05/27/1993BAYSHORE MANOR
A%K/A MONROE COUNTY HOME
ADULT CONGREGATE LIVING FACILITY
FOR THE ELDERLY
AMENDMENT TO AGREEMENT
THIS AMENDMENT to AGREEMENT entered this ;77day of VAY ,
19 13, by and between the County of Monroe, Florida, hereinafter
called "COUNTY" and JORGE V. MARTINEZ , hereinafter
called "RESIDENT" and NONE hereinafter
called "RESPONSIBLE PARTY".
WHEREAS, the high costs of pharmaceuticals has resulted in
budgetary difficulties in COUNTY providing medication for
residents whose medical insurance and/or Qther additional funds
are inadequate to pay the costs of medications; and
WHEREAS, both parties desire to avoid any undue financial
pressures which might result in the closure of Bayshore Manor
which would require finding alternative facilities for RESIDENT;
now, therefore
IN CONSIDERATION of the mutual covenants herein contained, the
parties agree as follows:
The AGREEMENT entered on the 1STday of MAY ,
19 92, between the parties hereby shall be amended as follows:
1. Paragraph A.7 shall be amended to read as follows:
Subject to the availability of funds, shall pay for such
medications as may be prescribed for RESIDENT by his/her
physician, as well as necessary non-prescription medical
supplies, provided that RESIDENT'S monthly rate under this
AGREEMENT is less than maximum rate and RESIDENT has
:insufficient medical insurance to cover such expenses, or in
the event that RESIDENT'S monthly rate under this AGREEMENT
is the maximum rate but RESIDENT has neither sufficient
additional funds nor sufficient medical insurance to pay for
-the above.
2. Paragraph B.7 shall be added to read:
Shall, if funds for medication expenditures become
unavailable, make arrangements for payment of medication
expenses which Bayshore Manor cannot pay or arrange for
RESIDENT'S transfer to an alternative, appropriate facility.
3. All other terms of the AGREEMENT, dated the 11T day of
MAY , 19 92, which are consistent
herewith, shall remain in full force and effect.
9Z=�L6z��
,p Zi SIGN
1Z11�Q
WITNESSES AS TO RESIDENT
WITNESSES AS TO RESPONSIBLE
PARTY
DATE: Y b7 7-3
DATE: &',)�—r3
APPROVED:
JU%01199
OF RESIDENT
SIGNATURE OF RESPONSIBLE PARTY
SIGNATURE OF DIRECTOR
BAYSHORE M
SIGNATURE OF ECUTIVE DIR
SOCIAL SERVICES DEPARTMENT
SIGNATURE OF ADMINISTRATOR
MONROE, COUNTY, FLORIDA
APPROVED AS TO Fr'
AN SUFFl�1 '.
By
rney's Ottic�./,//93
Date (v )'