What do you need to know about Private Duty Home Care to grow your business and get ready for the future? Chances are, you can find out here at the 9th National Private Duty Conference & Expo at the Rio All-Suites Hotel & Casino in Las Vegas, Nevada.

The annual conference is sponsored by DecisionHealth, a division of United Communications Group, and their newsletter, Private Duty Insider. Thanks to the Publisher, Jonathan Stern; Executive Editor, Wendy Johnson; and Editor, Maria Tsigas; for inviting us to participate.

I was fortunate to be the opening keynote speaker at the very first Private Duty Conference in St. Petersburg Beach, FL, back in 1997. What a difference nine years has made in the growth of this conference and expo. About 300 people were here today for two pre-conference workshops, and hundreds more will be here tomorrow for the opening of the main meeting.

Jump Start Your Business

The morning session began with two presentations on how to get started in a new Private Duty Home Care Business.

After a welcome by Maria Tsigas and Jonathan Stern, Lucy Andrews, founder of At Your Service Home Care in Santa Rosa, CA, opened with "Build Your Private Duty Business the Right Way." She was followed by David Berman, Principal of Simione Consultants with a "Financial Check-Up."

The majority of the participants in this morning session are brand new to Private Duty Home Care, and many represent Medicare Certified Home Health Agencies who are moving into Private Duty.

After lunch, the lawyers and accountants came to the platform to tell us about laws, regulations, and how to stay out of jail. That's always good. As Private Duty grows more complex, and as more states enact licensure laws, there are more and more legal issues for owners to consider.

John Gilliland, Labor Law Attorney with Gilliland, Markette & Milligan opened the afternoon session with the wake up call that wage and hour violations represent a large portion of the cases in Federal Court, and that private lawsuits brought by employees against employers are growing rapidly.

The penalties for non-compliance with wage and hour laws include paying back wages, liquidated damages, attorney fees, civil monetary penalties, injunction, and criminal penalties. Even a small suit can put you out of business.

John described the federal laws on minimum wage, overtime pay, hours worked, and how to calculate the "regular rate" which determines pay. One of the factors that complicates this "regular rate" is paying bonuses. When you give monetary gifts, gift cards, or other items of value to caregivers as bonuses, the value of the bonus must be calculated into the "regular rate" in order to accurately calculate overtime pay.

John was describing the Federal wage and hour laws, and advised everyone to be familiar with your state wage and hour Laws. Many states have their own laws for minimum wage and overtime that supersede the federal statutes.

One area where Private Duty companies get into trouble is not paying travel time between cases. If you are using a telephony system for payroll, and you only pay the caregiver for the time in the client's home, you may be violating this provision of the law.

Other areas of concern are paying caregivers for training time, calculating sleeping time, and how you calculate hours worked for live-in caregivers.

John also discussed unionization in home care, and presented "8 Keys to Maintaining Non-union Status."

1. Employees must know your agency is opposed to unionization.
2. Your agency must provide "competitive" wages and benefits.
3. Your agency must have clear, well-drafted, written personnel policies.
4. Your agency's actual practices must be consistent with those personnel policies.
5. Supervisors must know the importance of their personnel function.
6. Your agency must establish and maintain regular communications with its employees.
7. Your agency must act early at first sign of an organizing campaign.
8. Your agency must seek knowledgeable labor advice.

Private Duty companies are acutely aware of the importance of marketing their services to grow the business and stay ahead of the competition. Elizabeth Hogue, an attorney from Burtonsville, MD, gave us some important details on how to market Private Duty effectively without tripping over the law.

The two big areas of concern are: 1) Fraud and Abuse and 2) Patients Right to Freedom of Choice of Providers. She also discussed anti-trust laws and the Stark Laws and Regulations. Of biggest concern to Private Duty Home Care companies is violating anti-kickback and rebate laws by giving items of value to referral sources in exchange for referrals.

Any time you provide a referral source with something for no cost that they would normally have to pay for themselves, that could be considered a kickback. For example, if you provide training to the staff of a skilled nursing facility or ALF, and that training is required by regulation or client expectation, that could be a kickback.

If you rent space from a SNF or ALF, you must have a lease of at least one year, pay rent at fair market value, have a clear business purpose for the space, and the rent cannot fluctuate with the volume of referrals from the facility.

Elizabeth also discussed marketing to patients, and the limits on any gifts to patients under the OIG advisory. You are not permitted to give gifts exceeding $10.00 per time and $50.00 per year to patients, and the gift cannot be cash, gift cards, or gift certificates. That means, you can't give "Free Care" as a marketing incentive.

You can reach Elizabeth Hogue at 301-421-0143 or email ehogue@comcast.net.

Tim Purcey, VP of Operations and CFO of CK Franchising in Dayton, OH, gave us a clear, concise summary of state licensure laws for Private Duty Home Care. CK Franchising, Inc. is the franchisor of Comfort Keepers, with 530 locations around the country.

According to CKFI data, there are 21 states that currently require licensure for non-medical home care companies, and three more states (NV, PA, IL) are in the process of enacting legislation.

To demonstrate the importance of knowing your state licensure laws, Tim shared an interesting fact. In 20 states that require licensure, cooking is considered part of companion and homemaker services. However, in Texas, cooking is considered personal care. If you provide personal care in Texas, you must be licensed, but if you only do companion and homemaker services, you don't.

Very interesting, don't you think?

Liz Pearson, an attorney with Pearson & Bernard in Covington, KY, gave a very clear presentation on non-competition and non-solicitation agreements with your employees, and how to enforce them. She began by helping us understand the difference. The first one keeps your employees from becoming your competitors by owning, working for, or consulting with a competing company.

The second one keeps your employees from going to another company and soliciting co-workers, past or current patients, or referral sources.

Liz described in detail why you need these agreements, how they work, and the remedies for breach of the agreement. These agreements are tricky but useful, and you need the assistance of counsel in creating and enforcing them.

Joins us in Indianapolis on November 30th for a day of learning, listening, and laughing as a group of Private Duty Home Care owners and administrators come together to discuss how to grow their businesses and get ready for the future.

Leading Home Care along with Indiana Association for Home & Hospice Care, Illinois Home Care Council, Michigan Home Health Association, Ohio Council for Home Care and National Private Duty Association are partnering to sponsor the Academy for Private Duty Home Care in Indianapolis on Thursday, November 30, 2006.

As the CEO of a successful Private Duty Home Care company, you're often alone in your decision making. There's no one in your organization who really understands your feelings, frustrations, and concerns.

Based on significant research, the Academy for Private Duty Home Care has been designed as a one-day institute expressly for owners, administrators, and CEOs of Private Duty Home Care companies.

This is your opportunity to come together in an intimate, high-impact learning environment to share strategies, ideas, and insights on how to grow your business, multiply the performance of your team members, and increase your income.

Come join us:

Thursday, November 30, 2006
8:00 - 4:30
Holiday Inn North at the Pyramids
3850 DePauw Blvd.
Indianapolis, IN

For more information, download the brochure, or call IAHHC at 317-575-8751.

Private Duty Today! is published every other Wednesday by Leading Home Care . . . a Tweed Jeffries company. We invite you to pass this newsletter along to your friends and colleagues in Private Duty Home Care by clicking on the link below.

• Publisher - Stephen Tweed, CSP
• Circulation Manager - Diane West
• Editor - Jason Tweed

Permission to Reproduce: Permission is granted to home care companies, home care associations, and home care related publications to reproduce articles from this newsletter as long as appropriate credit is given as follows: "Printed with permission from Private Duty Today! Copyright 2006 Leading Home Care ... To sign up for your FREE Subscription, log on to www.privatedutytoday.com."

You may also sign up for your FREE Subscription to Stephen Tweed's Leading Home Care Report. This bi-weekly electronic newsletter is written for home care company CEOs and senior executives who want to grow their businesses and multiply their performance.

email: jason@leadinghomecare.com

phone: 1-888-668-9333

web: http://www.privatedutytoday.com