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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. 

Seven Reasons to Open Your Own Adult Care Home (and four reasons not to)

8/30/2022

1 Comment

 
Updated and reposted from March 2019.
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You’re thinking of opening your own adult care home for seniors and individuals with disabilities. Congratulations! This is an exciting decision. Maybe you’ve worked as a caregiver for several years in an adult care home, assisted living facility, nursing facility, or as an in-home caregiver. Perhaps you've worked as a nurse and would like to take it to the next level and be your own boss.

You’ve now decided you’d like to take the next step and become an adult care home provider with your name listed on the license. You most likely feel passionate about caring for seniors and individuals living with disabilities. This is great, though this is not a decision to be made lightly. Owning your own adult care home business and being a caregiver for someone else are two very different experiences with their own unique challenges and benefits. 

When I started my own business in 2018, I had a vague idea of the level of commitment it would take, but in retrospect, I really had no idea. I consistently work more than I've ever worked before in my life. I haven't taken a true vacation in four years, and I regularly work 12-14 hours per day and work at least six days per week. Like most small business owners, I work a lot, but I also recognize I have the luxury of having some down time because I'm not caring for others. 
I've heard this same feedback from new providers, as well. They didn't realize how much time owning their own business would take, especially a business where you're providing 24/7 care to other people. ​

​Frankly, running a small business is not for everyone. Sometimes the best advice I can give someone is to consider a different path. Often, providers mention they spend a lot of time on business management, rather than solely direct caregiving. If you simply love being a caregiver, you might want to consider remaining a caregiver and working for someone else, but working in a capacity with more responsibility, rather than owning your own business. If you have management and leadership skills, you're highly organized, have strong ethics, and you're business-minded while also passionate about high-quality care, then owing a care home business might be the right move for you. It's an added benefit to have prior experience running a small business.
If you're considering this next step in your career path, now is a critical time to reflect on your motivation...while also taking inventory of both your skillset and your understanding of the level of commitment this role entails. 
If you're considering this next step in your career path, now is a critical time to reflect on your motivation for becoming an adult care home provider, while also taking inventory of both your skillset and your understanding of the level of commitment this role entails. Now is the time for a frank discussion: I’d like to talk about seven reasons to open your own adult care home, and four reasons to not open a care home. 
​Let’s start with four reasons not to open your own adult care home.
1. You're just going to see what happens.
Starting any business requires a lot of foundational work. You want to lay a solid foundation on which to build your care home business. Do you have a business plan? Do you have a realistic idea of the money you can make your first year? I've heard a lot of misinformation out there. It's vital to get the correct information and guidance and have a plan before taking the next step. 

2. All you see are dollar signs. 
Sure, you need to make money, as this is a business; however, people who go into this field mainly for the money quickly burn out, or realize the money isn’t worth it. When starting out, you might go months without income while you’re working through the licensing process and finding your first residents. Residents paying privately can pay well, but the Medicaid rate is fairly low with the highest standard Medicaid rate plus room and board at around $3,500/mo. You also have to factor in the cost of your lease or mortgage, insurance, food for a large household, and utilities.

You also have the cost to hire and keep good caregivers, as payroll is one of your largest expenses and will run into the thousands of dollars per month. If you've planned well and have made good business decisions along the way, you’ll make a good living, but it's going to be a lot of work. 

3. This will be your side business. 
The State of Oregon and Multnomah County require you, as the licensee, to be involved in the business. Frankly speaking, everything falls on your shoulders. You shouldn’t expect to simply hire a resident manager and take a hands-off approach to your adult foster home business. This work requires direct and ongoing involvement, especially when you're just starting your business. 

4. You take issue with government regulation. 
This adult foster care home industry in Oregon is highly regulated. Let me say that again. This field is highly regulated. Did I mention this is a highly-regulated field? To put this into perspective, not only do you have state or county regulations, but there are both federal and local regulations you must follow as a small business and an adult care home. To top things off, state licensors will show up to your home unannounced, and you might have periodic visits from Adult Protective Services (APS), case managers, and a long-term care ombudsman.​ If you take issue with government regulation, this might not be the right fit for you. 
The purpose of mentioning this is not to scare you away from this business, but to make sure you’re going into this business for the right reasons and with a solid plan.
​I will admit, the reasons not to open a care home are a bit intense, but over the past decade working in adult care homes in several capacities, I’ve seen a lot. The purpose of mentioning this is not to scare you away from this business, but to make sure you’re going into this business for the right reasons and with a solid plan.
What are seven reasons you should open your own adult care home?
1. You've done your research and homework.
You've gathered the correct information you need to make an informed decision about starting your own care home. You know that you qualify and you know the requirements of the classification for which you'll be applying. You understand the differences between licensing types and State and County requirements. 
You know the training requirements and have started your training. You know how to market your business and find residents and you have a plan to recruit and train staff. You understand the importance of the home you choose and the role it plays in your business success. You understand the steps in the process and haven't skipped important steps.    

2. You have a plan.

You're willing to take a risk, but you take calculated risks that are well-planned. You've started a business plan and have a realistic idea of your possible income and have done a cost-benefit analysis of your option(s). You have enough funds saved to weather months where a resident moves out or passes away. You also have a plan, in advance, to find and retain quality care staff.      

3. You have a solid idea of the commitment this decision involves.
You understand going into this business often requires a complete lifestyle change. You've communicated with other providers to get an idea of their day-to-day experience and understand this is not like a typical job where you can go home and leave work at work. 
You’re okay with living where you work, and working where you live. Frankly, you’re excited about living in a multi-generational household. You enjoy talking with older individuals and hearing about their amazing life stories.

4. You've taken inventory of your own skills and abilities.
You've taken some time to really reflect on your own KSAs (knowledge, skills, and attitude). Are you highly organized? Do you have leadership and management experience? Have you ever recruited or hired staff? Do you have experience supervising staff or have the skills to do so effectively? Have you been responsible for communicating with doctors and overseeing all recordkeeping?  Are you a go-getter and a self-starter? Are you good at prioritizing, delegating, and effective time management? Do you have the skills, or willingness to learn, about how to run a small business?
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5. You’re an organizational wizard. 

Following along the lines of number four, the providers who we find are most successful are highly-organized. The Oregon Adult Foster Home Administrative Rules (OARs) and Multnomah County Administrative Rules (MCARs) require you to document practically everything. Are you organized enough to keep resident records, facility records, personnel records, and business/financial records straight, in addition to meeting the care needs of residents?

6. This is your passion and your calling. 
You know this is what you’re meant to do, whether it's a personal or spiritual calling. Working with older adults and/or individuals living with disabilities brings you immense joy and fulfillment. You feel called to do this work, and you’re committed to helping seniors live in a safe, home-like environment where you help them remain as independent and engaged as possible. You want to provide top-notch care and are willing to go above and beyond to meet the holistic care needs of residents and provide an enriching environment and experience for residents. 

​7. You’re ready to commit yourself 110% to the business, and everything that entails.​
​You've reflected on, and have completed the previous six steps and are ready to fully commit yourself to the success of your adult care home business. You recognize you don't need to do this alone and can get support along the way. 
Now is the perfect opportunity to really reflect on your skills, passions, interests, personality, and lifestyle before you make the leap into becoming an adult foster care home owner and licensee. It can be a challenging, yet highly rewarding career, especially if you go into the business for the right reasons and with a solid plan. As the old adage goes, find a job you enjoy doing, and you'll never have to work a day in your life. 
Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work, and the only way to do great work is to love what you do. If you haven't found it yet, keep looking and don't settle. As with all matters of the heart, you'll know when you find it." - Steve Jobs

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Author

Alyssa Elting McGuire, MA, MPA is founder and consulting & training director for Oregon Care Home Consulting & Training.
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​Email Alyssa

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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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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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On the Topic of Residents: Connect with the people seeking the care you provide

2/16/2020

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Article by Alyssa Elting McGuire, MA, MPA
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Originally posted 6/10/19. Updated 2/16/20.

One of the more common questions I’ve been asked, both when I was with licensing, and now as an independent consultant is, “How do I find residents?” My advice has always been to start thinking about your strategy to market your adult foster home from the very start of the process, and use a multi-pronged approach to getting your business noticed.

To better assist my clients now, I continuing to seek out beneficial resources and partnerships that will allow them to most effectively get the word out about their vacancies to the right people. That is key. To the right people. You want to go where people are looking for the care you provide. Don’t simply cast the marketing net wide, but instead be deliberate and strategic in your approach.

There are a several avenues for finding potential residents, both private pay and Medicaid consumers. The list below is not comprehensive, but is a start. The options listed below provide similar services, yet are targeted to different audiences. Just like your stock options, you want to diversify. I’d like to tell you a bit more about each option. 

Placement agencies: These agencies receive a fee from the adult foster home provider for successful placement. Generally the fee is between 75 – 100% of the resident’s payment for the first month. Their target market is individuals and families looking for placement in a long-term care facility, including adult foster homes. A good resource to connect with a referral agent is the Oregon Senior Referral Agency Association(OSRAA), which also has a page to post your vacancies.

Posting Websites: The target market for vacancy websites is individuals and families looking for placement in an adult foster home. Laria Care Finder is a local business that allows you to post detailed information about your home, about yourself as a provider, and about your vacancies. You can also add your business to the Alzheimer’s Association Community Resource Finder.

Discharge planners, care managers, and social workers: Get to know discharge planners, care managers, and social workers at your local hospitals and skilled nursing facilities. Contact the facilities to introduce yourself and let them know what level of care your provide.
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State diversion/transition program: The State has a program specifically to move Medicaid consumers from nursing facilities to community-based facilities, such as adult foster homes. You can locate the local diversion/transition (D/T) programs by contacting your local licensing authority (LLA), also know as your local licensing office.

As you can see, there is no single avenue to find residents. What it takes is a solid, strategic plan, and being both proactive and persistent. Put yourself out there and develop professional relationships with others so they both know and trust you, and the care you provide.

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About the Author

Alyssa Elting McGuire is the founder and consulting & training director for Oregon Care Home Consulting & Training.

Email Alyssa

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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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​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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