How I Made My Travel Certificates

Although my company is deeply involved in the design and sales of Travel Related Incentives and Rewards, first and foremost, we are a travel agency. Everything we do here is for the purpose of gaining access to travel customers.
Travel Agencies have been through some pretty big changes over the years starting with the airlines deciding that we didn’t deserve a commission for our services anymore. That sort of snowballed through many other travel service providers as the Internet opened up access to many of the same travel sources that we travel agencies used to call our own.
Today, instead of earning a commission by simply booking reservations for their clients, travel agencies must specialize in areas where they can guarantee travel service providers a large number of travelers. This allows the agency to negotiate rates below what is available to the consumer directly. So, the travel agency of this new era is now working for the travel services provider instead of the traveler. To make the new concept work, agencies are always looking for favorable pricing on the most desirable types of travel and then struggle to find the 1000’s of travelers they need so they can keep their contracts.
I developed my business model a number of years ago before the commission crunch began and unknowingly got a jump on the trend. I decided to try and market travel packages through the Human Resource departments of large companies. I put together cruise packages based on favorable rates I was getting from a few cruise lines sailing out of Florida. I offered these discount packages to employees as a company benefit. The companies loved it and were quite willing to put my flyers in their employee’s pay envelopes each week. That was almost 20 years ago and I still have a few companies that still use my original program today.
Getting really low rates on the most desirable types of travel is great but getting it for free is even better! While most agencies were desperately looking for more travelers, I knew if I could provide the travel services for little or nothing, this would never be a problem for me. I just had to figure out how I could get someone else to pay all or at least some of the travel expenses.
Living in Florida I watched as condominiums were being built one after the other from one coast to the other and all points in between. These were time share condo developments and they were some of the nicest resorts that Florida had to offer. They had a lot of empty suites week after week and they were looking for travelers too. I made a few calls and soon after I had arrangements with dozens of resorts that would give me access to their accommodations simply to have the opportunity to show my travelers around in hopes they would buy. All I needed now was a cost effective way to let people know what I had to offer.
It wasn’t just me that was looking for customers; everyone that was in any kind of business was looking for customers. I got together with a few marketing managers I knew and proposed that we work together. If they would cover the cost of the fees, I could give them a travel certificate that they could in turn give to their customers in reward for their business. It wasn’t long before I had several business owners who were promoting my travel packages by purchasing travel certificates from me and then giving them out to all their customers. It was the perfect idea: Travelers got to go to great places almost for free, my business associates got terrific sales incentives at a great price and I got plenty of travelers to fulfill my contracts with all my fees prepaid!
Since then I’ve design 100’s of travel certificate programs. The scope of each program is based primarily on the amount of money the business wants to pay per certificate towards the fees. The travelers makes up the difference but still has access to deeply discounted travel services that they would not be able to get elsewhere.

Understanding the Home Loan Application and Mortgage Approval – The Mortgage Lender Analysis

Do You Pass The Mortgage Lender Analysis? When a mortgage lender reviews a real estate loan application, the primary concern for both home loan applicant, the buyer, and the mortgage lender is to approve loan requests that show high probability of being repaid in full and on time, and to disapprove requests that are likely to result in default and eventual foreclose. How is the mortgage lenders decision made?
The mortgage lender begins the loan analysis procedure by looking at the property and the proposed financing. Using the property address and legal description, an appraiser is assigned to prepare an appraisal of the property and a title search is ordered. These steps are taken to determine the fair market value of the property and the condition of title. In the event of default, this is the collateral the lender must fall back upon to recover the loan. If the loan request is in connection with a purchase, rather than the refinancing of an existing property, the mortgage lender will know the purchase price. As a rule, home loans are made on the basis of the appraised value or purchase price, whichever is lower. If the appraised value is lower than the purchase price, the usual procedure is to require the buyer to make a larger cash down payment. The mortgage lender does not want to over-loan simply because the buyer overpaid for the property.
The year the home was built is useful in setting the loan’s maturity date. The idea is that the length of the home loan should not outlast the remaining economic life of the structure serving as collateral. Note however, chronological age is only part of this decision because age must be considered in light of the upkeep and repair of the structure and its construction quality.
Loan-to-Value Ratios
The mortgage lender next looks at the amount of down payment the borrower proposes to make, the size of the loan being requested and the amount of other financing the borrower plans to use. This information is then converted into loan-to-value ratios. As a rule, the more money the borrower places into the deal, the safer the loan is for the mortgage lender. On an uninsured home loan, the ideal loan-to-value ratio for a lender on owner-occupied residential property is 70% or less. This means the value of the property would have to fall more than 30% before the debt owed would exceed the property’s value, thus encouraging the borrower to stop making mortgage loan payments. Because of the nearly constant inflation in housing prices since the 40s, very few residential properties have fallen 30% or more in value.
Loan-to-value ratios from 70% through 80% are considered acceptable but do expose the mortgage lender to more risk. Lenders sometimes compensate by charging slightly higher interest rates. Loan-to-value ratios above 80% present even more risk of default to the lender, and the lender will either increase the interest rate charged on these home loans or require that an outside insurer, such as FHA or a private mortgage insurer, be supplied by the borrower.
Mortgage Closing Settlement Funds
The lender then wants to know if the borrower has adequate funds for settlement (the closing). Are these funds presently in a checking or savings account, or are they coming from the sale of the borrower’s present real estate property? In the latter case, the mortgage lender knows the present loan is contingent on another closing. If the down payment and settlement funds are to be borrowed, then the lender will want to be extra cautious as experience has shown that the less of his own money a borrower puts into a purchase, the higher the probability of default and foreclosure.
Purpose Of Mortgage Loan
The lender is also interested in the proposed use of the property. Mortgage lenders feel most comfortable when a home loan is for the purchase or improvement of a property the loan applicant will actually occupy. This is because owner-occupants usually have pride-of-ownership in maintaining their property and even during bad economic conditions will continue to make the monthly payments. An owner-occupant also realizes that if he/she stops paying, they will have to vacate and pay for shelter elsewhere.
If the home loan applicant intends to purchase a dwelling to rent out as an investment, the lender will be more cautious. This is because during periods of high vacancy, the property may not generate enough income to meet the loan payments. At that point, a strapped-for-cash borrower is likely to default. Note too, that lenders generally avoid loans secured by purely speculative real estate. If the value of the property drops below the amount owed, the borrower may see no further logic in making the loan payments.
Lastly the mortgage lender assesses the borrower’s attitude toward the proposed loan. A casual attitude, such as “I’m buying because real estate always goes up,” or an applicant who does not appear to understand the obligation he is undertaking would bring low rating here. Much more welcome is the home loan applicant who shows a mature attitude and understanding of the mortgage loan obligation and who exhibits a strong and logical desire for ownership.
The Borrower Analysis
The next step is the mortgage lender to begin an analysis of the borrower, and if there is one, the co-borrower. At one time, age, sex and marital status played an important role in the lender’s decision to lend or not to lend. Often the young and the old had trouble getting home loans, as did women and persons who were single, divorced, or widowed. Today, the Federal Equal Credit Opportunity Act prohibits discrimination based on age, sex, race and marital status. Mortgage lenders are no longer permitted to discount income earned by women even if it is from part-time jobs or because the woman is of child-bearing age. Of the home applicant chooses to disclose it, alimony, separate maintenance, and child support must be counted in full. Young adults and single persons cannot be turned down because the lender feels they have not “put down roots.” Seniors cannot be turned down as long as life expectancy exceeds the early risk period of the loan and collateral is adequate. In other words, the emphasis in borrower analysis is now focused on job stability, income adequacy, net worth and credit rating.
Mortgage lenders will ask questions directed at how long the applicants have held their present jobs and the stability of those jobs themselves. The lender recognizes that loan repayment will be a regular monthly requirement and wishes to make certain the applicants have a regular monthly inflow of cash in a large enough quantity to meet the mortgage loan payment as well as their other living expenses. Thus, an applicant who possesses marketable job skills and has been regularly employed with a stable employer is considered the ideal risk. Persons whose income can rise and fall erratically, such as commissioned salespersons, present greater risk. Persons whose skills (or lack of skills) or lack of job seniority result in frequent unemployment are more likely to have difficulty repaying a home loan. The mortgage lender also inquires as to the number of dependents the applicant must support out of his or her income. This information provides some insight as to how much will be left for monthly house payments.
Home Loan Applicants’ Monthly Income
The lender looks at the amount and sources of the applicants’ income. Sheer quantity alone is not enough for home loan approval; the income sources must be stable too. Thus a lender will look carefully at overtime, bonus and commission income in order to estimate the levels at which these may reasonably be expected to continue. Interest, dividend and rental income would be considered in light of the stability of their sources also. Under the “other income” category, income from alimony, child support, social security, retirement pensions, public assistance, etc. is entered and added to the totals for the applicants.
The lender then compares what the applicants have been paying for housing with what they will be paying if the loan is approved. Included in the proposed housing expense total are principal, interest, taxes and insurance along with any assessments or homeowner association dues (such as in a condominium or town-homes). Some mortgage lenders add the monthly cost of utilities to this list.
A proposed monthly housing expense is compared to gross monthly income. A general rule of thumb is that monthly housing expense (PITI) should not exceed 25% to 30% of gross monthly income. A second guideline is that total fixed monthly expenses should not exceed 33% to 38% of income. This includes housing payments plus automobile payments, installment loan payments, alimony, child support, and investments with negative cash flows. These are general guidelines, but mortgage lenders recognize that food, health care, clothing, transportation, entertainment and income taxes must also come from the applicants’ income.
Liabilities and Assets
The lender is interested in the applicants’ sources of funds for closing and whether, once the loan is granted, the applicants have assets to fall back upon in the event of an income decrease (a job lay-off) or unexpected expenses such as hospital bills. Of particular interest is the portion of those assets that are in cash or are readily convertible into cash in a few days. These are called liquid assets. If income drops, they are much more useful in meeting living expenses and mortgage loan payments than assets that may require months to sell and convert to cash; that is, assets which are illiquid.
A mortgage lender also considers two values for life insurance holders. Cash value is the amount of money the policyholder would receive if he surrendered his/her policy or, alternatively, the amount he/she could borrow against the policy. Face amount is the amount that would be paid in the event of the insured’s death. Mortgage lenders feel most comfortable if the face amount of the policy equals or exceeds the amount of the proposed home loan. Less satisfactory are amounts less than the proposed loan or none at all. Obviously a borrower’s death is not anticipated before the loan is repaid, but lenders recognize that its possibility increases the probability of default. The likelihood of foreclosure is lessened considerably if the survivors receive life insurance benefits.
A lender is interested in the applicants’ existing debts and liabilities for two reasons. First, these items will compete each month against housing expenses for available monthly income. Thus high monthly payments may reduce the size of the loan the lender calculates that the applicants will be able to repay. The presence of monthly liabilities is not all negative: it can also show the mortgage lender that the applicants are capable of repaying their debts. Second, the mortgage applicants’ total debts are subtracted from their total assets to obtain their net worth. If the result is negative (more owed than owned), the mortgage loan request will probably be turned down as too risky. In contrast, a substantial net worth can often offset weaknesses elsewhere in the application, such as too little monthly income in relation to monthly housing expense.
Past Credit Record
Lenders examine the applicants’ past record of debt repayment as an indicator of the future. A credit report that shows no derogatory information is most desirable. Applicants with no previous credit experience will have more weight placed on income and employment history. Applicants with a history of collections, adverse judgments or bankruptcy within the past three years will have to convince the lender that this mortgage loan will be repaid on time. Additionally, the applicants may be considered poorer risks if they have guaranteed the repayment of someone else debt by acting as a co-maker or endorser. Lastly, the lender may take into consideration whether the applicants have adequate insurance protection in the event of major medical expenses or a disability that prevents returning to work.
When a mortgage lender will not provide a loan on a property, one must seek alternative sources of financing or lose the right to purchase the home.

How to Choose Home Furniture: Anticipate the Activities in Each Room

Decorating a room with furniture can seem like an overwhelming task especially for new homes that are almost completely bare. It becomes easier to determine what kind of furniture to add by anticipating the area’s purpose and the activities that will be done in the room.
Is the room a place for entertainment? If so, then large seats such as sectional sofas may be needed if the room is meant to be the hub for all kinds of entertainment – from watching movies, to playing video games or board games, to simply conversing with friends and guests. An ottoman may be also added for extra seating. To complete the room, a side table or coffee table should be placed for cocktail trays and drinks during parties. An entertainment console is essential if you want to entertain guests with all kinds of media. This type of furniture conveniently keeps the television, DVD player, game consoles and stereo system all in one place. Media chests or drawers and cabinets may also be added for a convenient place to store DVDs, video games, TV guides and remotes.
On the other hand, if the room will be used for taking meals, then spare tables would come in handy. To keep the upkeep easy in your home, furniture that balances look and stain-resistance are excellent choices. Nowadays, you can easily find expandable wooden tables that don’t sacrifice look for utility.
If children will be frolicking in the room, then padded or upholstered furniture with no sharp edges can keep them safe. Kid-friendly cabinets and chests will also provide for easy clean up and storage of children’s toys. If this happens to be your child’s room, why not consider under-bed storage to help keep things neat and tidy? Another option is to choose bedding with a pull-out trundle to easily accommodate friends for sleepovers.
To redesign a room as the perfect place to read or study, consider adding various elements that give that cozy feel conducive to relaxed reading time. Reclining chairs, chaises and rugs are only some of these relaxing elements. Don’t forget the bookshelves and the right lampshades that provide ample light.
Planning out the layout of the house depending on the kind of activities expected in each room is one good way to narrow down what to look for before shopping for your home furniture. This way, you can anticipate what pieces to purchase first and avoid overspending on unnecessary furniture. This will work not only for your budget but also for the over-all order of your home. After all, a well planned home is one that guests are sure to remember when they come over.

Travel Website Dictionary

For the benefit and convenience of the traveler and adventure lover travel dictionary is compiled. This dictionary provided a complete guide to all the aspects of traveling. You might be a regular business traveler looking for some discount on travel cost or the wanderlust looking out for a vacation that many travelers do not take. For every kind of traveler with whatever their requirements, website dictionary is the solution.
There are a number of things that go into planning a vacation and without a good travel dictionary this is impossible on your own. The road map has to be conceptualized and the itinerary must be sorted out. While you can get a customized itinerary for you self you can also select one suitable to your travel destination from an array of great tours travel website dictionaries boast of.
Only a travel website dictionary will be able to get you the latest updates on prices of tours, discount packages and the umpteen frills all travelers look out for. You can get them right in your inbox by signing up with them. The latest fares and the festivals are all listed on travel website dictionaries.
Before spending your hard earned money on a lavished tour it’s always a good idea to sample its preview. And what better way to do that than through the eyes of experienced travelers and their travelogues. On a travel website dictionary you get the opportunity to communicate with there travelers who have been to the sites where you plan to go. Get the best tips and cultural information on the food habits, dress code and religious customs before you arrive.
A travel website directory is one that gives you the chance to sit back in your easy chair and book a travel guide over the net. Isn’t it a better proposition to have your travel guide waiting for you on arrival than to scout the alien city seeking one out. Travel agents who register on travel website dictionaries have a name for themselves, and can give you the right information which many guide books are unable off.
A travel website dictionary is also regularly updated and you will get all the latest information about new sites to visit, the recent change in hotel room tariffs and what is new in town. You can source contact numbers and get more information from their websites and agencies that have been listed. A Travel dictionary has a huge list of hotels, taxi services, insurance companies, travel guides and travel tips that you cannot expect to find any where else.

Organic Gardening Tips – 5 Tips to Successful Organic Gardens

Unlike the popular theories that state that the space shuttle could miraculously appear if blown up enough times, an organic garden is usually not the result of an accident. People that have a successful garden have created one based upon their consistent upkeep, planning, and a desire to make their garden grow. Regardless of the therapeutic value the gardening has, relaxation has little to do with the steps that it takes to ensure the success of your gardening endeavor. Here are a few organic gardening tips on how to make sure that your organic garden goals are reached by looking at planning, soil preparation, fertilizers, irrigation, and insect and disease control.
Tip #1 – a plan is always needed. Not something that is thought of and reconsidered over time intermittently, but a specified plan of action that leads to a specified end result. When you decide to grow your garden, and you choose to do it in an organic matter, you will need to take a few things into consideration such as location, the environment that the plants will grow it, the time that it will take in order for you to properly take care of your garden, how much effort will be involved and are there any resources that you may or may not be able to acquire in order to reach your final goals.
Once you have a clear written outline of what it is you need to do and what you need to acquire to reach your garden goals, it is time to start the plan into action. Action is everything once the goals are defined. If you set your goals but neglect factors such as good seed, compost, or even a source of good water for your plants, you will fail in your attempt because any compromise will lead to an overall failure.
Tip #2 – prepare your soil. Soil preparation is the foundation of the growth of any and all plants that you have. From the soil, the plants will be able to get their nutrients. Soil that is hard or dense will be almost impossible to aerate and therefore the plants will not get enough oxygen through the root system in order to thrive and flourish. Likewise, if there is no way for the water to evenly percolate to the plants roots in your garden, some plants will make it while others will die without consistent moisture, and some will be oversaturated and get root rot.
Another organic gardening tip is that you must also consider the consistency of the soil in regard to the amount of compost and nutrients that will be accessible to the seeds that will grow into the plants in the garden that you desire. By adding natural compost or other fertilizers to enhance the nutrients within the soil such as nitrogen or potassium, you will need to prepare this ahead of time, specifically as you are preparing the soil and getting ready to plant your seeds.
Tip #3 – Add compost. With reference to fertilizer, if you are doing this in an organic matter, some of the best fertilizer that you can get can either come from your compost pile or from a worm bin that you have created through your vermicomposting efforts. This needs to be prepared several weeks in advance so that it is ready to use when you are ready to plant. Compost that has not had time to properly finish will be detrimental to your soil and therefore proper preparation is always mandatory before getting ready to add these nutrients to the soil that will bear the fruit of your labor.
Tip #4 – Consistently water your garden. The consideration of water is also paramount in your success. You must have a way for your organic garden to get enough water on a regular basis so that it can grow unimpeded by the periods of droughts that are self induced by someone to did not plan ahead of time and create an optimal situation for the gardens irrigation needs. This includes having enough access to water, easy access through an irrigation system or hose system, and potentially a sprinkler system on a timer which can ensure that the garden is receiving water on a regular basis.
Tip #5 – Beware of insects. One final organic gardening tip that you should consider is that when your plants begin to grow, insects will appear. Weeds will also appear as well as potential diseases that can kill off your crop. This will take some wisdom on your part knowing the types of plants you are growing and finding natural alternatives to pesticides that may inhibit or deter the natural growth processes of your plants. If you are an organic gardener, you will not want to use these anyway and therefore finding beneficial insects that attack bad insects or natural scents or plants that will deter weed growth or disease is paramount in ensuring the healthy growth of your garden.
When considering all of these things together in a big picture, you realize that gardening cannot possibly be the result of an accident. There must be proper preparation and access to all of the tools necessary in order to make a garden successful and to make your efforts worthwhile. Take some time and use these five organic gardening tips to your benefit and make your garden one of the best you have ever had.

Black Friday: The Best Time To Get Discount Home Furniture and New Kitchen Appliances?

Ah, November. That time of year when (in most places) the air takes on a pre-snow chill, the last of the leaves start to crinkle and fall from the trees and, most importantly, the Shopper Monsters in us begin to poke their heads out and sniff the air.
It started on the very first day of the month. All through October you saw Christmas-y things peeking out from store corners — a roll of wrapping paper here, a sprig of holly there — but you didn’t really think about it. Maybe you didn’t want to think about it. You were still deciding on what candy to hand out to trick-or-theaters, after all.
Then, without warning, November hit, and with it, the holiday season. As you browsed department stores looking for day-after-Halloween candy deals, you couldn’t help but notice it looked as if the North Pole exploded all over. Your Shopper Monster growled and wagged its tail eagerly. You gently tugged at its leash and got into the checkout line, where you saw that they were already selling Christmas-themed candy, at three times the price of the discounted bag you were getting ready to purchase. The days have passed, growing shorter all the while, along with the patience of your Shopper Monster.
Soon it will be here. The most magical day of the year for your Shopper Monster: Black Friday. Just as it did in years’ past, by now the Shopper Monster will have wriggled its way out and started hauling you around, while all you can do is flail behind helplessly, holding onto the leash for dear life, pretending you have some semblance of power over the beast.
Other people’s Shopper Monsters are even worse; more than once they’ve been driven to go straight to bed after Thanksgiving dinner so they can wake up at an ungodly hour and spend the day fully energized, racing from store to store, finding the best deals on this mp3 player and that blender. Others have powered through the day aided by espresso shot after espresso shot. Still others waited for midnight to hit, refreshing their Internet browsers over and over so they can get first dibs on the online deals.
And what for? All in the name of discount home furniture and new kitchen appliances. The truth is that Black Friday can save you a lot of money, but being a smart consumer all year round can do the same thing. Black Friday is just one day out of the year stores have big sales — most will have at least one other big blowout at some point in the year, and will always have a few things on sale throughout the year.
Checking online frequently is the easiest way to check for discounts on home furniture, kitchen appliances and everything else you don’t want to pay full price for. You might be able to save a lot of money on Black Friday — your sanity is a whole other story. Keep your eyes and ears open for deals 365 days a year, and you’ll be able to keep that Shopper Monster happy all year.

Details About Working With an Online Travel Agency

When you are looking to book your next vacation or your next business trip, you may be considering using an online travel agency. Before you decide to do so, however, you should be aware of what to expect from an online travel agency so you can determine how best to match that to your own unique needs. There are several different levels of service in which to classify online travel agencies, the level you need depends on your trip requirements as well as your personal travel and leisure preferences or desires.
Quite simply, you should be able to find an online travel agency that can fulfill any expectation you may have. Whether you prefer self-service travel plans where you do all of your own searching and booking, or a full-service online agency that handles every detail on your behalf, there are many options available. Depending on the type of travel you will be undertaking, there are also various options that you can consider among online travel agencies. Some specialize only in travel packages, while others offer a la carte menus of travel services for you to pick and choose.
There are several expectations, however, that are universal to all online travel agencies. These have to do with the minimum level of service provided and the quality and competitiveness of the types of travel being sold. It is best to qualify the online travel agency on all of these expectations before you choose to enter into partnership with them for the travel you are seeking to plan.
The first universal expectation that you should have for your online travel agency is having a variety of destinations and packages available to choose from. It does not matter what specialty the agency might have, from full-service travel to niche travel such as cruises or unusual destinations. No matter what is being sold, you always want to partner with an agency that provides options. While the first option you see may very well end up being the best choice or the best value, you will have no means of determining that unless other options are available for comparison. Good self-service travel sites will readily offer you comparison information. Full-service online travel agencies should compile that same information and present it to you when you are in the process of making a decision.
The second universal expectation you should have when using an online travel agency is that they offer the same basic types of vacations from more than one carrier or provider. For example, you can choose between two major airlines for the same New York-to-Miami flight leg of your trip. If an online travel agency represents only one brand, they are not truly a travel agency; instead, they are a representative of that brand. If only one brand were offered, customers would have no means of evaluating whether the services and products offered were of value or were worthless. Having a number of providers to choose from when selecting hotel or airfare or cruise line shows that the travel agency is actively updating its site with the best prices and options currently available.
The third universal expectation that you should have for your online travel agency is price competitiveness. Although travel agencies sometimes charge fees to travelers in order to off-set their cost of doing business, those fees must be fair. The charges for the actual travel services you see published through online travel agencies should be no more than what you would pay if you went directly through the provider, and, in fact, less if bundled with other services.
The final universal expectation that you should have for your online travel agency is a service-level guarantee that ensures you get what you pay for and are treated in a courteous and appropriate manner. Online travel agencies should also offer some form of a guarantee for your purchases that no foreseeable action on their part or the part of the service provider will interrupt your travel. They cannot warrant against freak or random occurrences, but they can ensure that their own offerings are solid before offered.
Perhaps the best thing about using an online agency is the availability of customer reviews and feedback you can read before making a final purchase. Another nice convenience, for repeat customers, is the ability to create your own customer profile that allows you to save certain options in your preferences that will streamline future vacation planning. You can save time and hassle by storing any corporate or membership discount numbers, frequent flyer numbers and other pertinent information on your customer profile.
The expectations you hold for the online travel agency you select as a partner may be varied. If they can uphold these four basic standards of quality, you can be assured that you are getting sound representation and the best deals available.

Centers For Medicare and Medicaid Services – Home Health Quality Measures Explained

The Centers for Medicare & Medicaid Services (CMS) is part of the federal government’s Department of Health and Human Services. Because many Medicare and Medicaid recipients are elderly, much of the funding goes to nursing homes or eldercare services. Health agencies that receive certifications from Medicare undergo an assessment every three years. CMS assesses these home health agencies via quality measures and publishes each agency’s results.
CMS & Home Health
CMS provides scoring for all Medicare-certified home health agencies via Health Compare. The quality measures take into account: (1) the patient’s improvement in performing a variety of activities of daily living (ADLs), and (2) whether the patient’s health improves or stabilizes over time.
It is important to note that the quality measures should only be used as a general guide. Many home health care recipients are elderly, and each patient’s needs are different. Some patients are recovering from surgery or a medical emergency. Others have chronic and worsening medical conditions. Therefore, the lack of improvement in some home health care recipients is not due to poor standards or substandard care, but rather due to declining health. In addition, Medicare’s quality measures for home health are fairly recent and are still being refined. Currently, the quality measures provide a baseline to help consumers see how a local agency compares to both state and national averages.
CMS Quality Measures
CMS quality measures are used in Medicare-certified home health care agencies in order to come up with the final scoring. Medicare details the following quality measures:
* Three measures related to improvement in getting around:
– Percentage of patients who get better at walking or moving around
– Percentage of patients who get better at getting in and out of bed
– Percentage of patients who have less pain when moving around
* Four measures related to meeting the patient’s activities of daily living:
– Percentage of patients whose bladder control improves
– Percentage of patients who get better at bathing
– Percentage of patients who get better at taking their medicines correctly (by mouth)
– Percentage of patients who are short of breath less often
* Two measures about how health care ends:
– Percentage of patients who stay at home after an episode of home health care ends
– Percentage of patients whose wounds improved or healed after an operation
* Three measures related to patient medical emergencies:
– Percentage of patients who had to be admitted to the hospital
– Percentage of patients who need urgent, unplanned medical care
– Percentage of patients who need unplanned medical care related to a wound that is new, is worse, or has become infected

Your Home Furniture- A Reflection of Your Personality

Furniture is the basic essence of every home. Whatever the kind of furniture – bedroom furniture, patio furniture or , all go a long way in giving your house that special look. The furniture is among the very first things to get noticed the moment someone enters your house. After all, the furniture you choose is a reflection of your personality and gives an insight into your outlook towards life. Not only the essential furniture, but also the seemingly insignificant add-ons like rugs, lamps and tables give the onlooker a fair idea what you are all about. Beds, bunks, tables, chairs, couches, and spreads for all of them, clearly indicate the behavioral traits of the creator of that setup.
Picture a scene when you enter a friend’s flat. The is bare except for a used plate, and the dining chairs scattered around aimlessly. A piece of clothing lying on the dirty looking rug, and a bare look accentuated by a couple of poorly polished cane chairs. A center table that looks like it came straight from a garage sale. What comes to mind? A bachelor’s pad, no doubt, and one who is not too concerned about the way he lives. If this is the way he keeps the furniture in his home, this is probably how he will treat all who come in contact with him- a casual, laid back attitude that whatever is, goes. Neatness is the last thing I’m bothered about. Let me live my life- others don’t really matter.
Cut to another view. A neat, plush black leather sofa set inviting you to just sink into its depths. Promising to envelope you in comfort the moment you decide to settle into it. A dining set including an etched glass top dining table covered with a handsome , with smart looking, matching dining chairs to complement its beauty. A neat bar in the corner sporting all the latest and exquisite labels. Matching curtains to complement the entire set of the living room. What comes to mind? Obviously someone who doesn’t like to take things lightly. A perfectionist who would go out of his way to achieve that special something. Comfort matters to this man, but class is equally important. And we haven’t even entered the bedroom yet.
Which one would you like to be identified with? Take your pick.
Of course, what I have cited are two extreme examples, just to put across my point. While you may not fit into either of these, what matters is that you understand the immediate effect the look of your furniture has on the people whose opinion matters to you.
So when you decide to go in for that smart rocking chair in the home-decor exhibition, be sure to first give it a long, cool thought. Does that attractive looking piece in the show window really go with the theme of your home furniture, or is it looking attractive, yet would do well to continue sitting there itself? Take your time choosing your pieces, and you will never be the loser.

Eldercare Tips – How to Hire Help Your Parents Won't Hate Through an Agency

How can you find capable and honest people whose quirks won’t drive your parents nuts? How much will they be paid? For how many hours at a stretch? How many stretches per week or month? Will these people be employees of yours/your parents? Of an agency? Or independent contractors? Do you know how the IRS determines these things and what paperwork and record keeping are required? Have you thought about worker’s comp and withholding? Suppose the applicants don’t speak much English?
Finding Candidates
There are two common ways to find help. Your parents can hire workers through an agency or can hire privately using referrals from friends, neighbors, physicians, local groups, or advertisements. Do you and your parents know the pros and cons of each option?
Agency hires
What are the pros and cons?
If your parents hire through an agency, the helper is the employee of that agency. It will find candidates, select a helper, pay that person, withhold taxes, provide W-2 forms to the helper, and bill you/your parents at its hourly rate. Although your parents will not have to recruit, screen, or haggle over wages, they will have limited choice in whom the agency sends – but somebody will show up, including substitutes when your parents’ worker is ill or on vacation. Clients may ask about the agency’s hiring and screening policies but are expected to rely on the agency’s selection.
If your parents have a problem with the worker, they can call the agency and a supervisor will talk to the worker for them. This is a strong argument in favor of agency hires, as long as your parents are willing to ask for help. How likely are your parents to report dissatisfaction while problems are small and easily fixed? Will they have the moxie to call the supervisor? Will they let you know?
Your parents will probably be charged between $20.00 and $40.00 per hour and will have to agree to a minimum number of hours per visit, usually four. The worker receives about half of the agreed-on fee. If the worker is dissatisfied with the fee schedule or benefits, that dissatisfaction is with the agency, not with your parents. Most agencies have policies prohibiting clients from supplementing salaries or giving gifts to their helpers. This is to protect clients from pressure by rather poorly paid helpers. If a helper suggests ways to skirt this policy and bestow tokens or riches, the agency should be told immediately. This could lead to financial abuse. Will your parents tell you or the agency promptly if this happens?
Types of agencies:
If your parents need simple housekeeping, they should work with a housekeeping agency. If they need in-home help including personal assistance, they should use agencies that specialize in in-home helpers and non-medical personal care providers. If they need assistance with health problems, they’ll need to look into more skilled home health aides.
The first option, housekeeping agencies, provides people who clean homes. But even this apparently simple option should be influenced by the results of the check sheets.
• Some house cleaners sent by housekeeping agencies bring their own cleaning supplies. That’s a help if it saves you or your parents a shopping trip, especially one that involves hauling heavy containers. But it’s a problem if your parents want specific cleaning products used and not others.
• House cleaners from agencies probably are on a fairly tight schedule, will come in, clean, and move on to the next house and may work in pairs or teams. This is great if your parents want the house cleaned quickly because it reduces the time somebody is in their home. But it can be a problem for a parent who doesn’t like people in the house because it increases the number of people there at one time. And with a team cleaning, several rooms may be in upheaval at the same time.
• Agency house cleaners may also chat with each other, and not necessarily in English. This can be a problem if your parents don’t want the noise involved with several people cleaning and talking. If they want to work along with or supervise the helpers, they may hit trouble both because of the helpers’ time constraints and also because they may not speak much English. And, if your parents want sociability as well, they may want to avoid this option. These workers get paid for cleaning, not talking, and need to move quickly and get on to their next job.
The second option, agencies that provide personal assistance and light housekeeping, offers more services and more sociability. Even if your parents don’t need much assistance beyond light housekeeping at this point, choosing an agency that provides in-home health aides may make sense. As your parents’ needs increase, they won’t have to start fresh with a new agency. These agencies provide employees who can offer broader services including transportation, sociability, assistance with activities of daily living (ADLs), and other support. In essence, your parents make a list of things they’d like help with, how many hours a day/week they’d like assistance, and the agency does its best to match the request with their available staff. The agency bills an agreed hourly rate based on the level of difficulty of the services provided. It has policies about weekend, holiday, and overtime charges.
To get the best match through an agency that provides help beyond housekeeping, you and your parents should give the intake worker at the agency a detailed list of what your parents want help with and how they want to be helped. These checklists should be reviewed right away with any helper who shows up at the house to prevent the well meaning 19-year-old aide from driving your parents crazy by gabbing all day long about a fruitless search for a soul mate. Review the checklists and work regularly with the aide, and pass the feedback along to the aide’s supervisor at the agency. Attention to little details at the outset will make eldercare services more tolerable to your parents now and in the future.