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Home My WebLink About1984-01-09 84-69 ORDER84-69 Introduced by Councilor ffi'nM1m, Tonuary 9, 1994 CITY OF BANGOR (TITLE.) (jDrbtr, Authorising the. Bangor City Nursing Center to make a Respite Care Program Available. By iu City Cwmi! 4( We My ofeanyor: THAT the Barger city Nursing center is hereby authorized and direrbei to make available from time to time wcmimitted nursd home beds for Respite Care use in accordance with the accompanying pblicies and procedures. Respite Care Admissions shall be at the discretion of the Director of Nursing or her designee, and the Adm inistrator; and shall not interfere with the regular provision of inpatient S termediate ail Skilled level care. In City CouncilJanuary9,1984 Passed z, Ci Clerl 8449 ORDER Title, Au§ origing, the, Har$PP. Cjty, jiyraipg, Pppter to Wa .Reafite Care, Program, Ayallable Introduced and filed by A.�.: Eomnilman G' . POLICY ON RESPITE an Bangor City Nursing and Health Center offers Respite Care to area residents. Respite Care is defined as short term nursing care of a dependent adult currently being cared for at home by family members. The purpose of this as to give the family members temporary relief from this care. Short term All be considered Prem 1-7 days. Admission will be on a space available basis only. Priority as always will be given to regular inpatient admissions. The charge for Respite Care will be the same as the daily rate for Inteneediate .Care. Pryment in fall for basic room and board charges shall be made by the individual for wham respite care is to be provided or other responsible party, in advance a admission. Ary additional charges such as for supplies or med— ications shall be paid for in full within thirty (30) days a the lest day in which the period of Respite Care is provided and the billing data of such charges. Ary special supplies needed such as dressing changes, irrigation, etc., most be supplied by the family or other responsible party on admission or will be billed separately by the Famility. Medications from home may not be used. Medications needed All be ordered by the Facility from the pharmacy of the family's choice end billed to the family separately. ELIGIBILITY FOR ADHISSION Anv dependent adult 18 years of age or older currently being cared for at home by the family. There is no residency requirement for Respite Care. Admission will be at the discretion of the Director of Nursing based on the nursing care needed by the person and the ability oP our staff to provide that care at that time. There will be ne discrimination by race, color, creed, see or national origin. - RNJUIR®4gm The person most be seen by a physician within 5 drys prior to admission for a history, plysdcai assessment aM doctors orders. A family member meet complete the necessary nursing and social history form fly 79 and sign the appropriate admission agreement prior to leaving their relative. CHARTING RDQUIREMNM The nursi department most have the doctors History and physical and signed orders at the time of admission. The nursing and dietary department All complete a care plan on the day a admission. The activities and social services departments w'll not be required to maim out a once plan. The resident may participate in all facility activities. Judith Rncetti Admin. Asst. Patients BANGOR CITY NURSING & MF.ALTH CINTNR ADMISSIONS AGRN@fENT Admission Date: Patient No.: The Hangar City Nursing and Health Center ad Patient or Responsible Peaty hereby agree to the following tenor and arrangements: 1. Bangor City Nursing and Health center, hereinafter referral to as the Facility, will felly inform the patient prior to and at the time of admission and during stay, a his/her rights ani responsibilities. 2, The patient or responsible party has the right to view the policies oY the Facility at my reasonable time, as sell as current recertification deficiency lists. 3. The Facility will fully infomn the Patient prior to admission, of services available in the Facility not covered by the basic per diem rate. y. The Facility will fully inform the Patient of his medical condition unless medically umhrairadicated (as dacumented in his medical record) and will masse certain that he is affored the opportunity to participate in the planning of his medical. treatment and may refuse to participate in experimental research. 5• The Facility will encourage and assist the patient throughout his period a stay, to understand ad exercise his rights ard to this end, may voice grievances ad recommend changes in Policies and services to Facility staff and/or outside representatives ne his choice, free from restraint, interference, coarcion, discrimination or reprisal. 6. Me Facility assures the patient freedom from mental and Physical abuse, freedon from chemical ani (except in emergencies) physical reatralM,s, ex— cept as authorised in writing by a physician for a specified ail limited period of ties. 7. The Facility assures the Patient confidential treatment oI his personal and medical records. His/her written consent shall be required for the re— leame of information to persons not otherwise authorized under law ar thin Party payment contract to receive it. S. The Facility secures that the Patient will be treated with consideration, respect and with full recognition a his dignity and individuality, including privacy In treatment ani in the care for his personal needs. 9. The Facility assures that the patient will not be required to perform services for the Facility that ere net included for therapeutic purposes in his plan of care. 10. The Facility assures that the patient may communicate privately with Persons ne his choice unless medically cwtraindicated (as documented in his medical record) ani shall receive his personal mail unopened. 3—II 11. The Facility assures that the patient may meet with representatives and participate in activities a omi eraial, religious, and comeanity groups at his discretion. 12. The Facility assures that the patient may retain and use his personal clothing and possessions as reasonable. -13. The Facility will also supply to the above used and other patients a functional , swi.tary, and comfortable envirament as well as for the public and peasoemal. Adequate and comfortable bighting levels in all areas, limitation of sounds at contort levels in all areas, comfortable roan temp eraturee, procedures to insure water to all essential areas In the event of loss'a the regular supply, adequate ventilation through windows or mechanical means for a combination of both and the provision for firmly secured handrails on each side eP corridors, are also assured. 149 In the event of a change in the patients condition or a medical emergency the patients physician will be contacted. If admission to an acute care facility is necessary, they x111 be sent to the hospital of the pattern's choice via medic ambulance. The parson listed below will be notified, I hereby designate the following person to be ratified in case of emergencyi Address: The patient ar responsible party agrees: I. To provide spending money for incidental expenses (above or beyond any thlxd party provided personal funds) as needed or desired by patient. 2. To be responsible for transportation and hospital charges if hospitalization- becomes necessary. ' 3. To act a definite day when the resident will be taken home. This say not exceed 7 days. The responcfble party agrees to abide by this date. 4, that the attending physician will bi11 the patient or responsible party directly for physician's charges not uovered by other payment mechanism, if a physicians visit should be necessary . To be responsible for payment for all tests ordered by a physician. 5. That all medical supplies needed will be provided by the family or if facility supplies are used will is billed to the patient or responsible party. Medications from base may not be used. Medications needed will be ordered by the facility frau the phanmcy of the patient or responsible parties twice and billed sep- to the responsible party. Any item used not listed by the facility as a routine service item is a billable item and will be paid for by the patient or respon- sible party. Payment for these items most be made within 30 days of discharge. 3 -III 1. 3- 6. That the patient or responsible party will also pay for the follbwing items not covered by room and boeatl — rented T.V., rented wheelaairs or similar aids, newspapers, dry cleaning, personal supplies and siallar items. 7. Me patient or responsible party acknowledges that the City oP Bangor is not responsible for the loss or damage to personal property of the patient kept in the facility. The Facility asks that you not leave items aysignifloant value. 8. The patient or reaponsibie party hereby acl ledges that the financial arrangements for his care are as a private patient. Respite Caere roon and board at the prevailing City Council approved rate of day. Medicines and medical supplies and other supplies as rd. 9. The patient or responible party hereby agrees to make full payment for these services in advance. Date: Signature a facility representative Date: pagnfltdax of patient or responsible party 3-ry