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What Home Care Is Covered By Medicare?


What home care is covered by Medicare
Is there any financial help for caregivers?

Starting home care is often a challenging time for both the patient and the caregiver. Factoring in the financial component and what’s covered and by whom can make a stressful situation even harder. 

Home care services are a valuable Medicare benefit. They supply therapy, skilled medical care and other assistance to people that are who are largely or entirely confined to their homes.

In order to be covered, the services must be ordered by a doctor, and one of the 11,000 home health agencies nationwide that Medicare has certified must provide the care. If these conditions are met, Medicare pays the complete cost of home health care up to 60 days at a time. 

That period is renewable, meaning Medicare will still provide coverage if your doctor recertifies a minimum of once every 60 days that the house services remain medically necessary.

The specific conditions enrollees must meet for home care under Medicare Parts A and B are: 

  • A doctor has certified that the person is homebound.
  • The patient is under the care of a doctor who reviews his or her treatment plan regularly.
  • A doctor has certified that the patient needs skilled medical care or some sort of therapy.
  • The patient only needs physical, speech, or physical therapy for a limited amount of time
  • The home health agency to provide care is approved by Medicare.
  • Additionally, other than durable medical aid, patients usually don’t pay anything for in-home care.
  • The need for skilled nursing is merely part-time or intermittent.

There are several items Medicare won’t cover, including:

  • Meals delivered to your home
  • Homemaker services (like shopping, cleaning, and laundry), when these are the only types of services needed
  • Personal or custodial care (like bathing, dressing, or using the bathroom), when these are the only types of services needed
  • 24-hour-a-day home care

Many patients may require assistance with activities of daily living but might not have an actual medical condition. While Medicare doesn’t cover that scenario, a long-term care policy can help with the expense of home health aides who provide custodial services. It can also help pay for assisted living facilities, which offer seniors the ability to live independently but receive the help and care they need daily.

Is there any financial help for caregivers?

According to a 2016 AARP study, they estimate that family caregivers spend a mean of $6,954 on out-of-pocket costs for caregiving, which equates to approximately 20% of their annual income. In order to cover the out-of-pocket expenses, many caregivers make sacrifices in their own lives. 

Overall the study found that caregiving puts a financial strain on individuals caring for an adult family member:

  • On average, caregivers lose 33% of their income
  • Approximately 11% of caregivers quit working to provide care for a loved one full-time
  • Women who quit working to become caregivers lose approximately a total of $300,000 in wages, pensions, and Social Security benefits
  • 78% of caregivers incur out-of-pocket costs due to caregiving
  • 56% of employed caregivers experience at least one work-related strain, in the form of reduced hours, different work hours, or taking paid or unpaid time off
  • 16% of caregivers reduce contributions to their retirement savings
  • Approximately 50% of caregivers reduce leisure spending (dining out or vacations) due to caregiving expenses

Fortunately, there are several options for finical aid for caregivers. 

  • Medicaid – Aid may be available from the state for elderly loved ones who are low-income and eligible for Medicaid. To learn about the financial aid programs available in your state, contact your local Medicaid office.
  • Long-Term Care Insurance – this is another financial aid option for caregivers. However, it is important to note that only a few such policies allow for family caregiver payments. Older policies tend to have such a provision, so it is more likely that older seniors who have long-term care insurance have policies that will pay family caregivers. It is a good idea to contact the insurance company or agent who sold the policy to determine whether the plan allows for caregiver payments.
  • Veteran-Directed Home and Community-Based Services Program – This program provides caregiver support and authorizes a monthly flexible spending account for purchasing goods and securing services for disabled veterans to live at home. Veterans who opt for this program may hire family to act as their caregivers or to provide support to family caregivers. 
  • Tax Incentives – Caregivers also may find some financial assistance via tax incentives. Caregivers who are adult children younger than age 65 may deduct the costs of qualified medical expenses and mileage that are greater than 10% of their adjusted gross income if they itemize their deductions. However, it is in your best interests to discuss your options with an accountant or other tax professional to determine whether taking a standard deduction makes more financial sense. There also may be other deductions caregivers can take at tax time. While tax incentives are not as immediate as financial aid, they are one way to relieve the financial burden on caregivers.
  • The Family Medical Leave Act (FMLA) – Workplace benefits may be available to caregivers as a form of financial aid as well. The Family Medical Leave Act (FMLA) ensures employees working for any company with more than 50 employees and who have been employed for 12 months (working a minimum of 1,250 hours during that period) are offered 12 weeks of leave; however, the leave overwhelmingly is unpaid. 
  • Paid Leave for Caregiving Employees – If you don’t live in one of the four states that have implemented paid family leave options, don’t get discouraged yet. Fortunately, more companies are assisting caregiving employees today with paid leave, and larger companies are most likely to offer elder care programs. 
  • Family Payments – If the care recipient is ineligible for Medicaid or another state program, and the tax breaks are not as large as you need them to be to compensate you for your caregiving time and related out-of-pocket expenses, look into whether he can afford to pay you himself or if other family members are willing to pay you for your caregiving services.. However, this is a subject that should be discussed openly with all involved family members and any arrangement should be agreed upon by all parties. If your family determines that family payments are manageable, be sure to meet with an attorney and draft a contract that outlines your work and payment schedule so everyone in the family knows the situation. The contract also may become useful later if your loved one eventually needs to apply for Medicaid or enter an assisted living facility or nursing home.
  • Home and Community-Based Services Program – Care recipients who are not veterans can opt into a home and community-based services program (HCBS) if they meet the eligibility criteria (which varies by state, but is typically based on income and a qualifying medical condition, though recipients need not be age 65 or older to qualify). These programs offer guidance and financial assistance to caregivers to ensure they can provide the best possible care for their loved ones. They can also boost caregivers’ confidence and make it easier for them to provide a high level of care to their family member.

Last updated Jan 23, 2020. Information subject to change without notice. Due diligence is required.

Maintaining the Charm of an Old Home


If you own an older home like I do then you know that constant maintenance and improvement is a must. Love it or hate it, this is merely the price we pay for the charm, quality materials and workmanship not seen in many of today’s contemporary construction practices and materials.

Nearly every facet of your home is in a constant state of flux – this year might present the need for new windows, next year a new roof. In fact, depending on the construction year of your home you know that constant upgrades and repairs are essential to keeping ahead of the curve.

Immediately after purchasing our 1928 home we replaced the roof. A few months later we began the arduous task of replacing nearly every window. This was costly and time consuming, but we agreed it needed to be done. Next we added insulation to the attic floor which, unfortunately, is not accessible for storage purposes (but this made the project that much easier).

Over the next few years we repaired a leak in the roof, solved a major leak stemming from our biggest window AC unit that caused extensive water damage both to the window frame, the ceiling underneath and even led to some issues with the exterior brickwork.

The ensuing years saw us forced to dig out the sewer drain which was located underneath a four inch thick concrete slab … no small feat. A twelve foot hole, nearly eight feet wide was dug directly outside the back door in the middle of January. The inconvenience lasted well into the late spring and we had a perfect mud pit between the driveway and the back door with no alternative route. In desperation we built a makeshift plywood “dock”. Far from perfect, but it did its job and sufficiently eliminated most of the mud.

One of the best rewards you can give yourself is to cultivate a strong relationship with a home maintenance company with whom you trust, both for their workmanship and integrity. Finding such is not always easy – there are far too many to choose from in most communities. But if you are careful and know what your needs are the process can be significantly simplified. Best of luck with your next project!

basement note: info

Nothing but…A little Change


Best Practices and Process Improvement

Why are business professionals publically in favor of terms such as Best Practices and Process Improvement, but silently dread them in private?

One would think identifying the top methods in their industry would have great appeal. Improving procedures would be near the top of all professional’s on-going education.  Yet, far too many of these individuals revel in putting major stumbling blocks for transformation between them and the success they ultimately seek.

We often encounter these business professionals fighting this change every inch of the way, with arms folded and heels dug in. Fears include increasing costs, demonstrating competency and sustaining quality.  The ego of leadership can also be a major stumbling block. Past failures with innovation can make a company shy about new efforts. Yet, none of these are valid excuses.

Many organizations lack the brutal honesty to deal with changes in policies, processes and procedures. Only when laws are passed and mandates are made will these companies react to these better practices. Trusted, tried and true methods often have with them a perceived safety net effect. If it worked in the past, many rationalize that it still has to be relevant.

A young equipment leasing sales rep once reported that he was calling on a capital equipment dealer and his contact was the company’s general manager, a man many years his senior. His company appeared perfect for leasing and finance programs. When he would ask the general manager questions about financing options for their customer, the prospect would reply, “Steve wouldn’t like it.”  Each question would inadvertently boil down to the same response, “Steve wouldn’t like it.”  About forty minutes into the sales call, the young account manager asked the sales manager, “I keep hearing you say that Steve wouldn’t like it. May I talk to him and find out what he really thinks?” The general manager responded, “Steve died in 1977.”  The tried and true methods from preserving “The Legacy of Steve” had won out over offering their customers payment plans and finance options.   The account manager reported the company was sold eighteen months later.

Leading and innovative organizations know differently. They are part of the disruption culture. They fully understand that if they don’t look to the horizon and watch what’s coming, they will be found out of style, obsolete or part of the past just like a Montgomery Ward’s catalogue. Having an empowered team of professionals who do the right thing every time, see their part in the picture and can adapt to new tools, techniques and thoughts on how their industry works is critical to maintaining long term success.

In today’s evolving business marketplace, companies need to respond with every best possible method to leverage efficiencies, protect margins, improve process and remain responsive to competitive pressures. The idea behind studying and implementing Best Practices and Process Improvement is crucial. Organizations who perceive change as a strategy to avoid are as outdated as continuing to manage one’s operations by the Gospel according to Steve, circa 1977.

Nothing but…A Little History


Major events and steaks just seem to go together and there’s seemingly no more of a classic American meal than steak and potatoes. This means that steakhouses have become American, and particularly Midwestern, staples. It of course was not and has not always been this way. So, how did these oh-so delicious establishments come to be popular?  How are they being reinterpreted for the modern palette? Let’s explore.

In the 1800s, the popularity of red meat was on the rise, and those seeking the best cuts were located in New York City, the home of the first steakhouse. Because of the demand in the city for quality products, restaurants opened in order to cater to that need. Thus, the steakhouse was born.

They started, though, as food establishments that served meat along with beer and other pub and bar style drinks. They also played on many of the European food concepts. Take the porterhouse steak, for example. The name of the porterhouse steak was derived from a cut of meat often served in pubs with porter ale. As time went on, and these establishments became known for having alcohol and meat, steakhouses became masculinized, and with that, became exclusive. Prohibition made the growth of steakhouses a bit difficult, but people continued to want delicious meals and premium steaks. And nothing makes people want a product more than exclusivity. As exclusivity continued to rise and steaks and masculinity became synonymous with one another, prohibition was ending and popularity rose astronomically.

People flocked to steakhouses in New York City, and word spread until the meals served there became American staples. This trumped the foods many had previously considered elements of an all-American meal, namely hot dogs and hamburgers. And while a hot dot at a baseball game and apple pie for dessert are ingrained in our hearts as edible representations of America, this is a hearty meat and potatoes country. Steakhouses continued to spread to other parts of the country, and arguably made their most welcome stay in the Midwest.

But it wasn’t just about the food. Yes, steaks have clearly been the defining factor of the steakhouse concept, but people could easily buy and make steaks at home. There was a very specific ambiance that these restaurants created. Going out to dinner became a special occasion, and with that so did steaks. Steakhouses became an excellent place for couples to enjoy a meal together, and they also were a welcome environment for families who wanted to treat themselves to a lovely dinner out.  But this was not always how families celebrated; it was a progression over time. So, if you love your local steakhouse and you equally love dining out, you can thank 1960s America.

Since then, several steakhouses can be found in each city, and choosing the right one can seem daunting. Premium cuts of meat, interesting takes on classic dishes as well as expertly cooked favorites are all signs of a wonderful steakhouse. Some might have a more formal ambiance while others are casual, and of course, that makes for exciting restaurant options. And options, paired with quality cooking, are beautiful things.

Once you’ve found a favorite steakhouse (or two—they’re wonderful establishments) you’ve also found the perfect hosting spot for a large dinner event or even a banquet. What better way to showcase appreciation, happiness, love, celebration or excitement than with a delicious, filling meal? What better way to talk something out or ease a bad time than with a cooked to perfection medium rare steak?

Though steak options are primary on the menu because, let’s face it, they are steakhouses, there are a variety of options to choose from at your favorite local steakhouse. From chicken dishes to varieties of potatoes to salads and soups and excellent starters, the options for a delicious meal and an entertaining banquet are plentiful.

Really, once you’ve found a steakhouse and location you love, any occasion is the perfect occasion to get together and have a meal or host an event. Celebrate anything from a birthday to a holiday to a family get together to girls or guys nights with a delectable and always memorable meal at your favorite steakhouse.

So grab your date, your friends, or your family and get ready for a classic, delicious, and hearty meal. And, of course, don’t forget to thank the wonderful people of New York for creating a genre of restaurants that plays off of European tradition, but is American to its core.

Nothing but…A Little Sound


A popular saying among musicians is that they’re only as good as the person running the sound for them. Obviously, there is plenty of talent on display when a professional band takes the stage, but having an audio engineer with an expert knowledge of mixing a band in a live setting can make or break a single performance. Another complication can arise if the lighting of the stage is poor. The band needs to be visible to the audience first and foremost, but there also needs to be a presentation of the artistry on display through the lighting design. If the lights compliment the tone and energy of a particular song, the audience will be that much more engaged. Knowing these facts are half the battle when it comes to having live music at a corporate party.
With spring finally here, corporate  parties happen a lot between now and the holiday season, and in the coming months outdoor venues are generally the preferred locale. You know that you want a true professional, someone who has mixed bands of every size at an outdoor concert. The first thing any sound person will think of is the lack of acoustics in that type of environment. You also want the band for a specific amount of time; probably going past sundown if that’s the kind of party you’re going for. Another red flag pops up: how will everyone see the band? Great lighting equipment and operators are just as critical as having an audio engineer who knows what he/she is doing.

Some bands, have a dedicated lighting equipment manager and audio engineer at every event. But that old saying, “It’s not what you say but how you say it”, applies to having musicians perform at a large corporate event. A general rule is that if the band knows they’re taken care of, and their only concern is engaging with the audience, the night will be a blast, not only for the guests but for them as well. Musicians tend to be much less stressed when they know that they can rely on a professional to mix them out front and in their monitors properly, rather than worry all night if they’re even coming through the speakers.
So when you’re planning your next party, hire the band that fits the occasion, but remember that professional sound and lighting makes all the difference in the world between a good company party and a great company party.

5 Essentials for Outdoor Festivals and Events


Spring is around the corner and that means festivals and events outside are sure to follow. The outdoors are great, but in many cases some structure or outdoor facility is still required to meet the needs of performers or attendees. Here are a few ideas to fill in the blanks for your upcoming festival.

1. Portable Lavatory
Often maligned as dirty and unsavory, this is nevertheless an essential part of any event where access to indoor plumbing is limited. Many lavatories are now equipped with pumpable water and hand sanitizer to alleviate any sanitary worries.

2. Pavilions
For fairs or family picnics, sometimes all that is needed is a little shade or cover from a spring rain. It’s important to have basic protection from the elements, especially during the summer heat and sun. Also, this is the critical element to any beer tent, besides the beer of course.

3. Air Conditioned Cool Down Booths
These are becoming common with VIP admission to certain events. It’s simply a room inflated with cooled air to help guests beat the heat. These are really nice for festivals that last a few days in the peak of summer. Maintaining body temperature is very important in July heat to avoid sunstroke or dehydration.

4. Expandable Trailers
Expandable trailers are custom built to suit the needs of any outdoor event. They provide power and a stage for performers, or can function as an installation for art or educational pieces for expos. The interiors are even suitable as classrooms or command centers for extended usage. Trailers can create enclosed shelter or have completely collapsible walls and graphic art for banners or logos. They are versatile and powerful solutions for a number of functions.

5. Water Fill Station
Environmentally conscious festival goers are moving away from overpriced disposable water bottles in favor of these multi-spout filling stations. It’s more common now to see attendees refilling water bottles or Kamelbacks, and it’s much easier to enjoy nature knowing you aren’t harming it as much by your presence and consumption. These will keep you hydrated and minimize your footprint on the environment.

The myriad opportunities to experience outdoor events this summer are meant to be enjoyed without worry for necessary facilities or concerns for well-being. It’s important to be aware of your safety, but that shouldn’t stop anyone from having a great time in the sun.


Nothing but…A Visit


An apple a day keeps the doctor away. We all know that. But what can we do everyday that helps us keep the dentist away?

For starters, always brush your teeth. It seems that when we were kids, it was very easy to brush your teeth twice a day because your parents made you. Then things start to slip in college, and by the time you have kids you have forgotten about your own hygiene. Flossing is also just as important, but often people don’t take the time to fumble with the conventional string. Instead of the typical floss, try the flossing picks that are now in stores. The flossing picks allow you to floss in the back of your mouth without trying to awkwardly cram you fingers near your tonsils.

Mouthwash is often important as well. However, there are a lot of brands to choose from. Check with your dentist on which mouthwash would be best for you.

One thing to be careful of is whitening strips. Yes, we all want whiter teeth, but it’s important to make sure your not doing yourself more harm then good. You might be stripping your teeth of important nutrients in the process of changing their color.

The next time you visit the dentist make sure to ask what you can do everyday to make sure you’re keeping your teeth as healthy as they can be.

Nothing but…A Close Call


Close calls are at the bottom of the safety pyramid. But, they can escalate.

We’ve all had them. That close call where you almost got hit by a speeding car, that time you almost slipped and fell, that time you got lost with a dead battery. Don’t feel bad, because we’ve all had close calls. we all take that deep breath and forget about it the incident. However, don’t be so quick to forget about that close call. It may be a warning to change your practices or how you act, before your close call actually turns dangerous.

If you’ve had a close call at work, let your boss or supervisor know. They don’t want you getting hurt anymore than you want to. If safety is becoming an issue in your workplace, than maybe it’s time to bring in a safety consulting firm to implement safety practices.

If you’ve had a close call while driving, you know it can be scary. Car accidents are no joke, and safety on the road should be taken very seriously. If you are worried about your skill set when it comes to driving, then see if you can enroll yourself in a driver refresher course. Unfortunately when it comes to driving, there aren’t many alternatives unless you are in a large city. Carpooling, walking or biking are always other options as well.

If you’ve ever had a close call while at home, whether it be a slip in a kitchen or a trip down the stairs without breaking or injuring anything, count yourself lucky. However, next time you might not be so lucky. This about any hazards in your hallways or stairs, any slippery surfaces. When it comes to clutter and stuff, less is more.

When it comes to close calls, let’s be optimistic and hope that no accidents happen. But, let’s be safe, just in case they do.

Nothing but…A Little Cold


It’s midway through this winter, and it’s certainly feeling quite arctic. Cars are groaning to a start, pipes are starting to freeze, sidewalks are turning into rinks and so on. Then one day when you pick up your mail your heating bill comes, and your heart almost stops looking at the amount due. How can one place rack up so much in heat? But then you remember, the temperature outside is flirting with below zero and your windows are starting to frost over.

Check out these couple of tips on how to save yourself some money when it comes to your heating bill this winter:

1. Lower your thermostat either when you’re gone for the day at work or during the night.
2. Invest in drapes or blinds that will further bock the cold air from sneaking in. You want to keep the cold air out and the warm air in.
3. Call a local plumber or someone who can check the outside of your house for leaks or openings. If you house feels drafty at all, chances are you’re wasting heat.
4. Space heaters sometimes take up more energy than your normal heating unit. Sometimes, blankets are the best bet.

Keep warm this winter, friends!

Nothing but…Dinner


It’s New Years Eve Day! Which means everyone is running around, trying to get out of work, figure out midnight plans and keep track of family members. But what about dinner?!

It’s important to get a good meal before the long night. Kids need energy to stay up so late, adults need a hearty dinner for the same reason. Plus, eating one good meal before is healthier than snacking throughout the entire night on fattening dips and foods.

Instead of cheap Chinese takeout, think of getting take-out from a local restaurant. It’s a healthier, tastier option than pizza or fast food. Or, if you want to go the homemade route, think crock-pot or slow cooker.

Happy 2014, everyone!