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Care Home Corner.

​Welcome to the Care Home Corner blog where we reflect on the business of caring for seniors and individuals with disabilities in Oregon. 

Provider Spotlight: Margaret Gikaru, RN-BSN

5/31/2022

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We want to continue to highlight the work of our amazing adult foster care home providers in Oregon.

Matt Gannon spent some time talking with Margaret Gikaru, RN-BSN, operator of Troutdale Adult Home Care, which is a classification 3 care home in Multnomah County. Please read below to learn more about Margaret.
Tell us a bit about your background and what lead you to work in care and service.
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My husband and I arrived together in the United States from Kenya in 1995. We flew into Los Angeles with only $70 between us, and I was 9 months pregnant. We started our lives in the United States in California but moved to Seattle, Washington two years later.
 
Being African immigrants, we are used to taking care of our elderly and I helped to take care of my grandma when I was a little girl. We didn’t have nursing homes in Kenya then. When our parents grew old, we’d take care of them. It was a new experience for us when we came to America and realized we could work in care settings to take care of elders. We decided to move from California to Washington because most of our family was in Seattle.
 
I started working as a certified nursing assistant (CNA) and started working in a nursing home in 1997. We recognized that it is easy to get a job as a CNA and raise a family. Within a few weeks, you can be working with a certificate from the state. While raising a family, we found this to be easier than having an office job, especially arriving from Kenya. I then began working in in-home care and was also working at an adult family home. I worked as a CNA for a total of six years.
 
My husband was in a different field before we started this business, mostly in computer software engineering and health information management systems focused on global health. Switching his career to be part of this business was a challenge, but he fit in quite fast,  and I value his support.

At what point did you decide to become a nurse?
I was encouraged by my manager at the time who was a registered nurse (RN) and was the owner of the adult family home I was working in. She encouraged me to go to school to become a licensed practical nurse (LPN). She saw something in me. In fact, she once told me if she ever got ill or needed care, she would want me to be her nurse. After graduating as an LPN, I worked at a home care agency for six years while pursuing my RN degree.
 
After graduation, I continued working for the home care agency. Soon thereafter, I went back to the same school to get my bachelor's degree in nursing, BSN. Soon after graduation, I started working at Valley Medical Hospital, a University of Washington affiliate. I worked there for six years - three of those years were in the intensive care unit (ICU). I worked there up until January of 2021, which was right before starting our Troutdale Adult Home Care business in Oregon. 
Why are adult foster care homes so special?
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As compared to institutional care, you can care for people in a more person-centered way. For example, regarding a resident's diet, the idea is to create an environment that is as like a family home as possible. Serving only five people we can really tailor the menu to the residents' desires, so this is never a problem.
 
Because it is a home-like setting, we can be more flexible in involving the special and important family and friend connections. We feel it provides better outcomes for the residents in this type of care setting. We have live-in caregivers, and they get to know the residents in a uniquely special way, as compared to many other places where turnover is high and the few caregivers working must care for so many. There is more consistency here, and this is good for everyone. 

"We feel it provides better outcomes for the residents in this type of care setting." ​
What does nursing add to the overall success of care homes?
Because of my experience and training I can move into any high-acuity care situation with a resident and provide the right care to them with confidence, ease, and experience. When giving reports or communicating with the healthcare teams, I understand the language and can interpret important information. This is information such as what to ask and how to use my voice as an advocate, and this can make things so much clearer for everyone. This matters for quality of care. This experience and skill set makes a difference.
What do you love most about the work you do?
We live where we work. Having the flexibility makes a real difference and I enjoy being my own boss. Countless times in my career my patients or residents have told me they cannot do what I do for people, and they don’t know how I do it. It is in those times I know I am making a difference, and we get to make this difference in our own care home and do this together.
"It is in those times I know I am making a difference, and we get to make this difference in our own care home and do this together."
Anything else you'd like us to know about you?
We have four kids: three boys, and one girl. In this country, there is the old motto from the Army “be all that you can be,” and as immigrants, we feel we are here to achieve our dreams. Now, we are doing just that, and we know we cannot do this where we come from. Also, as immigrants, we are so very grateful to have the opportunities we've had and to create the life for our family that we want.
 
Together, we notice some challenges in this business. Finding caregivers is one of the biggest and we know this is a problem in many different healthcare settings. As a community of care home providers, we do not have a voice yet. We, and some other interested providers, are looking to gather and create a Council of Providers and have a seat at the table at both the state and county level to create necessary changes in the industry.
 
You can reach out to Margaret at troutdalehomes@gmail.com.

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Author

Matthew Gannon is a communications coordinator & trainer with Oregon Care Home Consulting & Training.

Email Matt.

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Provider Spotlight: Cherie Bray

3/16/2022

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We want to continue to highlight the work of our amazing adult foster care home providers in Oregon.

Matt Gannon spent some time talking with Provider Cherie Bray, owner of Country Comfort Adult Foster Home in Lane County. Please read below to learn more about Cherie.
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​How long have you worked in the adult care home business?
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I've worked in the business since July of 2015. I was a career hairstylist and was looking for something new, so I enrolled in Lane Community College's Women in Transitions (LCC WIT) Program. My co-worker from the salon later referred me to a caregiver job at Country Comfort Adult Foster Home in Veneta, Oregon. Country Comfort was established in 1999 and is a class 2 home. I ended up taking the caregiving job and after thirty days I knew this was exactly what I wanted to be doing, so I quit my other career. 

For the next three years, I was groomed and mentored by the provider of the adult foster home. I then became a co-licensee of Country Comfort in February of 2018. Then, in May of 2018, I took over the business completely when the previous provider retired. 
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For about the first ninety days, I was the only caregiver and worked full-time doing everything to completely wrap my arms around the responsibility I took on, and to get my bearings. Opportunities for staffing support presented itself, and once I had that support and partnership, I was really underway. 

What do you believe makes adult foster care homes special?
The adult foster home model is designed to enable people to live independently in a family home environment, but it is much more than that. Too many people become isolated in later life. The adult foster home gives them more of an opportunity for new connections, sustaining old connections, and supporting traditions and life experiences. We don’t want people to feel isolated at the end of their lives, and so we give them a place to feel like this transition and the experience of us all being together in the home is another positive chapter in their life.
My journey from career hairstylist to caregiver opened a path to service for me that is so much more profound... 
​What do you love most about the work you do?
This career came to me as my youngest child was going to college, so I was going through the empty nesting stage which is a big change. The adult foster home allows me to continue to care for others. Being the provider of the home has afforded me so much healing in my own life through caring for others, and it distracts me from any of my own issues. This healing began to happen immediately when I took my first job and began serving others in this special way, and it continues to do so.  My journey from career hairstylist to caregiver opened a path to service for me that is so much more profound than just helping someone look pretty. 

There was a woman living in the home early on in my caregiving career, Mrs. H., who was nonverbal and a full assist with ADLs (activities of daily living). We meet people in this stage at times, and you of course never knew them before they required the level of support you must give, even though they’ve lived a very full life up until you become a part of their life. Something special happened. I realized she would respond to my touch, and if I gently put my arms around her, she would then begin to lean into me and want me to hold her. I realized I made a difference to her with this act alone, in this world - in her world, I made a difference through my presence and through my touch. 
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She was also the first resident I cared for who passed away. I realize still to this day, what I do as a provider, I do for her and the gift she gave me. 
It is successful work when you are being told that your presence and what you do makes a difference in their lives - this is what it is all about for me.
What do you believe makes someone’s work successful?
Positively impacting the lives of others; providing a safe home for the residents and protecting them in some of the darkest days they've ever had. It is successful work when you are being told that your presence and what you do makes a difference in their lives - this is what it is all about for me. 
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Since taking over as sole provider, I’ve also incorporated hospice care through a community partnership. This partnership has allowed me to also be there for my residents until the very end. It makes me feel triumphant in my work of service knowing I was able to serve them the whole way home.
Anything else you’d like us to know about you?
I do not do this work alone. My best friend is my live-in substitute caregiver. My daughter and her husband are my backup caregivers. With the pandemic, getting staff has been the greatest challenge I have ever faced in this line of work. 

My husband does all of our finances and shopping so we don’t have to worry about more exposure issues. Without them, the team, I could never do this at the level I do. 

The residents' families also become family to us. There are residents who’ve passed away, and their families still remain in touch with us as time goes on because they value the ongoing connection. It helps them feel closer to their loved ones, I believe.

​Being an adult foster home provider has given me the extended family I’ve always wanted. I make sure everyone hears from me just how important they are to me. This is key.  We invest in everyone's self care in different ways because it matters to us that everyone has the balance in life to be happy and not rundown. 
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And, I know you cannot give what you haven't got, so it starts with me. 
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​Visit Country Comfort Adult Foster Home on Facebook. 

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Author

Matt Gannon is a communications coordinator and trainer with Oregon Care Home Consulting & Training.
Email Matt

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Provider Spotlight: Hana Legesse

11/8/2021

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We want to continue to highlight the work of our amazing adult foster care home providers in Oregon.

Matt Gannon spent some time talking with Provider Hana Legesse, owner of Furlong Way Adult Foster Home in Beaverton, Oregon. She is both an Aging & People with Disabilities (APD) and Intellectual/Developmental Disabilities (I/DD) provider. Please read below to learn more about Hana.
How long have you worked in the adult care home business?
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When I was in high school I assisted the teachers in the special education class, and I discovered I truly loved working directly with people where I could make a difference. This stuck with me. When I graduated high school I became a private in-home caregiver where my skills to care for others really took shape.

While serving my clients as a private caregiver, oftentimes they would transition from their home to other levels of care, and I would continue to work with them through their transitions. It was during this time I was exposed to what caring for a lot of people in a large place looked like and it felt very busy, to say the least. Between 2014, and 2015 I made a switch from private in-home care to adult foster home care, in both APD and I/DD homes. 

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In 2019, I became a licensed APD care home provider and began Furlong Way Adult Foster Home in Beaverton. Earlier in 2021, I became Co-licensee of a DD-licensed Home in Beaverton.

What do you believe makes adult foster care homes special?
Care homes are built for companionship. Each day comes with flexibility, creativity, and one-on-one time together in many important ways, allowing the residents’ daily wishes, desires, and needs to be fully met. How the day unfolds is up to what the residents feel like doing or not doing that day. We can adapt to whatever the residents are feeling or needing and also have the time to throw in creative ideas or improvise and adapt to what is best for them at each moment of their day.

​This is a special way of providing care, and it is special to the residents who benefit from the one-on-one attention. We do virtually everything together, as a home and as a team, and we all are considerate of each other in what we decide to do. Companionship is key to making a difference as a caregiver, and caring for residents in a care home allows your relationships to have real depth, which I feel is special. 
Companionship is key to making a difference as a caregiver, and caring for residents in a care home allows your relationships to have real depth, which I feel is special. 
​What do you love most about the work you do?
This question reminds me again of being in high school and working with a teenager who was in the special education program. This student was living with Down syndrome and could not read. We worked together and tried different creative ways to approach reading, and after working with her for long enough it finally worked! She loved reading and was always wanting to do more and more, and she felt so good about herself.

​I love working on creative solutions to meet the needs of others, and when it works - the joy you feel is simply amazing. This is exactly what I get to do now with our homes. I also love being a part of resident care and their meaningful activities. We make sure our residents have the opportunity to participate in what matters most to them, and if that means taking a ride in the car with me to the store or going to the beauty salon together, we tailor it to what they like most and we get to do it with them. I love how I get to repeatedly have the same feeling of making a difference in our homes I felt when working in the special education classroom where it all began.
What do you believe makes someone’s work successful?
What makes someone's work successful is pushing through, even when things seem the hardest and not giving up. Also, staying motivated because you know what you are working toward and the difference it makes for you and all of the people around you. You also must remain positive because there will be times when you face difficult problems and obstacles along the way, but you cannot give up.

​Believe me, there are mornings I do not want to wake up early to go to the gym, but I push through anyway knowing it is best for me and for those who depend on me so I have the strength and energy I need to be my best. This is how you will find success. You must believe in hard work and how it pays off. You must continue to work hard, do the right thing, have integrity and understand the reason why you are doing what you do; believe in your "why" and believe in yourself. Be your own best friend and push through!
You must continue to work hard, do the right thing, have integrity and understand the reason why you are doing what you do; believe in your "why" and believe in yourself.
Anything else you’d like us to know about you?
Our residents and team really do all enjoy being together and making decisions that best support each other. It's a very harmonious and friendly atmosphere. We are great at teamwork. We are not afraid to get out of our comfort zones to do what it takes to meet the residents’ needs and to support the entire team. We all have individual strengths, and because we recognize this and can work to those strengths, everyone achieves more.

We have such a variety of skill sets and experience levels on the team and so we put all of the knowledge to good use in support of each other. I still have staff who began with me on day one. I depend on them for so much, and I recognize how they depend on me too. I invest in them by offering competitive wages, bonuses, vacation days, gifts for self-care, just to name a few. We also celebrate their birthdays and recognize and honor each of their own cultural and religious happenings throughout the year. 


I cannot be successful and our residents cannot be fulfilled without my team, and I make it a priority to know what they want or need to be successful. 
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We all have each other’s back, which makes all of the difference because no one can have a successful home all on their own. 

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Author

Matt Gannon is a consultant & provider services coordinator with Oregon Care Home Consulting & Training.
Email Matt.

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I See You: The Importance of Person-Centered Language in Dementia Care

3/26/2021

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Article by Matt Gannon
Smiling elderly woman
Life is fundamentally about relationships and our connections to others. Humans operate to gain and maintain control (in varying degrees) within relationships: to ourselves, with others, to our environment, spiritually, and to our place in the larger world around us. This is like a balancing act we operate throughout our lives.

​We ascribe meaning and purpose to the different relationships. Many relationships will shift and change over time, while others remain relatively the same. Within our relationships we have choices and we maintain control of our time, effort, participation level and, the interests being served - all of which shape who we are, our characters, and our identities. 
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The Dementia Experience

Dementia is progressive. Over time dementia demands a different type of communication to find and keep positive connections in relationships. Dementia creates a loss. For the people living with dementia, there is a progressive loss in abilities and independence.
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When we attempt to understand the dementia experience, what can become more understood is how a person living with dementia is losing a sense of control in their lives. 

One thing I have come to know well in my time of caring for people living with dementia is how life for them tends to become less about content and detail - and more about feelings. I also know people living with dementia do not lose their ability to feel, understand and recognize the emotion they are having when feeling it. They may not be able to understand and express fully why they are feeling what they are, but the feeling itself is familiar.
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Emotional memories are very deep-rooted memories and are still often more accessible and familiar (especially when utilizing the senses). The emotional experiences of a person living with dementia can be broken down into two categories: positive & negative. They may be feeling one way or another, or a combination of both at times, but how they are feeling and what they are feeling matters when it comes to providing care.

Over time dementia demands a different type of communication to find and keep positive connections in relationships.​
What is Person-Centered Language?

When providing person-centered care and communicating with a person living with dementia, it is important to do all we can as providers so the person ultimately feels
more of a sense of control - this becomes our goal in each moment. It starts with an acknowledgment and validation to the moment you share, and to what emotion you sense is being felt. This can be done by communicating with feelings, both verbally and non-verbally.
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What is person-centered language and why is it important when caring for people who are living with dementia? It is about respecting the individual in our care approach at all times. Once we know the person we are caring for, we can plan and deliver care to them based on our knowledge of who they are as a unique person who also happens to be living with dementia.
​As you read the phrases below, ask yourself how does it feel to switch from one phase to another?

​I have a dementia resident.......​​
  • ​​Our resident is a person living with dementia.
My dementia resident is having challenging behavior…….
  • ​Our resident is having a negative emotional expression.
When I am dealing with a dementia resident…..
  • ​When I am caring for a resident who is living with dementia.
You need to, you have to, we have to now......
  • ​​​Would you like to, what do you think/feel about this?​
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When we move to using person-centered terms, our approach, attitude, tone, body language, and empathy can change. It will benefit both us and the person living with dementia because what we do and say can have a significant effect on how they are feeling. If we carry the right mindset, the right attitude, and the right outlook then we are ready in our right care approach.

Less is often more when choosing the words we say as we communicate to a person living with dementia. Show more, talk less is generally a good formula. 
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We pursue short, brief, and repeated words and sentences as many times as necessary. We strive to create words together that become familiar between us and familiar to whatever activity we may be doing within our routines, we can identify the words and use them repeatedly as they become mutually understood. We can look to use words the person living with dementia tends to use or respond best to, or phrases that mean something to them. It is up to us to learn what those important words and phrases are, and when we do, to share those words with anyone else who provides care to that person.

When we move to using person-centered terms, our approach, attitude, tone, body language, and empathy can change. 
Insert positively-charged words into statements, such as “ah, that’s a good thing, that’s a good one isn’t it, I like that, I love that, that feels good, doesn’t that feel good? that looks good, and thank you”. A positive way of communication can be to offer suggestions over telling or directing what one needs to do.
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When assisting a person in any way, from pushing their chair in for them to buckling their seat belt, or helping to get a jacket sleeve on, it is important to seek their sense of satisfaction or approval before moving on to the next thing/task. This can be done by simply asking, “Ok then? Are you happy with that? Does that feel good? Is that a good one?” Or even doing the thumbs-up gesture and awaiting their response before moving on, as this communicates respect and how you see them and care enough to ensure they are satisfied with what you’ve done to assist, before another task or agenda takes over. This is person-centered language.
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Why is this important?

How much or how little we know about a person we are caring for makes a big difference. A person living with dementia is still the “person” they have always been and in many ways will continue to be. But they are also changing and different in some ways now. What they need from us the most is to SEE them for who they are and to know what makes them unique. By doing this we are reaching the center of a person and can care for them in a way that charts their personal care course - providing a feeling of control, not taking more away. 

Person-centered language is part of how we communicate to people living with dementia who depend on us to understand, and to be able to connect in the most respectful ways possible. Respect matters in all of our relationships, but for the person who is living with progressive dementia that is affecting their brain, we must ensure our approach and the language of our care is received in the way our residents living with dementia require - to have the strongest relationships we possibly can.

What they need from us the most is to SEE them for who they are and to know what makes them unique. By doing this we are reaching the center of a person...

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About the Author

Matt Gannon is a consultant & provider services coordinator with Oregon Care Home Consulting & Training. He co-developed and instructs Pre-Service Dementia Training.

Email Matt
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Provider Spotlight: Noel Ngure, RN

2/15/2021

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Article by Matt Gannon
In honor of National Caregiver Day on February 19th, we wanted to highlight the work of our amazing adult foster care home providers in Oregon. 

Matt Gannon spent some time talking with provider Noel Ngure, RN with Living Springs Homes in Portland. Please read below to learn more about Noel.
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How long have you worked in the adult care home business?

I’ve been a licensed care home owner since the Spring of 2020.

In 2004, I relocated to this country after having been a a high school teacher for 12 years. I started working humbly as a CNA, went to LVN school in 2007, doubling efforts since I was in my bachelor's class at that time. I graduated in 2008 with bachelor's degree in human services with a major in management. In 2009, I started my master's degree journey and graduating in 2011 with my Masters in Education: Curriculum and Instruction. My passion of offering competent, uncompromised care continued pushing me. In 2014, I started my RN classes, and by grace, we are here today successfully.

What do you love most about the work you do?
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The results. In 2017 I was found with Invasive Ductular Carcinoma. The care I received from my family was amazing. My RN daughter quit work to take care of me. When one day I said I'd never repay her, she replied, "Mum , Pass it on." Those are powerful words do drive us to performance.

When I take care of a family member living with dementia and observe her every day, seeing the positive progress, the strength and persistent beauty despite the situation, that encourages me. When I work with a client and see them improve, change and progress with near-normal life, it makes me smile and move forward. I love the difference I am making in the lives of the people I touch in this career. The impact made is immense, and this gives me strength.

I love the difference I am making in the lives of the people I touch in this career. The impact made is immense, and this gives me strength.
What do you believe makes someone’s work successful?

Consistency and continuity of care make someone's work successful. We are consistent in what we do and this allows better communication between our team players. Communication is key, or else we would have a big mess. Caregivers take time to talk to each other, passing over clear and concise communication. This is not about competition, it's about bringing our strength to the table and doing what each of us does best for productive results. This leads to competent care, which is encompassed by integrity. 
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Accountability is key, every one of us has to take responsibility of what we do or what we miss. A positive attitude for both the licensee and the caretakers is very important, and we have to support each other for best results. We licensees need to allow our staff to bring their strengths to table, allow them to positively utilize their skills without focusing on weaknesses. This is not a competitive business, it's about offering competent care.
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This is not a competitive business, it's about offering competent care.
Anything else you’d like us to know about you?
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​We are a Christian home, we practice our Christian values and have a table for prayer every morning for everyone to come to if they choose.

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I am hopeful in the years to come we will have more homes, caregivers, and more people reached through the care we can give.

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Author

Matt Gannon is a consultant & provider services coordinator with Oregon Care Home Consulting & Training.
Email Matt

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7 Ways an Accountant will Benefit Your Care Home Business

1/30/2021

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By Guest Author Yohannes Zewudie with Yohannes Tax & Accounting
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The Oregon Department of Human Services identifies adult foster care home licensees as independent business owners. Owners, who are responsible for Adult Foster Home (AFH) businesses are usually expected to wear so many hats to discharge their responsibilities and achieve their company’s vision. Trust and relationships created with owner(s), customers, employees, government (federal & state) agencies and the society determine the success of businesses.
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Small businesses, including adult foster homes, deserve the opportunity to be successful in their line of business. Regardless of the business size, accounting as a profession plays a significant role in creating a conducive environment for success. It is with this in mind that I argue small businesses should consider having an accountant if not a certified public accountant (CPA) to achieve their ultimate goal. 
Here are seven ways an accountant will benefit your adult care home business:
1. Effective and Efficient Business Management

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Businesses need historical, current and projected financial information to make the right decision in their business. Without complete and accurate financial recordkeeping and reporting, a small business owner cannot say for sure the true profitability of his/her business. Small businesses that tend to measure their profitability and success based on available cash flow or bank balance are only looking at one criterion. Business owners who rely on incomplete or wrong information usually make decisions that impact their business negatively.  
 
Accounting, as a support function to owners, is tasked with recording business financial data, analyzing them and generating timely and reliable financial reports to show the true picture of business status and profitability. It is for this reason that small businesses need accountant who can assist them in running and evaluating their business.  
2. Peace of Mind

In the ever increasing federal and state regulatory environment, small businesses are required to comply with various tax laws and regulations. Among other, businesses including AFHs have to report:  
  • Federal Payroll & Income Taxes
    • Social Security and Medicare Taxes (FICA taxes)
    • Federal Unemployment Insurance Taxes (FUTA)
    • Federal Income Taxes
  • State Payroll & Income Taxes
    • State Payroll Taxes
    • Transit taxes (Tri-County Metropolitan Transit District (TriMet) and Lane Transit District (LTD)
    • Employment Taxes (State Unemployment Insurance or SUTA):
    • Workers’ Benefit Fund Assessment (WBF)
    • Workers’ Compensation Insurance
  • Local and City taxes
  • Periodic Payroll Reporting
  • W-2, W-3, 1099 and other annual reporting

​Many AFHs are not well-equipped to meet these and other regulatory and compliance requirements. Having an accountant who properly handles these mandatory compliance requirements gives AFH owners peace of mind for them to focus on other important business matters. 
Having an accountant who properly handles these mandatory compliance requirements gives AFH owners peace of mind for them to focus on other important business matters. 
3. Ease of  Annual Business and Personal Income Tax Reporting

The United State Internal Revenue Service (IRS) and the State of Oregon expect taxpayers to:
  • File a timely return;
  • Make accurate reporting; and
  • Pay the required tax amount by the due date. 

Small businesses and their owners face challenges in compiling the necessary business records during tax season. Without a good recordkeeping and tracking method, it is daunting for small businesses to fully meet the tax reporting requirement.

Lack of proper accounting system could result in understated business income and/or deductions that may result in higher taxes, interest and penalties.  If the owner or business deliberately attempt to evade taxes or willfully fails to file or pay taxes, they could be subjected to criminal tax fraud cases.
 
AFH owners can ease the stress associated to tax return filing by hiring an accountant who:
  • Maintains proper financial recordkeeping throughout the year;
  • Maintains proper classification of taxable income and non-taxable income;
  • Claims all available and qualifying business deductions;
  • Files annual & quarterly tax returns in a timely manner; and
  • Pays timely quarterly estimated payments.
4. Utilize Available Business and Financing Opportunities

More than large and medium businesses, small businesses tend to miss out on available business and financing opportunities due to lack of information or poor financial recordkeeping. The missed opportunity to utilize the Small Business Administration Paycheck Protection Program (PPP) is a very good example. Significant number of small businesses failed to utilize federally available PPP. An accountant comes handy to assist small businesses to have the necessary records and enable them seize these available business and financing opportunities.
5. Quality of Life

AFH owners assume so many duties and responsibilities (manager, receptionist, purchaser, accountant, janitor and many others) in a single day to be successful. Since AFH owners are not expected to be knowledgeable or proficient in every task, they might have to work more than 12 hours a day to accomplish all these tasks. These business burdens make the owners unhappy and inefficient. The opportunity cost of spending too much time at work may also negatively impact their health, family dynamics and other social life.
 
An accountant can shoulder one burden and perform the accounting-related duties in the right way. Delegating the accounting tasks to the right professional would result in the following:
  • Improved quality of work.
  • Standardized financial reporting.
  • Reduced owner work-related stress.
  • Increased owner productivity and job satisfaction
  • Potential long term cost reduction.
6. Financial Consultation

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Based on available company financial data and their business environment, a certified public accountant can provide knowledge-based financial consultation to AFH businesses. These consultations could have a significant impact on tax savings and business growth.
7. Representation in Federal and State Audits

In case of federal or state audits, a CPA can represent an AFH to handle their audit. Unlike an accountant, which is limited to the return prepared by him/her, a CPA can represent any business in federal or state audits. 

"While all CPAs are accountants, not all accountants are CPAs”. A CPA is an accountant that passed the rigorous testing and strict licensing requirement to practice in the state. CPAs are expected to abide by the code of ethics and must update themselves by taking the required continuing educations every year.
A CPA is an accountant that passed the rigorous testing and strict licensing requirement to practice in the state. CPAs are expected to abide by the code of ethics and must update themselves by taking the required continuing educations every year.
​The benefits listed above are not an exhaustive list as to why adult foster care homes need an accountant, if not a CPA. It is always advisable for small businesses to reach out to professionals and seek advice on how they can achieve their ultimate business goals.

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About the Author

Yohannes Zewudie is a certified public accountant with over 15 years of experience. He owns Yohannes Tax & Accounting Services, located in Clackamas County, Oregon. His company's mission is to provide complete and accurate tax and accounting services to small and medium businesses at a competitive price. You can reach Yohannes at yz@yohannestax.com or at 612-987-0621 (cell).

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A New Normal: Screening & Admission During COVID-19

4/28/2020

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Article by Tracey Diani
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Photo by Allie Smith on Unsplash. For use with attribution.
The world as we’ve known it has come to a complete halt. Schools are closed, businesses have shut their doors, farms are losing their crops, and millions of people are adapting to a new way of life that very few ever imagined would happen in their lifetime. COVID-19 has wreaked havoc on cities, states, and countries around the world. 

As we all adjust to new ways of life, some things are still very much the same. The need still exists for people to receive care. There are specific challenges for caregivers who are tasked with providing intimate care and assistance with activities of daily living, yet this time, our seniors greatly rely on top-tier caregivers who are essential workers. 

Invaluable methods of adjusting include teleconferences and video screenings, which have become extremely vital pieces to the placement puzzle as we search for the ideal placement for patients.

As a lifelong optimist, I cannot help but accentuate the silver lining I see in the near and distant future for us all. An adult foster home provider is now able to conduct the screenings and assessments over the phone and in live video calls. It’s small adjustments such as these that are opening our minds to new ways of running adult foster homes.

This option means owners and operators can schedule multiple screening appointments and gather much-needed information from home. Providers can make multiple calls to all the necessary parties involved together with all the information they need to make an informed decision regarding admission of new residents.


I want to share five ways to integrate new admission policies and options in your home during the pandemic: 
  1. Request a COVID-19 test be completed prior to admission, and be sure to check the State's list of facilities with positive COVID-19 cases.
  2. Get in touch with the potential resident and family to schedule a video conference.  Some facilities may offer appointments through Zoom, Google Hangouts, FaceTime, Google duo, Facebook Messenger or other platforms.  You may even want to give a virtual tour of your adult care home and the bedroom they would be living in. You may want to schedule more than one video appointment throughout the week at different times of the day to give you more perspective on the person's situation.  Sometimes a phone call will do the trick to obtain all the information you need as well.
  3. Request medical records that indicate diagnosis, current medication list, important contacts, and other important information to be emailed or faxed to you.
  4. Be in constant contact with the discharge planners, social workers, case managers and diversion transition workers who are involved in the care and placement of your potential resident. It is so important for the people you are working with to have an idea of your timeline and whether or not you are planning to admit the individual. 
  5. As soon as you have made a decision whether or not to admit, communication with the resident and all other parties involved is paramount.

Keep in mind, policies and procedures around wearing masks, social distancing, going out in public are changing weekly if not daily. Please be sure to call the institution that you are working with, whether it’s a hospital, post acute rehabilitation center, nursing home or assisted living facility, please check with them to see what their policies are and help them to keep them in place.

I see a glimmer of hope as humanity comes together during times of crisis. I encourage all of us to take a moment to reflect on the good things we have in our lives, and some positive changes. We can use new options to effectively screen and admit residents. We can adjust to our new normal and make it through this together.

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About the Author
​

Tracey Diani is a consultant & training support coordinator with Oregon Care Home Consulting & Training.

​Email Tracey

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About Oregon Care Home Consulting

Oregon Care Home Consulting & Training is the compass that helps current and future APD adult foster care home licensees successfully navigate the licensing process and have a successful adult foster care home business. ORCHC provides coaching, consultation, training, and ongoing support. This ultimately saves time, reduces stress, and improves compliance, which allows AFH/ACH licensees to focus more time on providing excellent care to seniors and individuals with disabilities.

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Office hours by appointment only

​Oregon Care Home Consulting LLC
​1500 NW Bethany Blvd., Ste. 200
Beaverton, OR 97006

​Email: info@oregoncarehome.com

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​Disclaimer: Oregon Care Home Consulting LLC is not affiliated with the State of Oregon or Multnomah County Adult Care Home Program (ACHP). We are not State licensors, therefore we are unable to require compliance or guarantee your adult care home is in full compliance with current state and/or federal requirements. State and/or County licensors make the final determination of compliance. Additionally, we are unable to offer legal or medical advice, and no guidance provided by Oregon Care Home Consulting LLC should be construed as legal or medical advice. Always consult an attorney or doctor, when necessary. 


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