through an agency. Home health care agencies often have a staff that includes social workers and nurses that will manage your care. However hiring an independent home health care worker is generally more cost effective, it will also give you more control over the type of care you receive.

Senior home care workers should be carefully screened for proper training, qualifications, and temperament. Fully discuss the needs of the elder care recipient during an interview with a prospective home health care employee. There should be a written copy the job description and the type of experience you are looking for.

References

Have applicants fill out an employment form that includes the following information:

Full name
Address
Phone number
Date of birth
Social Security number
Educational background
Work history
Before hiring, you should ask to see the senior home care worker’s licenses and certificates, if applicable, and personal identification including their social security card, driver’s license, or photo ID.
References should be checked out thoroughly. Prospective employees should provide the employer with names, dates of employment, and phone numbers of previous employers and how to contact them. It is best to talk directly to previous employers, rather than just to accept letters of recommendations. Also ask the applicant to provide or sign off on conducting a criminal background check

Special Points to Consider

Make sure the person you are considering hiring knows how to carry out the tasks the elder care recipient requires, such as transferring the senior to and from a wheelchair or bed. Training may be available, but make sure the worker completes the training successfully before hiring him or her.

No one should be hired on a seven-day-a-week basis. Even the most dedicated employee will soon burn out. All employees need some time to take care of their personal needs. No worker should be on call 24-hours a day. If the elder care recipient needs frequent supervision or care during the night, a family member or second home health care worker should be able to help out or fill in.

Live-in assistance may seem to be more convenient and economic than hourly or per-day employees but there can be drawbacks. Food and lodging costs must be calculated into the total cost of care, and it could be difficult to dismiss someone without immediate housing alternatives. If you decide to utilize a live-in arrangement, the employee should have his own living quarters, free time, and ample sleep.

Job Expectations and Considerations

Before hiring a senior home health care worker, you should go over the tasks you expect them to perform and other issues, such as promptness, benefits, pay scale, holidays, vacations, absences, and notification time needed for either employer or employee before employment is terminated. If you work and are heavily dependent on the home health care worker, emphasize the importance of being informed as soon as possible if he or she is going to be late or absent so that you can make alternative arrangements. Be clear about notification needed for time off, or what to do in the case the home health care worker experiences a personal emergency that requires them to abruptly leave work. It is important to have a backup list of friends, family, other home care workers, or a home health care agency you can call on.

Be clear about issues concerning salary, payment schedule, and reimbursement or petty cash funds for out of pocket expenses.

You should spend the day with the home health care worker on his first day to make sure you are both in agreement over how to carry out daily tasks. It would also be helpful to supply the home health care worker with a list of information on the elder care recipient such as: special diets, likes, dislikes, mobility problems, health issues, danger signs to monitor, possible behavior problems and accompanying coping strategies, medication schedule, therapeutic exercises, eye glasses, dentures, and any prosthetics.

You should also provide the following information to your home health care worker: your contact information, emergency contacts, security precautions and access to keys, clothing, and locations of washing/cleaning supplies, medical supplies, light bulbs, flashlights, fuse box, and other important household items.

Transportation

Another big consideration in hiring a senior home care worker is how he or she is going to get to work. If they do not have a reliable car or access to public transit, then you might want to consider hiring someone to drive him or her, which might be more economical than using taxis. Inform your insurance company if the home health care worker is going to drive your car when caring for the senior. Your insurance company will perform the necessary driving background checks. If the home health care worker is using his or her car to drive the elder care recipient, then discuss use of her or his car, and conduct a driving background check.

Insurance and Payroll

Check with an insurance company about the proper coverage for a worker in your home.

Make sure all the proper taxes are being drawn from the employee’s check by contacting the Internal Revenue Service, state treasury department, social security, and the labor department. If you do not want to deal with the complexities of the payroll withholdings yourself, than you can hire a payroll company for a fee.

Even if your home health care worker is working as a contractor, you are still obligated to report the earnings to the IRS. Talk to your accountant or financial adviser about making sure you are following IRS rules.

Ensuring Security

You should protect your private papers and valuables in a locked file cabinet, safe deposit box, or safe. If you are unable to pick up your mail on a daily basis, have someone you trust do it, or have it sent to a post box. You should check the phone bill for unusual items or unauthorized calls. You should put a block on your phone for 900 numbers, collect calls, and long-distance calls.

Keep checkbooks and credit cards locked up. Review credit card and bank statements on a monthly basis, and periodically request credit reports from credit reporting agencies. Lock up valuable possessions or keep an inventory of items accessible to people working in the house.

You can help to prevent elder abuse to your loved one by:

Make sure the home health care worker thoroughly understands his or her responsibilities, the elder care recipient’s medical problems and limitations, and how to cope with stressful situations.
Do not overburden the home health care worker.
Encourage openness over potential problems.
The following are possible signs of elder abuse or neglect:
Personality changes
Crying, whimpering, or refusing to talk
Sloppy appearance
Poor personal hygiene
Disorganized or dirty living conditions
Signs of inappropriate sedation, such as confusion, or excessive sleeping
Mysterious bruises, pressure sores, fractures, or burns
Weight loss
If you suspect abuse, act immediately. Do not wait until the situation turns tragic. Investigate the situation by talking to the elder care recipient in a safe situation, or install monitoring equipment. Examples of abusive behavior include yelling, threatening, or over controlling behavior that could involve isolating the senior from others. If the situation is serious, you should replace the home health care worker as quickly as possible. If you fear the elder care recipient is in danger, he or she should be separated from the home health care worker as soon as possible. Place the elder care recipient with a trusted relative or in a respite care facility. Make sure your loved one is safe before confronting the home health care worker, especially if there is concern about retaliation.
Report the situation to Adult Protective Services after ensuring the safety of the elder care recipient. The police should be contacted in the case of serious neglect, such as sexual abuse, physical injury, or misuse of funds.

Supervising a Home Health Care Worker

The most important thing to remember after hiring a home health care worker is to keep the lines of communication open. You should explain the job responsibilities clearly, and your responsibilities to the home health care worker. Do not forget that the home health care worker is there for the elder care recipient and not the rest of the family. For live-in arrangements, the maximum amount of privacy should be set up for the home health care worker’s living quarters. Meetings should be set up on a regular basis to assure that problems are nipped in the bud. If conflicts cannot be resolved after repeated attempts, than it is best to terminate the employee. In such a case, you may have to either place the elder care recipient in a nursing home temporarily or hire a home health care worker through an agency. Reserve funds should be kept on hand in the case of such an emergency.

General Eligibility Requirements for Home Care Benefits

Hiring a home health care worker directly is usually less expensive than hiring through a home health care agency; but if the elder care recipient is eligible and you wish to use assistance from Medicare, you must hire someone through a certified home health care agency. For the senior patient to be eligible, three or more services must be ordered by a physician. Other factors or eligibility are the required need for skilled nursing assistance, or one of the following therapies: physical, speech or occupational. The elder care recipient’s medical needs will determine asset and income requirements.

Hiring Home Health Care Workers through Home Health Care Agencies versus Independently

Different health professionals can assess the elder care recipient’s needs. A nurse or social worker can help with design and coordination of a home care plan. Your care manager, doctor, or discharge planner can help with services being covered by Medicare. They generally help make the arrangements with a home care agency.

You should ask the home health care agency how they supervise their employees, and what kind of training their employees receive. Find out the procedures for when an employee does not show up. Also ask about the fee schedule and what it covers, there may be a sliding fee schedule. Furthermore, find out if they have a policy for minimum or maximum hours. Ask the agency if there are any limitations on the types of tasks performed.

Especially if you have to pay for the care services yourself, find out if there are any hidden costs such as transportation. If all the costs for hiring a care worker through an agency become too much, you may want to consider hiring directly.

Hiring independent home health care workers is not only more economical than using an agency, but it also allows more direct control over the elder care.

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The cozy warmth of a log cabin designed with magnificent cusped arches has a very dramatic feel. The plank floors, an Anglo Indian carved wood railing, peeled patina rustic door cabinets lend a vintage sophistication to the entrance, which leads to the living room in the gorgeous Colorado Ranch Cabin. A tribal Indian Manjoosh or kitchen chest with iron cladded door and carved horse heads is enchanting in its earthy red patina. A Buddha bust sits atop with mala beads in amethyst and Lapiz Lazuli reminding you to take some time out for meditation and self improvement.

Using reclaimed woods and natural distressed handmade furniture we are being environmental conscious, opting for recycled materials through out the Idaho lodge. The holistic renovation retained the original logs and also salvaged dying trees on the farm for posts, the wood floors and panelled walls. Rustic and eclectic vintage trunks studded with iron nails and straps gives the grounding element to the living room removing harmful ions and making the energy positive.

The 5,000-square-foot log house on Long Island, New York, features an antique Indian double door with iron horse shoes and an elaborate header carved with fishes and peacocks. The triple arch veranda encases the bay windows, rustic old world architectural design at its best. The hand loom cotton throws are used to upholster the plush sofas. Printed by hand in vegetable dyes they are totally in sync with Nature and have a minimal carbon footprint. Hand Woven cotton textiles are good for Mother Earth, our climate and are all natural. The bathroom vanity is repurposed from a console that is made from salvaged doors. Reclaimed old woods add to the rustic beauty of the decadent cabin, merging luxury with conscious design.

In this review, we examine some pertinent and extant academic literature on effective adverse selection and moral hazard optimal mitigation strategies. Each mitigation strategy has costs and benefits. Therefore, the objective function is to maximize the net benefit of mitigation strategies. In practice, the optimal risk mitigation strategy equates marginal costs to marginal benefits by minimizing the incidence of adverse effects derivative of decision failures and maximizing the profit producing capacity of the enterprise.

Adverse selection and moral hazard are terms used in risk management, managerial economic and policy sciences to characterize situations where one party to a market transaction is at a disadvantage due to asymmetric information. In market transactions, adverse selection occurs when there is a lack of symmetric information prior to agreements between sellers and buyers, while moral hazard occurs when there is asymmetric information between the two parties and material changes in behavior of one party after agreements have been concluded.

For example, adverse selection arises in any situation in which one party to a contract or negotiation, possesses material information relevant to the contract or negotiation that the other party lacks; this asymmetric material information leads the party lacking relevant and material information to make decisions that cause it to suffer adverse effects. Therefore, adverse selection occurs when one party makes decisions without all the relevant material information, which changes the risks allocation between the parties to the transactions.

When one party has access to better or material relevant information than the other party during a transaction, it is said that one has asymmetric information. Therefore, when a party has asymmetric information, they may make an adverse selection. Adverse selection arises when the actual risk is substantially higher than the risk known at the time the agreement was reached. One party suffers adverse effects by accepting terms or receiving prices that do not accurately reflect actual risk exposure. The consequences of asymmetric information may be exacerbated by bounded rationality and cognitive biases attendant to most competitive use of information. Conversely, moral hazard occurs when a party conceals or misrepresents material relevant information and changes behavior after the agreement is concluded and is shielded from the consequences of the risks emanating from material change in behavior.

Economic and policy sciences suggest the decision makers must not only know, but indeed, understand and anticipate consequences of asymmetric information to mitigate risks of adverse effects attendant to adverse selection and moral hazard. There are classic examples from academia and insurance industry.

Non-selective academic programs attract a disproportionate number of students whose previous academic background and profile make them higher risk for academic success, retention, graduation, and placement. Indeed, this is a classic case of adverse effects derivative of adverse selection and moral hazard.

For example, non-selective admission process combines recruitment and selection which results in adverse selection. And once admitted, refusal to attend classes, refusal to complete assignments, refusal to take notes in classes, critical listening, disruptive and inattentive conduct in classes are instances of post-enrollment moral hazard that make non-selective students a higher risk for retention, graduation and placement. Please note, it is not the change in behavior per se that causes moral hazard in this instance. It is the discounted consequences from changed behavior that gives rise to moral hazard.

There is gathering evidence that some of these non-selective academic programs are increasingly willing to accept higher risks derivative of adverse selection and moral hazard because their operating budget is enrollment driven. Therefore, in the short-run enrollment is a more pressing need than retention, graduation and placement rates. The focus on enrollment is necessary but short-sighted and misguided because in practice, these benchmarks and indices are interrelated, circular and cumulative.

In the insurance industry, insured healthy females in child bearing age and healthy middle-aged females who subsequently seek creative ways to get pregnant present adverse selection and moral hazard problems. Further, insurance applicants whose actual risks are substantially higher than the risks known by the insurance company are potentially interesting case studies. The insurance company suffers adverse effects by offering coverage at premiums that do not accurately reflect its actual risks exposure.

Risks Mitigation Strategies and Some Practical Guidance

Please consult with competent professional for specific advice. The following are general guidelines based on review of extant academic literature, cumulative professional practice and best industry practices. In sum, adverse selection and moral hazard derivative of asymmetric information expose parties to transactions to undue amounts of higher risks for which they are not adequately and appropriately compensated. Therefore, it is essential for parties to take all the steps possible to mitigate risks of adverse effects derivative of asymmetric information and the attendant decision failures.

Managerial economic principles and best industry practices suggest screening and sorting to mitigate adverse selection, and incentive contracts to mitigate moral hazard. Additionally, strategic intelligence systems (SIS) that provide relevant, accurate and timely identification and quantification of risk factors is strongly recommended.

In risk management, the use of aggregate limits of liability and policy riders that proscribe post-contract material unilateral actions, and caps aggregate financial risks to parties is strongly recommended. Further, dispositive disclosure, discovery, monitoring, random inspection, and verification are highly recommended.

Finally, because adverse selection derives from hidden characteristics and profiles and moral hazard derives from hidden actions, the decision systems and strategic intelligence systems must be transparent and provide relevant, accurate and timely information to facilitate decisions based on known probability of risks incidence and allocation between the parties to the transactions with due and appropriate compensation.

When you come across a game of craps, there’s a good chance that it will employ the standard rules. However, variations on craps do exist, and the following are some of the most common:

Simple Craps – In this basic version of the game, the player wins on a roll of 2, 3, 4, 10, 11, and 12. If a 5, 6, 7, 8, or 9 is rolled, the player loses.

High Point Craps – A player wins if they get an 11 or 12 on their first roll. If a 2 or 3 are thrown on the initial roll, the dice are returned to the player for another try. Any number from 4 to 10 can be established as the point, and the player must exceed that total on their next roll.

Crapless Craps – The player can’t lose on the come out roll, but the only automatic winner is the 7. Since the house edge is nearly quadrupled, most experienced players avoid this game.

Die Rich Craps – A single die is used in this version of the game, and the player wins on the come out roll by getting a 6. The pass line bet loses on a 1, and the numbers 2 through 5 establish the point. The player then gets three rolls to make the point, and the payout fluctuates with the number of rolls. Rolling a 1, however, always results in a loss.

Chuck a Luck – Three dice are rolled from a shaker, and players wager on a number from 1 to 6. The bettor wins according to how many times their chosen number comes up on the roll. While it’s closer to sic bo than craps, novice players may confuse the two.

New York Craps – There are several differences in the rules, but the biggest is that Come and Don’t Come wagers aren’t allowed. This variant can be found on the East Coast, as well as certain parts of Europe.

Best Craps Bets

If you want to reduce the casino advantage as low as possible, stick with the following wagers.

Pass Odds- If the come-out roll results in a 4, 5, 6, 8, 9, or 10, the player can take odds by wagering a set multiple of the pass line bet. This new wager wins if the point is made, and it pays at the following odds: 2:1 for a 4 or 10; 3:2 for a 5 or 9; and 6:5 for a 6 or 8.

Don’t Pass Odds – Like the previous wager, except this time the player is betting on a 7 to be rolled after the point has been established. Pays 1:2 against a 4 or 10; 2:3 against a 5 or 9; and 5:6 against a 6 or 8.

Worst Craps Bets

Craps at US casinos provide a lot of fun betting options, but some of them are heavily slanted in favor of the house. If you want to gamble smart, always avoid the following wagers:

Any 7 – Pays 4:1if the shooter rolls a 7. Unfortunately, the house edge is 16.67%.

World – Pays 26:5 if a 2 or 12 are rolled and 11:5 on a 3 or 11. If a 7 comes up, the result is a push. The house edge is 13.33%.

The Art of Dice Control

If you’re playing craps games online, this won’t be an option. For the land-based player, however, dice control is an interesting strategy that’s intended to negate the random nature of the game. The player positions the dice in his hand and tosses them in such a way that they graze the back wall instead of bouncing off.

Casinos frown on dice control, so hours of practice are needed to perfect its execution. Some Gamblingpedia.org experts argue that it’s impossible to determine the outcome of the roll with any consistency, although there are players who claim over 100 throws in a row using this method.