CDPAP Packet

This Live-In Caregiver Agreement is made and entered into by and between Meadows Home Care, CDPAP. DBA Blossom Home Care, LLC (hereinafter"Meadows") and (hereinafter"Caregiver") (together, the "Parties").

1. The Parties agree that Caregiver will provide services that may require Caregiver to be on duty for a period of 24 hours or more (a "Live-in Shift").
2. The Parties agree that Caregiver will maintain the following schedule:
a. Work Schedule: If Caregiver works a Live-in Shift, Caregiver is expected to maintain a work schedule,per 24 hour live-in shift,of thirteen (13) hours of work, three (3) hours of meal breaks,and eight (8) hours of sleep, five (S) of which are uninterrupted. The Parties agree that this schedule identifies the Caregiver's expected work schedule and the times when the Caregiver is intended to be completely relieved of their responsibilities. Caregivers must work ONLY the hours scheduled. In the event that the client's needs require additional care, Caregivers will be compensated at the applicable hourly rate, including overtime pay as appropriate. Any work in excess of the thirteen
(13) hours per day MUST be reported to the Caregiver's Staffing Coordinator and be documented using the telephony or other call-in procedure and/or a time sheet, as directed by the Company.
b. Sleep Time: If Caregiver works a Live-in Shift, Caregiver is required to take eight (8) hours of sleep time. Caregiver cannot volunteer to skip sleep time without prior authorization, although how the Caregiver chooses to spend their sleeping time is up to the Caregiver (within reason and according to Company policy). Although all working time - authorized or unauthorized - will be paid, failure to take sleep time and failure to report interruptions in sleep time may result in disciplinary action or termination. Eight (8) hours of sleep time is excluded from compensation when the Caregiver has been provided with adequate sleeping facilities and can generally enjoy an uninterrupted night's sleep. If the Caregiver's sleep is interrupted by work, the duration of the interruption will be considered working time and the Caregiver will be paid for that time. If the interruptions are so frequent that the Caregiver cannot get at least five (S) hours of uninterrupted sleep, the entire sleep period will be considered working time and the Caregiver will be paid. The five (S) hours of sleep need not be consecutive. Adequate sleeping quarters will be provided for the Caregiver. In the event that a Caregiver's sleep time is interrupted, they MUST notify their Staffing Coordinator and report the interuption by using the telephony or other call-in procedure and/or a time sheet, as directed by the Company.
c. Meal Periods: If Caregiver works a Live-in Shift, Caregiver is required to take three (3) one-hour meal breaks per shift. On those occasions where the Caregiver continues to work through their meal period because they are interrupted or called back to work, the entire meal period is considered working time and will be paid. If a Caregiver's meal period is interrupted or missed for any reason such that the employee does not receive the uninterrupted meal period as set forth above, they MUST notify their Staffing Coordinator and report the interruption by using the telephony or other call-in procedure and/or a time sheet, as directed by the Company. Failure to report interruptions in meal periods may result in disciplinary action, up to and including termination.
Time Certification: The schedule above does not substitute for an accurate reporting of hours worked. The Caregiver is required to use the telephony or other call-in procedure and/or a time sheet,as directed by the Company, to clock in and out everyday of the 24 hour live-in shift and verify that they received eight (8) hours of sleep time, five (5) of which were uninterrupted, and three (3) hours of break time, during the most recent shift. Additionally, clock in and out times for sleep, sleep interruptions, meal periods, and meal interruptions must be reported to the Company, and should match the system records. If a Caregiver states, via the telephony or otherwise, as applicable, that the required sleep time or meal breaks were not received, Caregiver will be required to provide full details on the length of and reason for the interruptions(s). I understand I am required to notify the Agency in the event I am unable to take all of these sleep and meal periods as a result of the patient's needs during my off duty period. I am required to notify the Agency if the patient's needs prevent me from sleeping 8 hours, or 5 uninterrupted hours, or if all tasks on the patient's plan of care are unable to be completed within 13 hours per day. I understand that nothing in this agreement is intended to prohibit me from providing essential care to patients whose medical condition would be seriously affected if I withheld such care. However, if doing so means that I work in excess of 13 hours, I must notify my coordinator or supervisor immediately. Failure to notify my coordinator or supervisor will mean that I am working 13 hours or less per day.
3. Caregiver's total weekly earnings must be at least equal to the sum of the applicable minimum wage for the first 40 working hours in a workweek plus the applicable overtime rate for all working hours in excess of 40 in a workweek. Caregiver acknowledges and agrees that all hours worked in accordance with this Agreement shall be compensated by the rate of pay set forth in their Notice of Acknowledgment of Pay Rate and Payday, as may be modified by the Company from time to time.
4. Caregiver cannot allow any friend, family member, or associate entry to a client's premises.
5. I understand that it is my responsibility to maintain proper records of my shift times, including start times, meal breaks, off-duty time (if applicable), and end times. I also will track and accurately record times when a meal break and/or the 8-hour off-duty period are interrupted. I fully understand that I must accurately record any and all hours worked for the Agency on a daily basis on the Extended Shift Time Sheet ("Time Sheet") that has been provided to me. I will accurately record all interruptions to meal periods and applicable off-duty time on the Time Sheet. I further understand that, on the next calendar day following any day on which I perform services pursuant to this Agreement, I must accurately report all hours worked on the previous day to the Agency via telephone. I understand that, for pay purposes, the Agency will compensate me based upon the hours reported on the Time Sheet that I submit, and that any discrepancies between the Time Sheet and the hours that I report 6. I understand that my Time Sheet, completed and signed by the client, must be submitted to and received by the Agency office by the Monday morning following the work week in which the work recorded on the Time Sheet is performed. The Time Sheet may be dropped in the Agency lock box or submittted electronically.
7. Except as set forth in the Agreement, as well as the applicable Notice of Acknowledgment of Pay Rate and Payday, this Agreement contains the entire understanding among the Parties hereto with respect to the subject matter hereof, and supersedes all prior and contemporaneous agreements and understandings, representations, wa rranties,guarantees, inducements or conditions express or implied, oral or written, among the Parties with respect to such subject matter, except as herein contained. The express terms hereof control and supersede any course of performance and/or usage of the trade inconsistent with any of the terms hereof. This Agreement may not be modified or amended other than by an agreement in writing executed by all Parties hereto. Further, only the Administrator of Blossom is authorized to execute any such written amendment or modification on behalf of Blossom. The Parties enter into this Agreement with the express understanding that it supersedes and replaces any previous agreement between Caregiver and Blossom with respect to Live-in Shifts, and replaces all the terms either stated in or implied by that agreement.
8. Caregiver understands it is their decision to accept live-in cases based upon the terms of this agreement. Caregiver is in no way being coerced into accepting this agreement and recognizes the decision will not adversely affect assignment of future cases to them. Caregiver understands that they are, at all times, employed on an "at-will" basis.
Caregiver acknowledges and understands the content of this Live-in Agreement.Caregiver understands that this agreement is not intended to give rise to contractual rights or obligations of employment, nor is it to be construed as a guarantee of employment for any specific period of time or any specific type of work. Cargiver understands that, as an "at-will" employee, their employment may be terminated by the Company or at their discretion at any time, with or without cause, with or without notice, for any reason or no reason at all. By signing this agreement, Caregiver acknowledges receipt of, and agreement to, the above stated terms of employment regarding compensation. In the event that I have questions or concerns about my compensation, I will confer with my immediate supervisor or Coordinator 718-732-0100.

I have received, read and understand my role and responsibilities as Personal Assistant working for a Consumer or their Designated Representative participating in the MEADOWS HOME CARE CDPAP. I have had an opportunity to ask questions concerning my wage and benefit package. I understand that MEADOWS HOME CARE CDPAP is the Fiscal Intermediary and is responsible for processing on behalf of the Consumer the payroll and benefit administration for the PA. I understand that MEADOWS HOME CARE CDPAP is NOT my employer. I understand that I am hired, trained, supervised and receive my schedule by the Consumer and/or their Designated Respresentative. I also understand it is the Consumer or Designated Representative who can terminate my services or dismiss me from working for them if they choose to do so. I also acknowledge that I have received a copy of the MEADOWS HOME CARE False Claims Act Policy. I HAVE READ STATEMENTS PERTAINING TO FALSE CLAIMS AND FALSE STATEMENTS. I have been informed by my Consumer or Designated Representative regarding the policy for Federal and State False Claims Act and False Claims Policy.

This Live-In Caregiver Agreement is made and entered into by and between Meadows Home Care,
CDPAP. DBA Blossom Home Care, LLC (hereinafter“Meadows”) and (hereinafter“Caregiver”) (together, the “Parties”).

1. The Parties agree that Caregiver will provide services that may require Caregiver to be on duty for a period of 24 hours or more (a “Live-in Shift”).
2. The Parties agree that Caregiver will maintain the following schedule:
a. Work Schedule: If Caregiver works a Live-in Shift, Caregiver is expected to maintain a work schedule, per 24 hour live-in shift, of thirteen(13) hours of work, three(3) hours of meal breaks, and eight (8) hours of sleep, five(5) of which are uninterrupted. The Parties agree that this schedule identifies the Caregiver’s expected work schedule and the times when the Caregiver is intended to be completely relieved of their responsibilities. Caregivers must work ONLY the hours scheduled.
In the event that the client’s needs require additional care, Caregivers will be compensated at the applicable hourly rate, including overtime pay as appropriate. Any work in excess of the thirteen (13) hours per day MUST be reported to the Caregiver’s Staffing Coordinator and be documented using the telephony or other call-in procedure and/or a time sheet, as directed by the Company.
b. Sleep Time: If Caregiver works a Live-in Shift, Caregiver is required to take eight (8) hours of sleep time. Caregiver cannot volunteer to skip sleep time without prior authorization, although how the Caregiver chooses to spend their sleeping time is up to the Caregiver (within reason and according to Company policy). Although all working time - authorized or unauthorized - will be paid, failure to take sleep time and failure to report interruptions in sleep time may result in disciplinary action or termination. Eight (8) hours of sleep time is excluded from compensation when the Caregiver has been provided with adequate sleeping facilities and can generally enjoy an uninterrupted night’s sleep. If the Caregiver’s sleep is interrupted by work, the duration of the interruption will be considered working time and the Caregiver will be paid for that time. If the interruptions are so frequent that the Caregiver cannot get at least five (5) hours of uninterrupted sleep, the entire sleep period will be considered working time and the Caregiver will be paid. The five (5) hours of sleep need not be consecutive. Adequate sleeping quarters will be provided for the Caregiver. In the event that a Caregiver’s sleep time is interrupted, they MUST notify their Staffing Coordinator and report the interruption by using the telephony or other call-in procedure and/or a time sheet, as directed by the Company.
c. Meal Periods: If Caregiver works a Live-in Shift, Caregiver is required to take three(3) one-hour meal breaks per shift. On those occasions where the Caregiver continues to work through their meal period because they are interrupted or called back to work, the entire meal period is considered working time and will be paid. If a Caregiver’s meal period is interrupted or missed for any reason such that the employee does not receive the uninterrupted meal period as set forth above, they MUST notify their Staffing Coordinator and report the interruption by using the telephony or other call-in procedure and/or a time sheet, as directed by the Company.
Failure to report interruptions in meal periods may result in disciplinary action, up to and including termination.
d. Time Certification: The schedule above does not substitute for an accurate reporting of hours worked. The Caregiver is required to use the telephony or other call-in procedure and/or a time sheet, as directed by the Company, to clock in and out every day of the 24 hour Live-in shift and verify that they received eight (8) hours of sleep time, five (5) of which were uninterrupted, and three (3) hours of break time, during the most recent shift. Additionally, clock in and out times for sleep, sleep interruptions, meal periods, and meal interruptions must be reported to the Company, and should match the system records. If a Caregiver states, via the telephony or
otherwise, as applicable, that the required sleep time or meal breaks were not received, Caregiver will be required to provide full details on the length of and reason for the interruptions(s). I understand I am required to notify the Agency in the event I am unable to take all of these sleep and meal periods as a result of the patient’s needs during my off duty period. I am required to notify the Agency if the patient’s needs prevent me from sleeping 8 hours, or 5 uninterrupted hours, or if all tasks on the patient’s plan of care are unable to be completed within 13 hours per day. I understand that nothing in this agreement is intended to prohibit me from providing essential care to patients whose medical condition would be seriously affected if I withheld such care. However, if doing so means that I work in excess of 13 hours, I must notify my coordinator or supervisor immediately. Failure to notify my coordinator or supervisor will mean that I am working 13 hours or less per day.
3. Caregiver’s total weekly earnings must be at least equal to the sum of the applicable minimum wage for the first 40 working hours in a workweek plus the applicable overtime rate for all working hours in excess of 40 in a workweek. Caregiver acknowledges and agrees that all hours worked in accordance with this Agreement shall be compensated by the rate of pay set forth in their Notice of Acknowledgment of Pay Rate and Payday, as may be modified by the Company from time to time.
4. Caregiver cannot allow any friend, family member, or associate entry to a client’s premises.
5. I understand that it is my responsibility to maintain proper records of my shift times, including start times, meal breaks, off-duty time (if applicable), and end times. I also will track and accurately record times when a meal break and/or the 8-hour off-duty period are interrupted. I fully understand that I must accurately record any and all hours worked for the Agency on a daily basis on the Extended
Shift Time Sheet(“Time Sheet”)that has been provided to me. I will accurately record all interruptions to meal periods and applicable off-duty time on the Time Sheet. I further understand that, on the next calendar day following any day on which I perform services pursuant to this Agreement, I must accurately report all hours worked on the previous day to the Agency via telephone. I understand that, for pay purposes, the Agency will compensate me based upon the hours reported on the Time Sheet that I submit, and that any discrepancies between the Time Sheet and the hours that I report via telephone must be recorded, explained, and initialed on the Time Sheet. I will contact the Agency office immediately at 718-732-0100,Option 2 if I have any questions concerning this Agreement or any other matter arising out of my employment with the Agency. I further agree to promptly contact the Agency if the client’s condition changes.
6. I understand that my Time Sheet, completed and signed by the client, must be submitted to and received by the Agency office by the Monday morning following the work week in which the work recorded on the Time Sheet is performed. The Time Sheet may be dropped in the Agency lock box or submitted electronically.
7. Except as set forth in the Agreement, as well as the applicable Notice of Acknowledgment of Pay Rate and Payday, this Agreement contains the entire understanding among the Parties hereto with respect to the subject matter hereof, and supersedes all prior and contemporaneous agreements and understandings, representations, warranties, guarantees, inducements or conditions express or implied, oral or written, among the Parties with respect to such subject matter, except as herein contained. The express terms hereof control and supersede any course of performance and/or usage of the trade inconsistent with any of the terms hereof. This Agreement may not be modified or amended other than by an agreement in writing executed by all Parties hereto. Further, only the Administrator of Blossom is authorized to execute any such written amendment or modification on behalf of Blossom.
The Parties enter into this Agreement with the express understanding that it supersedes and replaces any previous agreement between Caregiver and Blossom with respect to Live-in Shifts, and replaces all the terms either stated in or implied by that agreement.
8. Caregiver understands it is their decision to accept live-in cases based upon the terms of this agreement.
Caregiver is in no way being coerced into accepting this agreement and recognizes the decision will not adversely affect assignment of future cases to them. Caregiver understands that they are, at all times, employed on an “at-will” basis.
9. Caregiver acknowledges and understands the content of this Live-in Agreement. Caregiver understands that this agreement is not intended to give rise to contractual rights or obligations of employment, nor is it to be construed as a guarantee of employment for any specific period of time or any specific type of work. Caregiver understands that, as an “at-will” employee, their employment may be terminated by the Company or at their discretion at any time, with or without cause, with or without notice, for any reason or no reason at all. By signing this agreement, Caregiver acknowledges receipt of, and agreement to, the above stated terms of employment regarding compensation. In the event that I have questions or concerns about my compensation, I will confer with my immediate supervisor or Coordinator 718-732-0100.