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Title: Big pay raises ahead for Paloma… More >>

Big pay raises ahead for Palomar Pomerado nurses: new contract will increase salaries up to 30 percent over 3 years. : An article from: San Diego Business Journal

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I work as a travel nurse in California (i’m a Ca. resident), and took an assignment at a Ca. hospital but it was through a staffing agency out of Florida.
The contract with the Company in Florida had a “non-compete”
clause, which I have since heard is not enforcible in California.
The Florida company is threatening to sue me for breaking this, and I need to find a quick way to nullify the contract before it ends-up in a Florida court. I am having much difficulty finding a lawyer to pick it up, and I need to act quickly before I’m sued. What are my options? Can I get this nullified without a lawyer? Is that part of the contract already null and void since it is not in keeping with California state law, but was signed by me in California and I worked in California? All help appreciated!!!

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The burgeoning senior care market has introduced a slew of new concepts and terms that are easily confused. Many people believe, for example, that life care and continuing care communities are the same thing, and they use these terms interchangeably. However, life care is actually a subset of continuing care. While the offerings may look similar at a glance, don’t be fooled. Let’s take a look at the differences between the two, beginning with continuing care retirement communities (CCRCs). CCRCs vs. Life Care Communities CCRCs offer contractual agreements to people sixty years or older, providing them with a continuum of services, usually on the same campus. These services include independent living, assisted living, skilled nursing and sometimes memory care. Although all CCRCs offer a continuum of care, some rely on contracts with other care providers to administer the higher levels of care, which may be located off campus. This means that residents who move in at the independent or assisted living levels would have access to higher levels care as their needs progress, but they may need to move off campus to access those services. Most contracts require payment of an entrance fee (sometimes referred to as a “buy-in” or “purchase” fee) and monthly fees. Some contracts include the purchase of real estate (i.e., the resident’s apartment within the community), which can be willed or deeded to an heir just like any other real estate purchase. However, not all contracts involve the purchase of real estate. Under these terms, the seniors would become residents of the community, but would not own any real estate under the contract. Buy-in or entrance fees can range from $10,000-500,000+. Life care communities provide the same continuum of care to a resident for life, but the biggest difference is this: residents who become financially unable to pay their monthly care fees will be subsidized by the community, with the same access to services, and with no interruption in care or change in priority status. In other words, residents are guaranteed the same quality of care and access to care from day one through end-of-life, regardless of their personal financial situation. In addition, most life care communities offer all health care services on the same campus. The idea is that, after qualifying through a health and financial application process, residents will never have to move again, except between levels of care as needed. So, for example, a resident may be required to move from assisted living to skilled nursing as his or her care needs progress, but the new place of residence will be on the same campus. However, certain states allow life care communities to provide skilled nursing services off campus as long as it is under the ownership and supervision of the life care provider, and not through a contract agreement. There is one other significant difference. In a life care community, residents do not own real estate under their life care contract. Upon a resident’s death, the apartment (or room) that he or she occupied reverts back to the community. Because there is no federal agency that governs CCRCs and life care communities, the terminology and requirements vary from state to state. However, the easy way to distinguish between a life care community and a CCRC is by the contract type: Type A is considered life care; Types B and C are considered continuing care. The Contract Types: A, B & C In general, there are three types of continuing care contracts: Type A (Extensive or Full Life Care), Type B (Modified or Continuing Care) and Type C (Fee-for-Service). Each contract type involves a different degree of risk to the resident and the community. The highest level of risk is assumed by communities with a Type A contract and the lowest with Type C. The opposite is true for residents, where Type A is the lowest risk and Type C is the highest. Each contract type has different fee structures, which correspond to the levels of risk assumed by either party. Some continuing care communities offer only one type of contract, so contact the community you’re interested in to see which one(s) it offers. Here’s an overview of how each contract operates: Type A: Extensive or Life Care Contract With this type of agreement, consumers assume the least amount of risk, but pay top dollar. A Type A contract provides housing, services and amenities, and unlimited access to long-term nursing care at little to no additional cost, apart from periodic inflationary increases. The higher initial fee is based on the assumption that these residents may require-and utilize-higher levels of care as their needs develop over time. This can add up to substantial savings over a resident’s lifetime, considering that Medicare does not cover custodial nursing care, which currently runs $250+ daily, for a private room in a nursing home. In addition, the prepayment of future health care costs qualifies these residents for significant tax benefits (the IRS medical deduction). Typically, residents must maintain a minimum level of Medicare coinsurance. Who it’s good for: People who want to ensure that all of their health care needs will be covered for the remainder of their lifetime. Type B: Modified or Continuing Care Contract A Type B contract also provides housing, services and amenities, but access to long-term health care and nursing services is restricted to a specified number of days. After that, the resident is responsible for any additional care costs incurred. Some contracts allow residents to pay for the additional care at a discounted rate once they have utilized the care included in their contract. Just as with a Type A contract, residents are eligible for the IRS medical deduction. Who it’s good for: People who are able to pay for the costs of care not covered through their contract, and those who do not expect their health care needs to increase significantly over time. Type C: Fee-For-Service Contract With a Type C contract, access to health care is guaranteed, but residents must pay the full cost of the services they use. Under this type of agreement, residents receive housing, services and amenities as defined in the contract. Some communities do not charge an entrance fee for Type C contracts, instead charging only a monthly fee. However, other communities do charge an entrance fee, with the funds subsidizing a resident’s assisted living or skilled nursing care. If the cost of care exceeds the funds obtained from the entrance fee, then the resident would be charged for the full cost of any services utilized. This can happens if a resident requires extended skilled nursing care. For those who require higher levels of health care later on, the cost can be extremely high. At a daily rate of $250, nursing home care costs escalate rapidly, creating a major financial burden for residents without long-term care insurance or considerable financial resources. Residents do not qualify for the IRS medical deduction under a Type C contract. Who it’s good for: People who are willing to assume to the full risk of health care costs. Benefits of Continuing Care Continuing care grants residents convenient access to most of the services that they require, all in one place. With the exception of a Type C contract, the cost of those services is included in the fees they pay under their contract. Although health care constitutes the basis of the contract, it’s certainly not all about health care. Let’s take a look at what’s included under a typical continuing care agreement: * Access to an on-site doctor by appointment, five days a week. * House calls during an illness to assess the condition. * Meal delivery during the illness. * Daily van service to an off-campus hospital. * The option to retain services under a separate medical plan, with certain provisions. * Three meals a day, weekly housekeeping, and laundered linens and towels. * Access to banking services, recreational outings and numerous on-site activities. Regulatory Conditions Although CCRCs and life care communities are highly regulated in some states, there is no federal agency that oversees these types of retirement communities. However, there is a system of checks and balances in place to protect the consumer. Here’s how it works. Life care providers must submit audited financial statements and reserve reports, usually to the state Department of Social Services, on an annual basis. Various financial and reserve requirements are mandated by continuing care contracts statutes, to help ensure that providers will have sufficient financial resources available to meet future obligations to residents. This is so that residents will be protected from any financial difficulties that may affect the life care provider. Providers must recalculate reserves each year. If the Department of Social Services determines that a provider is in unsound financial condition, it will exercise its statutory authority to require that corrective measures be taken.

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Over time the need to have a written employment contract has become a necessity .In the past employers and employees used to make verbal agreements concerning the rights and obligation of their employment relationship.

Since verbal agreements are difficult to prove, these days, contract of service are preserved in a written documents known as the “Employment Contract.” This document categorically states the terms and conditions that govern the employer and employee .In the event of dispute between the two parties, this written contract becomes evidence tat can be used in court to settle such disagreements. Furthermore, since job descriptions are not as simplistic as in the past, verbal conversations governing an employers / employee relationship will not prove as effective as a written contract.

The employment contract not only allows for certainty, it also allows for any collective agreement that an employer would want to negotiate with other employees of the organization. In addition where disciplinary procedures are drafted within the employment contract, it serves a two- fold purpose in that firstly, the employer can only enforces these particular procedures and secondly it also ensures that the employer does not take advantage of any statutory provisions or for that matter exploit his or her employee.

The benefits of documenting terms and conditions into an employment contract is that it provides for certainty and protection to both parties alike .Any variation in the agreement can be added to the document so that employment contract permits flexibility.

Basically the general principle of contract law applies to all and any employment contract. Before an employment contract is effectively concluded there could be several prior negotiations. An advertisement in the news paper or job website like about a pending job offer does not constitute an offer as it only operates as an “Invitation to treat”. This means a party can enter negotiation to take up the offer but at this point it is not legally binding.

Interviews are held to further negotiations. Employers at interviews are only assessing the applicant as a potential candidate for the position. There may be a second or even a third interview and at this point still nothing is legally binding. Perhaps a final interview, there may be discussions held on terms and conditions, remuneration and other benefits. It is still a point of negotiation. If the employer soon thereafter offers the job to the potential candidate, it still does not bind the candidate as he or she would counter- offer by asking for a higher remuneration.

If the employer accepts these terms, an offer can be made on such terms and if the candidate accepts then there is an intention to create legal relations. A contract for employment may be verbally concluded at this juncture. It is at this point of appointment that the potential employee usually receives his employment contract stating all the terms and conditions agreed upon the negotiation stage.

If both parties agree to the terms and conditions in the employment contract they will subsequently sign the document constituting the agreement. Then for the agreed number of years or indefinitely, this document will govern the employment relationship.

One of the crucial elements for entering an employment contract is that parties must have the legal capacity to enter the contract .Examples where there is no such legal capacity if either party dies, is of unsound mind or falls sick so that the contract cannot be fulfilled. Under the Employment Act of Singapore, a person who is a minor (below the age of 21) can enter into a binding employment contract provided only if the person is qualified for the particular job description. For an illustration, an unqualified 18 year old cannot be employed as nurse in a hospital purely because he or she lacks the legal capacity to do so.

Please visit http://www.rikvin.com for more information on Employment Pass (EP) – Work Pass for Professional Employee & EntrePass for Entrepreneurs.
contact us at info@rikvin.com

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I thought we had a contract. I look after you and when the time came for reciprocation, you would look after me. For some, it may appear to be selfish to expect my children to care for me in their homes instead of placing me in a nursing home because of my stroke. The contract, my children’s and mine was formed at their birth. Their precious lives belonged to me. Their fate entrusted with me until they reached maturity and could fend for themselves.

As they grew our dependence on one another was unquestionable, our silent contract now melded together. I looked after them at the most vulnerable times of their lives and at some point I trusted they would do the same for me, their protector, their confidante, loving friend and mother.  Once I began to age and couldn’t fend for myself, my hope was that my children would honor our contract initiated at their birth.

I am now dependent on my children, trusting their judgment and compassion as they now control my life, where I live, what I wear and even my finances. A role reversal of sorts, that has begrudgingly taken place without my input or consent. My mental state, despite the stroke that paralyzed the left side of my body, was left intact without any effect on my speech.

I suffer a deep denial of my plight as I stare down unbelieving at my lifeless left arm and leg unable to move or feel the touch of another human being. I can’t walk and therefore, I am confined to a wheelchair. However, my will to walk, to be back in control of my life still prevails despite the choices my children have made for me.

My life once filled with joy and excitement with the ability to dictate my actions from one minute to the next is now one that is dependent on strangers and family members as I long to have my life back again.  I want to go home.

Most of my days are spent either sitting or lying expressionless in a silent display as I reflect over my life now stifled by consequence. I will tell anyone who will listen.  I want to go home. I pray daily and eagerly solicit prayers from my visitors to ask God to be merciful and restore me back to my prior self. I want to go home.

I suppose the easy thing to do would be to give up, to succumb to this existence. My life now consists of waiting. I wait for time as my life slowly slips from my grasp with each passing sunset and sunrise. I sob deeply and behind the tears is the sadness and the pain as I struggle to comprehend why I have been left in this place.

I’ve had to conform to a way of life that I have never known or thought would ever live. I have asked my children to take me to their homes, can’t we work something out? With each explanation of why it can’t be, their words bitingly remind me and it’s as if they don’t know . . . that we had a contract.

My children seem oblivious to my situation. They are comfortable with their obligatory visits. However, the fact still remains, I want to go home.  For living here for me is not living. My time is spent disconnected and suspended by emptiness which gives one ample time to ponder life as it is and what it was.

So, I wait. I fill the empty moments with memories of days gone by as I slowly come to terms with my plight.  I wish to discuss the terms of this contract, which appears to be binding and for me, one sided. With each passing day I realize that a negotiation is not possible. So, I wait and wish I could go home.

Although, some residents find it hard to come to terms with their disability, their family would serve them well to consider an assisted living facility.  The resident may respond better to an assistant living situation where they are still able to maintain some independence.

Depending on the circumstances, sometimes a nursing home is not the best choice. As caregivers we have to understand how the resident may have to mentally digest the change in their living status from being able to protect their privacy to now having to live in an environment that is more public and structured.

Additionally, some nursing home residents are often apprehensive about having to interact with care givers because they are strangers providing them care. Because some of the personal care nursing home personnel provide at times creates a sense of familiarity which the resident may not be accustomed to receiving from strangers, especially when it’s not by choice.

Further, it’s important that residents are able to maintain their family relationships. If the resident doesn’t feel alone or abandoned, but still part of their family, residents tend to be able to handle living in a nursing home or assisted living facility better.

It’s not easy having a parent living in a nursing home. Sometimes there is a need for emotional support and daily affirmations can be a great pick me up for caregivers when necessary.

It’s not easy having a parent living in a nursing home. Sometimes there is a need for emotional support and daily affirmations can be a great pick me up for caregivers when necessary.  If your loved one is living out of state in a nursing home, traveling to their location shows the importance of staying connected as a family.

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I had a DUI last year, and besides all the things I have to do for probation for both county and State board, they told me I needed approaval before I can work as a nurse and they want me to sign some contract, in which no one else has to do. They have been trudging their feet to get me into classes for orientation. Is this fair, or am I being treated like a disease?

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I want to end this employment and move on, however the contract states I will owe them $3000.00, if i terminate before 18 months. I have only been with this employer for 6 weeks. I am not gaining the experience I had hoped to gain. What are my options?

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NEW YORK, NY–(Marketwire – October 27, 2009) – Allied Healthcare International Inc. (NASDAQ: AHCI) (AIM: AHI) (http://www.alliedhealthcare.com), a leading provider of flexible healthcare staffing services in the United Kingdom, has implemented a three-year contract with the London Borough of Islington Council in the United Kingdom.

Under the Islington contract, Allied has the opportunity to deliver up to two thousand five hundred hours of home care services a week (130,000 hours a year) as one of two providers for the South region of Islington, a borough in North London with a population of 175,000. This award, which was secured in March 2009 and is Allied’s first contract with Islington, has now completed its implementation stage with the opening of a new branch, London North.

Sandy Young, Chief Executive Officer of Allied, commented: “Our stated objective of materially increasing our presence across London Boroughs is yielding excellent results as this win comes on the back of recent long-term contract wins in Waltham Forest and Redbridge. I look forward to updating our shareholders on further results of this successful strategy.”

For more news and information on Allied Healthcare International Inc., please visithttp://www.IRGnews.com/coi/AHCI where you can find the CEO’s video, a fact sheet on the company, investor presentations, and more.

ABOUT ALLIED HEALTHCARE INTERNATIONAL INC.

Allied Healthcare International Inc. (http://www.alliedhealthcare.com) is a leading provider of flexible healthcare staffing services in the United Kingdom. Allied operates a community-based network of 111 branches with the capacity to provide carers (known as home health aides in the U.S.), nurses, and specialized medical personnel to locations covering approximately 90% of the U.K. population. Allied meets the needs of private patients, community care, nursing and care homes, and hospitals.

FORWARD-LOOKING STATEMENTS

Certain statements contained in this news release may be forward-looking statements. These forward-looking statements are based on current expectations and projections about future events. Actual results could differ materially from those discussed in, or implied by, these forward-looking statements. Factors that could cause actual results to differ from those implied by the forward-looking statements include: general economic and market conditions; Allied’s ability to continue to recruit and retain flexible healthcare staff; Allied’s ability to enter into contracts with local government social services departments, NHS Trusts, hospitals and other healthcare facility clients on terms attractive to Allied; the general level of patient occupancy at our clients’ hospitals and healthcare facilities; dependence on the proper functioning of Allied’s information systems; the effect of existing or future government regulation of the healthcare industry, and Allied’s ability to comply with these regulations; the impact of medical malpractice and other claims asserted against Allied; the effect of regulatory change that may apply to Allied and that may increase costs and reduce revenues and profitability; Allied’s ability to use net operating loss carry forwards to offset net income; the effect that fluctuations in foreign currency exchange rates may have on our dollar-denominated results of operations; and the impairment of goodwill, of which Allied has a substantial amount on the balance sheet, may have the effect of decreasing earnings or increasing losses. Other factors that could cause actual results to differ from those implied by the forward-looking statements in this press release include those described in Allied’s most recently filed SEC documents, such as its most recent annual report on Form 10-K, all quarterly reports on Form 10-Q and any current reports on Form 8-K filed since the date of the last Form 10-K. Allied undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise.

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One of the scariest things about moving your nursing career overseas is the feeling of uncertainty when it comes to accepting a contract. Many questions go through your head, is this enough money? How much will it cost to live? Will I have enough to send home?

When looking at an employment contract for a nursing job abroad it is very easy to focus on the salary you’ll be receiving and judge the medical recruiter’s offer on that basis alone. However, should you fall into this trap you could be robbing yourself of some very attractive opportunities…

If you want to send money home, or have enough money to travel with and take advantage living in another country, then it is not the salary offered that you should be looking at when deciding if a contract is worth signing or not. What you need to be considering is the amount of money you will have left over at the end of the month, or you disposable income.

Disposable income is the difference between the income you receive in your pay packet and what you have to spend to live. Many factors affect your disposable income, and you need to consider them all when you are assessing a nursing employment contract.

Firstly, and probably most importantly, the cost of housing in the area where you will be nursing will have serious impact on how much money you have left at the end of the month. To find out how much accommodation will cost you – use the power of the internet. You can Google something like ‘1 bedroom apartment Albany New York’. And take a look at what is on offer with the letting agents that come up. Alternatively you can try to find the name of a local newspaper and check the classified section for ‘Apartments for Rent’.

You may find that accepting a nursing job in an area which has a low cost of housing, or one where housing is included will result in you having a higher disposable income, even if the salary figure is lower than you are being offered in other places.

The second highest expense would probably be your food bill, and the cost of food can vary drastically, even within a country. The cost of food includes your groceries that you bring home and cook for yourself, and also the food and drink that you purchase while you are out. To find out how the cost of food will affect your budget you can again use the power of the internet. Many restaurants now have internet sites and you can even check out their menu and the cost of things like their set meal.

Of course there are some exceptions to this rule. If you are only going to shop at large chain stores and eat at restaurants like McDonalds then your cost of living will be largely unaffected by your food purchases because these companies generally set one price for across the country.

Now, between countries, that’s different. You can actually use McDonalds to help you compare the cost of living between two countries. Each year economists work out the Big Mac Index which compares the cost of living in a number of countries and shows the information as how much a Big Mac costs. So the USA has a Big Mac cost of a dollar and places like Sweden have a higher Big Mac cost, but countries where it is cheap to live, like Indonesia, have a Big Mac cost of less than a dollar. It is a very rough guide to the cost of living in different countries.

Lastly, when working out your disposable income remember to use your take home pay when you work it out rather than your salary pre-tax. Unless you are nursing in the United Arab Emirates or Saudi Arabia you probably will not receive a tax free income.

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Nursing is one of the most mobile professions and no more so than now when the world is in the grip of a severe shortage of nurses. In fact, registered nurses are the biggest human export of many developing countries.

When choosing a medical recruiter or when assessing an offer of employment, you need to look at the contract conditions being offered as well as the salary in order to be able to make an informed decision…

Some contract conditions you may be offered in addition to a lucrative salary are:

* Housing or a housing allowance

* Flights paid for out to the country to take up your new position

* Visa fees paid for you

* NCLEX-RN and/or CGFNS fees paid for you

* Ability to contribute to a company pension scheme

* Medical insurance (especially important if you want a nursing job in the USA)

* An end of contract bonus

* Referral bonuses (these can be as much as 1000USD with some nursing agencies)

* Uniforms provided

Not every nurse recruiter offers any or all of these conditions in their contracts. When you are looking for a nursing job overseas you should keep these contract conditions in the back of your mind, so that you can ask recruiters about them. You may find that even recruiters that do not initially offer these benefits may have the ability to do so, if you ask.

Some of these conditions will be offered by agencies as standard to all registered nurses who sign a contract with them for a specified period. It is a wise idea to check the length of any contract you’re signing and what the penalties are if you leave early.

Usually when nursing agencies or recruiters are offering a benefit that will require them to invest money in getting you into a job they will ask you to sign a contract for a specified period. This can provide you with job security. However, it has been my experience that such contracts also have a penalty clause that will cost you money if you leave the position before the contract period has elapsed.

There is a great deal of diversity in contract conditions offered between countries and also between different nursing recruitment agencies and hospitals within any one country. Before you start applying for nursing positions overseas you need to consider what contract conditions you’d like to receive and how you’re going to compare different employment offers that have differing benefits.

One way to do this is to rank possible conditions in order of their importance to you. For example, if you are particularly interested in any potential employer paying for your flight – then you would put that at the top of your list of contract conditions to look for. Then you move on down the list putting the conditions in order of relevance for you.

This way, once you get offered a nursing employment contract you can assess it against your list and make an informed choice about whether you want to accept it or not.

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