We met a lady that does home health, she has become a friend! How do we pay her and also keep track of what she spends to be able to show to Medicaid if they have to go to NH later?

Before all that, do a reference and background check. Have her complete a routine job application that you can find a blank copy of on the internet.
If she has an issue with this, that would be a huge red flag for me.

Do not give her charge of the finances. Send grocery gift cards, and more when she e-mails you a receipt. She should be willingly providing you with all receipts, needing to ask you for funds for their care.
Be sure to notify her if her meals are included.

Have a contract, references, background check.

A friend leaves way too much leniency for taking extras from your parent's budget.

Still, I would be generous, not making her job more difficult by becoming a tightwad with parent's money. Keep her pay separate from the household budget. She is not to advance her own money for your parent's needs. Have boundaries, and rules.

If you provide her an I-phone on your account, you will know e v e r y t h i n g.

Be sure she knows not to move in her boyfriend, or other family members.
She will have her own home to go to on her days off? Place a value on the room rental
and adjust her pay accordingly.
Since she is an employee, a friend, AND a live-in caregiver, consider a rental agreement as well as a caregiver contract. One always needs to consider an exit strategy, as anything can happen. Have your documents lined up in advance.

There are threads on here started by others who have had issues getting rid of "friend".

References & background check. Then a contract outlining duties, hours, vacation, pay, etc. Then use a payroll service that will withhold social security and income tax. You will need to match social security. Don't forget unemployment insurance and worker's comp.

Set up a petty cash fund of $250. She should accumulate receipts and submit them to you and you will replenish the fund. At all times, the cash on hand and the unreimbursed receipts will total $250. The agreement should spell out what types of receipts your will reimburse.

She is an employee. The biggest mistake most people make is not keeping the communication professional so that she can discuss problems that she is having with the job and so that you don't feel that your parents are being taken advantage of.

Any "friend" showing up after a natural disaster is suspect, especially since the neighbors have already allegedly committed check fraud. Your parents will be viewed and targeted by so many. Would it be better to move them now to AL, since you won't be there nearby?

Thanks for all the answers!! I didn't know her before the hurricane and got to know her before we talked about her being a caregiver or even who my in-laws are or where they live. I am DPOA for my in-laws and will not be turning over any money to her without receipts. She is a really nice lady we have done background check. Trust me I am not going into this blind after what we have already had to deal with!! There really isn't anything she can take from them that is worth anything. But she has a lot of experience and has helped me with my mil already and mil loves her. She just talks to her and is so sweet!! I will take all of your advice to heart!!!! Thank you

Jkrystal5, "their Dr. said this would be ideal for them!!!". Ah, not really. It would be better to use an Agency where there are 3 shifts of caregivers, the night shift would be required to stay awake throughout the night to listen for any sounds. This way, the morning caregiver comes in all refreshed from getting a good night sleep, same with the other two shifts.

If you feel you still want a live-in caregiver, you will need to go to your parent's home insurance carrier and have your parents purchase a "workman comp" insurance in case the live-in caregiver gets hurt on the job.

With an Agency, the Agency is licensed, bonded, insured, and they have workman comp for their employees. Plus they do the payroll, taking out taxes, etc.  Oh, speaking of payroll, check with your State to see if there are any laws limiting the number of hours a live-in caregiver can work.

Another thing, people get sick, thus who would take care of your parents if the caregiver has the flu, etc. or has to leave for a couple of weeks to take care of their own family member. That's why I liked using an Agency, if a regular caregiver couldn't make his/her shift, the Agency would have someone fill-in for that day or week.

All in all, my Dad found out it was less expensive for him to move to senior living, then to have around the clock caregivers. Plus he was around people of his own age group which he really liked. He really perked up when he moved in :) Plus he sold his house and was so relieved not to have to worry about property taxes, homeowners insurance, all utilities, shoveling snow, mowing the yard, etc.

They do not need 24 hour care at this point just someone to help out with choirs, hygiene, running errands, transportation, make sure they take meds and to check on them daily as we are doing for them now. They are not incontinent and are able to fix cereal or sandwiches. I just signed them up for meals on wheels. She will be living on property in case they need help at night but not in their house she will have her own place.

JKrystal - I’d like to add some thoughts on what I see as pretty serious red flags in your in laws situation & I say this as one who went through Katrina. In laws had their trailer flooded from Hurricane Harvey so they are getting post disaster housing due to Harvey, right??? FEMA trailer, right? So probably on 18 months rental assistance from FEMA.

Probably also gotten $$, supplies, foodstuffs, donations due to their Harvey situation as well. You wrote in an earlier post their getting SBA loan too.

If so, their applications - FEMA, SBA, county outreach, etc. - were approved & based on their living situation prestorm. FEMA, SBA regs are pretty exacting & they do follow up. Having someone move in & live rent free, I’d bet is so out of compliance for FEMA. The friendly caregiver is not family dropping over for an occasional overnite or a caregiver with a TXDADS program. For those suggesting “rent”, In-laws cannot charge rent nor can they do a rent-free living arrangement as they do not own the trailer. It’s FEMA property. 
JKrystal- You mention she’d be living on the property but in her own place, so is this caregiver lady too in a FEMA trailer? So this is a FEMA village? If so is it both homeowners who flooded and renters whose apts or subsidized housing flooded? Does she want to be paid cash so doesn’t affect her relief eligibility? 

Disasters bring out opportunities to start anew as well as con artists. If word has gotten out that in laws did SBA, then word on the street will assumed that they have 240k fresh SBA $$$. You’ve already posted about fil giving $ to some guy in the ‘hood for helping out, checkbook stolen, they are unable to manage to pay their bills.

If their health deteriorates, they’ll need to move into a facility. If they need to apply for Medicaid, they will need to clearly show where $ was appropriately spent or family will face dealing with a transfer penalty inquiry by Medicaid. This oh so friendly caregiver needs to be paid all aboveboard with FICA & taxes & notarized caregiver agreement to keep that $ from looking like an issue for Medicaid. Or hire a caregiver through an agency. 

Was any consideration given to them moving into an AL or NH rather than going the FEMA trailer and SBA loan to get a new home? 

Is she CPR certified? Any formal training in caregiving?
Have you done a criminal background check?
I know, I am very cynical. But there are bad people in this world just waiting for the right scenario. Scammers take time to watch and evaluate to plan their scam. How do you know that this woman hasn’t been doing just that?
Be cautious & good luck!

I want to yell "danger, danger, Will Robison!".

Storms bring out the grifters. Your FIL has dementia and is going to progess. It is much easier to get a demented elder acclimated to an AL when they are in the early stages. 

When he needs 24/7 care, what are your options going to be for getting "friend" off the property?

We didn't do the SBA loan after all. Haven't received the FEMA trailer. They have their own property not in city limits. I appreciate all of your concerns. We had a long discussion with her yesterday and she even told us it would be better if we called her agency that she works thru. We are getting a contract drawn up also. Thanks again for your responses!!

I’m trying to visualize their situation...... You wrote “she (new caregiver) will be living on property but not at their (in laws) place...she will have her own place”. So it’s multiple mobile homes on in laws property? Income producing? So everybody living in their flooded & now dried out mobile home till FEMA housing gets delivered and set up?

Why not SBA? At disaster loan SBAs 1.78% interest, well you can’t get cheaper $$ unless you marry it or bury it. Disaster loans now have max at 200k property & 40k contents. I imagine they can buy & pay for in full a very very nice mobile home for way under 200k. Maybe under 100k. Why not get SBA? 

We did postKatrina SBA both personal & biz, & it was a beast of application & reporting process but do-able. (As an aside on this, going through postK fema, insurance co, SBA, safety & permits crap beyond totally prepared me for dealing with Medicaid, NH, etc). For us the issue with SBA was that it companionizes all assets. But for a single property homeowner situation, SBA - assuming they qualify - is incredibly good interest & loan length. Why not get SBA?

I am their DPOA the banks know my inlaws situation (this is a small community) and I have control over their finances now and I pay their bills (I used to work for a bank) I Have taken car keys away from FIL so he isn't able to get much out of the bank at a time if he gets a ride to town, he has no checks or debit or credit cards therefore he has to go inside bank or drive thru to get cash.

We tore down their home is was irreparable due to black mold over taking everything!! The caregiver will NOT be living in the FEMA trailer with them; they have acreage not part of a  community.  My hubby and I have decided not to do the SBA loan for several reasons mainly due to their age and not wanting to use the few resources they have on a home that may be left empty once they go to assisted living if they have too until we see how they adjust in a few months we will reassess their condition We would rather have them stay home as long as possible but we travel for work so need someone close to help them since no other family will step up. These decisions we have made were not easy and I have stressed out for months trying to get it all done. Nothing has been spur of the moment I have spoken to several different agencies, attorney and their Doctor.
My question was about the best way to pay the caregiver. But after speaking with her yesterday we now have a plan in place.
Thanks again for your help and suggestions!!

You are making a big mistake!!! You need to get professional care for your in laws. I emphasize “professional.” You sound like a very intelligent, capable person, but you came to this forum because you have some doubts. This solution to your problem seems too good to be true and; most likely, it is. More care will be needed in the future, so go in the right direction: agency or a living facility. You will have more peace of mind.

I rather agree with jkrystal - she just wants to know how to keep the paper trail legal, for the benefit of both sides.
I have a strong suspicion that this care lady will be closely monitored.
If only professional help were not so expensive in the US!!

Jkrystal,
You have done your homework! This lady works through an agency, great!

Hoping that anyone posting can read all the careful things you have done and not jump to conclusions. You have faithfully responded to all of our concerns.

Welcome caregiver!

BEWARE.....Do a complete check on this person, and I mean complete. Also check with people who know her. Many years ago a dear elderly friend befriended a stranger selling a house to house product. To make a long story short, the family found out that she had signed over $100,000 to her and forged checks. I was asked to step in and became her guardian and POA for 28 years until she passed. I got the money back but my life was threatened in the process. In those first months to fix and end the horrible harm that had been done was like living in hell for me. Eventually, I was able to handle all the horrors that had been happening. She lived happily and safely until she passed at 98. But BE CAREFUL. Have understandings and rules, IN WRITING, and let an attorney look things over. Again, BEWARE.

What I would do to prove you paid this healthcare worker is let it be deducted from the bank account since banks keep records. If you've come to an agreed amount, you can use that amount to help banks look up specific transactions along with any other info you have. I wouldn't use a checkbook, just use your debit card or even send the money from their end through online auto bill pay since this is a friend if she does this privately. If she does this privately, only send the money to her through your online bill pay, that way it's safer and there's proof you paid since your bank keeps records and you could pull up at transaction anytime. You can go to your bank and have them pull up a history of that specific transaction to show Medicaid. I wouldn't pay my bills no other way except to send it through my online auto bill pay. Anyone who would request otherwise it's shady and you shouldn't do business with them. For instance if someone requires you to pay by cash only or check or money order, it's shady and you should avoid doing business with them because they're preventing you from sending payments through online auto bill pay and protecting yourself through bank statements. I personally would run for the hills as far away from them as fast as I could if I was required to pay any other way than what I usually pay. Only pay people through digital banking, the bank will send them a check or if you have a special account number, it'll go electronically into their account

Background checks

The first thing you're going to want to do is a background check on this person to make sure they're legit and not some scammer. In light of dealing with the aftermath of elder financial fraud against my dad who had Alzheimer's, that case has now become a lawsuit, It was proven the POA changed the life insurance beneficiary to herself, definitely illegal in Ohio. Let my story be a warning why you need to do a background check on people who are new to the elder who suddenly appear wanting to help. Some people do help out of the kindness of their hearts as we all know what among them are vultures who will help with the sole purpose of taking advantage of the elder. I'm telling you the truth because I'm dealing with the aftermath of it right now as we speak. This person wormed her way into my dad's wife but I couldn't be anywhere around to prevent it from happening due to circumstances beyond my control. I had no idea my dad was alive all this time when I thought he died many years ago since I heard nothing from him or mom who I found out died Christmas Eve of 2006. Since dad was widowed, he was very vulnerable and ended up being taken advantage of. The sad thing is I didn't know who this person was but come to find out she's from my town and I remember seeing her around here many years ago but I didn't know who she was. Also come to find out she works at a dollar general. I never knew this stranger would one day become my dad's POA and I think someone was right that my parents knew some people in my town, this is one missing piece to the puzzle. If I would've been able to have protected my parents specifically my dad since he was the only breadwinner, I definitely would've and this ugly mess would've never happened. Sadly though the fraudster ended up with everything and now she's facing serious legal trouble after it was discovered and was actually proven she took advantage of my dad after abusing her POA powers. She probably did this boldly, apparently according to what I found out, the POA admitted to changing the life insurance beneficiary to herself and she was the informant on my dad's death certificate so she knew I existed. I only wonder what kind of mess she caused when she lived with my dad. Let my story be an example of why you really need to check people out because they can go behind your back and turn your own relatives against you and keep them from providing for your future if their elder would've otherwise left you something. Vultures are notorious for doing this, and again, I'm dealing with the aftermath of it because it was discovered by a reliable resource. Please do your research and check this lady out because this is how it all starts, exactly how you're describing it. They come in and want to help, become friends and you never know what will happen after that. It might go good and I hope for your sake it does but it might turn bad like what happened to our family. Apparently there's a pattern because I think this fraudster we're dealing with has most likely done this before and I think there may also be other victims  so check this person out especially if they're suddenly friends and they haven't been around that long. Please, protect your elders and let my story be a warning to everyone out there. I don't think it can't happen to you. If it can happen to one person, it can happen to anyone so I'm all for background checks

Take steps to protect the finances

If your seniors have a checkbook, either lock it up or ditch it altogether and just use the debit card instead. 

Set them up through online auto bill pay and login to that account and carefully monitor those accounts regularly. Only leave enough money on the debit card for what's on the shopping list. This should be common practice anytime you must lend out your card and let someone go pick something up for you. I only leave just enough for that item let's say it's just one item like a gallon of milk. Whatever milk costs, just leave that amount on the debit card just for that item and nothing more. Sweep all the rest of the money into savings and keep it there. That way, if anything extra comes across to check out, you'll know it right away because the card will be declined only because there's not enough money to cover anything extra that comes on the conveyor belt at the checkout. You'll know right away if something other than that milk comes through the checkout and the  care giver tries to run that card and there's not enough money except for just the milk. You can go on the elders online banking account right when that caregiver  leaves for the store but wait just a few minutes right around the time they're supposed to be checking out if you know the store well enough to know they're not that busy. Keep logging in and checking the account balance for that particular account where you left the money and you'll know right away when that person checked out because the money is automatically transferred electronically through the system from your account to the store's account. If the person says the card was declined and you know the store where you're sending them and know the prices well enough, you'll be able to face them right then and there and tell them  something other than the milk came across at the time of checkout and then that's when you can reveal how well you know the store and the prices if you frequent there all the time. That's when you'll have caught them red-handed. Yes, you can monitor through the online auto banking and know when that person checks out. I previously  sent a friend to the store to pick up something for me and I sent my card with him. I only left just enough for that particular item and I know exactly when he checked out because I logged in and saw the amount was less so I know he checked out and was on his way back. This is another  reason why online auto bill pay is so handy, you know when someone has checked out and picked up the item by monitoring the bank account through your online device. you see, all of my money pretty much stays in savings and I don't put no more on the card then I absolutely need for specific items but there are times I'll  put a little more on the card depending on what I need. This is how I protect my own finances. That way, if my cards are ever lost or stolen, they can't really be used because I can just go online and sweep all of my money back into my savings should I ever lose my card or somehow goes missing. My device is always separate from my wallet, so no one's going to get a dime from me if I ever lose my wallet or just the card. This is why all of your money should stay in savings and it should always stay in the bank where it's safe. Keeping your money in savings in a separate account attached to a different checking account will help to protect your money, especially if you don't have an ATM card for that particular account. Then again you can also link other checking accounts to it but then that's where you're going to have to be more careful not to lose that card that's linked to your savings because then you could sweep money back-and-forth between the accounts. Then there are the new able accounts  where are you can send money and the system just comes in and gets it. If you have one with no debit card by default, that's the best way to protect all of your savings. Putting all of your extra money in a secure savings well in advance before you need care but not telling anyone where it is is a sure way to protect it and make sure no one finds it 

I have absolute control over their finances I can look at all transactions whenever I want the bulk of their money is not available unless I make it so. I hate controlling someone elses money but it was necessary. The banks and the sheriff's department said it needed to be done that way.. thanks Komen for your support I was beginning to feel like an idiot!!! Our caregiver is a professional she currently works for a 6'4 paraplegic man; from getting him out of bed dressed, wound care, showering cooking transportation errands etc. I think if she can do all of that she can handle my in-laws!!! Again thanks for all of your input! Happy New Year!!

You should definitely do a background check, ideally on the state Judiciary Case Search before you finalize this.

JKrystal5, what I had to do with my parent's bank was set up a separate account that had the primary funding in all our names, then I set up a separate account with only my name on it linked so I could transfer funds out of their primary account. I use this account for all the bills which are paid online. Their primary account has funds remaining for groceries etc which my brother uses for his personal living expenses as well (he has a set amount kept in there we consider his payment for living at home and caring for both parents along with room and board). This way I have control over the bills getting paid on time every time from out of state, he can't access the bill money and still has enough to comfortably eat, and entertain himself while caring for our parents. When he shops he uses the debit card which tracks the purchases and what it is for. ATM is considered his personal payments not for expenses. That way we can track how much he spends on what without him being able to drain all the funds.

Thanks RaBonn that was along the lines of what I was thinking also!! I already have accounts set up like that so I can pay their bills and expenses out of their ssi with a separate account for their savings.