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Resolution 213-1979RESOLUTION NO. 213 1979 RESOLUTION ADOPTING THE ADMISSION CRITERIA AND POLICIES FOR THE MONROE COUNTY HOME AND MAKING SAID ADMISSION CRITERIA AND POLICIES EFFECTIVE OCTOBER 1. 1979. BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, as follows: 1. That the Admission Criteria and Policies for the Monroe County Home, Adult Congregate Living Facility for the Elderly, Level II, located on Junior College Road, Stock Island, Key West, Florida, a copy of which is attached hereto, is hereby approved. 2. That said Admission Criteria and Policies for the Monroe County Home, Adult Congregate Living Facility for the Elderly, Level II, shall become effective as of October 1, 1979. Passed and adopted by the Board of County Commissioners of Monroe County, Florida, this 25th day of September, 1979. BOARD OF COUNTY COMMISSIONERS OF MONROE CO FL IDA By Cla`irman (Seal) LWC45eE '.04' rk AiO!WW At FO FORM AND ANAL $MWICIENC1! er , AEtpvr WS 0/iO APPROVED ON_""� BOOK 1 T � � PAGE 5 oI x i MONROE COUNTY IIOME JUNIOR COLLEGE ROAD KEY WEST, FLOPIDA -1 ADMISSION CRITERIA AND POLICIES The Monroe County home, Adult Congregrate Living Facility for the I?lderly', Level II, hereinafter referred to.as the Facility, is licensed through the State of Florida'Department of Health and Rehabilitative Services, hereinafter referred to.as HRS, and operated by the Board of County Commissioners of Monroe County, Florida. The Facility is governed in accordance with the requirements of Chapter 400, Part II, Florida Statutes and the Rules and -Regulations as adopted by the Board of Monroe County Commissioners hereinafter referred to as County, contained herein. Elderly residents of Monroe County, Florida., sixty (60) years of age or older., ambulatory, in good health, in need of a home and having no family able to meet theirneeds, yet able td care for themselves to a certain degree and not in need of nursing care., con.valescant care; temporary or emergency shelter shall be eligible fo.r admission to the facility in accordance with the terms and conditions as contained herein. Applications are accepted.on a non-discriminatory basis including but not limited to sex, color, race'or creed.' The facility shall provide a homelike atmosphere (room and board), personal services and a compre- hensive program -to meet day to day needs of the ambulatory aged..on an individual basis --conducive to group living. Personal Services means services,.in. addition to housing and food service which include but are not limited to: personal.assistance with bathing, dressing, ambulation, housekeeping, supervision, emotional'security, and any other related service which the facility may define.PERSONAL SERVICE DOES NOT INCLUDE MEDICAL SERVICES. ELIGIBILITY AND ADMISSION POLICIES The admissioh of each resident to this facility shall be under the supervision of the Administrator of the Facility within the confines of the following genera]. policies: (1) A'resident/app'licant must: (a) Not have a-.cbmmunicabae disease in a trans- ferable. stage. (b) Have a chest x-ray or skid test (TB) within ninety (90) clays prior to adm.-is.si.on -to the facility. . (c) Be a resident' of Monroe County, Florida for at least one (1) • year_ and furnish verification --of same. (d) Furnish proof of need -for. the facility and that there is no -family able to meet"their needs for adequate care. (e) Furnish written medical examination from a licensed physician (form will be furnished) which shall .certify that their medical condition is such that. they will _ meet the requirements of the facility and that services beyond those that are permitted in;Ithe 0 315 facility are not required. (f) Be ambulatory - that is'the condition of being _ physically* and einotionall.y able to arise from a horitizontal or sitting position, and in an emergency to exit the building to a point- of safety. This would include those individuals who may be able "to ambulate with .the assistance . of'prosthetic_devices such as crutches__walkers or wheel chairs. (g) Be sixty (60) years of age or older and_f_urnish . age verification by either proper identification, documents,_or by information from other public agencies .such as the Social -Security Administration. (h) Furnish proof of hospitalization and medical insurance which -is equal to.or better than coverage offered by Medicare. (i) Execute a written contract with this facility,at the time of admission, or prior thereto, between the facility and the resident or his. designee or legal representative. A copy of contract to be executed is attached hereto and made a part thereof. (2) THE ADMINISTRATOR SHALL: (a) Maintain a written record in the resident's personal file of all financial arrangements with the resident, his next of kin, or sponsor, with copies executed by and furnished.to each party,. This shall include detailed records of any funds or property held.for the resident for safe keeping in accordance with Chapter 400 F.S. Part II. (1) The facility may hold personal funds for the resident not to exceed $100.00. (2) The facility shall not accept.any other funds or property except as set forth in 1 above. (b) Assess no additional charges, expenses or other financial liabilities in excess of the provisions included in the admission contract. Rates which may change will be conspiciously posted in the facility. (c) Determine and include as a minimum, the following provisions' and services in the basic admission contract with each resident, next of kin or sponsor: (3) J 1. The daily, weekly, or: monthly .rate, and refund provision for unused portions-; thereof. 2. A listing of services to be, provided. 3.. Social Tempbnents appropriate to the needs of the residents. (d) Apply the following restrictions to admission and retention of residents:' 1. A resident who manifests such degree of behavior that he is a danger to himself or others, or whose behavior is so unacceptable or disturbing as to interfere with the adequate care or comfort of other residents in the facility shall. not be admitted or retained, and shall_ be removed from the facility.. 2.. 'No resident shall be held in the facility against his will, unless under Court Order. 3. No resident shall be admitted to or retained in a facility who requires services beyond those the facility is licensed to provide. This facility may not provide nursing care unless for a temporary illness, not to exceed seven ( 7 ) days. 4, A resident absentfrom this facility in excess of fourteen (14)_ days, due to ' hospitalization or abandonment shall be terminated as a resident in this facility. Such resident may re -apply for admission. following the same procedure as that of a new applicant. The monthly rate for applicants/residents shall be according to the ability of the applicant/resident to pay, with the minimum rate established at $210.00 per month and the maximum of $410.'00 per month. Applicants/residents with income.over the minimum but less than the maximum will be allowed to.pay that amount as their monthly rate, this would include any increases in their income during the course of their residency, up to the maximum rate. (a). This monthly rate shall be established at the beginning of the fiscal year and shall. prevail through out the year... (b) Monthly rates may be reviewed and admended by the Board of Monroe County Commissioners. .(c) When applicant/resident receives income and has assets less than the minimum monthly rate, supplemental support -will be accepted from their family, other assistance agencies or -,represen- tatives. 31-) _4_ (d) If there is no supplemental support available each applicant/resi.d�.nt, will then be considered on an in-vidual. basis. (e) Appl-icants/residents paying the minimum rate and above may be reimbursed $10.-00 per month for their personal use. (4) Upon certification by the Administrator of the facility : with the concurrance of the Executive Director_ of the Monroe County Department of Social Services, that all criteria and requirements set forth herein have been complied with and/or met, the applicant shall be admitted to the facility) Vizbject to adequate facilities being available and execution of the admission agreement by the resident and the County. -OPERATIONAL STANDARDS The. facility shall offer close supervision and living �onditibns.as,is necessary to the condition of the resident. This includes supervision - of diets as to quality and quantity, watchfulness over the general health, safety -and well being of residents. There shall be a daily awareness of the residents by designated staff of the facility as to the apparent well being of the individuals with sufficient provision for contacting the resident's physician, if the resident has not already doneso, at any time there appears to be significant deviation fromhis normal appearance or state of health and well being. Appropriate notice of such instances. shall be recorded in the personal records of the individual.. Written agreements between the facility and each of its residents shall provide that, upon certification by a physician that the resident is no longer capable of meeting the requirements for occupancy in this facility, the resident,.next of ]<in, legal representative, or agency acting on.the resident'-s behalf, will be notified that the resident will have to make arrangements for immediate transfer to an appropriate care setting. In the event a resident has no person -to represent him, this facility shall be responsible for referral to-an'appropriate social service agency for placement. The-admission.of a resident to this facility and his presence therein shall not confer on tho-facility, its administrator,.employees or representatives any authority to manage, use or dispose of any property of the -resident; -nor shall such admission or presence confer on any of 34R such persons any aut_horiy or responsibility for the personal affairs of the resident, except what- may be necessary for the sa.fe and orderly management of the facility oi.'for the.safe,t-y of the resident. This facility, administrator., employee or representative thereof, may not act as the court' appointed guardian, trustee, or. conservator_ for any resident of the facility or any of such resident's property. This facility shall be organized on a professional basis consistent with good business practices. This facility shall be responsible for providi:ng.services.:for residents as required consistent with the level of services offered. This facility shall. employ -or otherwise arrange for the service of such personnel as are requi.red•to properly staff the facility. ADMINISTRATIVE STANDARDS This facility shall be under the control of an administrator.. (1) The facility or its.duly designated representative shall_ maintain the following written.records and any.other record required by the County or HRS in a place, form and system ordinarily employed in good business practices. (a) An admission and discharge register listing names of resident's and date admitted, identifyinq information about each, the place from which the resident was.admitted; the date and.reason for: discharge, adequate identification of the facility to which the resident is discharged or transferred. (b) A personal file for each resident consisting.of appropriate data, including identification of next of kin, and all data required for the Florida Certificate of Death. Details of the referral, admission, pertinent non -medical and medical information concerning the -resident shall be maintained with the general fiscal record of each, including copies of all agreements or contracts, account record's and a current inventory of personal. property held for safe-keepinq. (c) A facility accident/incident record file, containing a clear description of each accident/incident and any other. incident.invol.ving hazardous or defiant behavior of a .resident or staff member with names of individuals involved, description of medical or. 'other services provided and the steps taken if any to prevent recu rrance. 31g (d) -Personnel record of each staff member. 'Nii.s record will. be kept updated and contain original empLoymont application with -references furnished. (ram)' A record of personnel policies, inc.ludinq state --me of .policies and work assignment:, for each position. (f) A record of monthly fire drills, indicating the date, hour and general description of. each drill, the extent of the -staff involved and the name of person in charge. (g) 'Financial records which identify all, income' of the facility by source and describing all expenditures by category in such a manner as to be auditable by basic accounting procedures. FISCAL STANDARDS The administrator of_this facility shall maintain fiscal records in accordance with the requirements of Chapter 400, F.S. Part II. There shall be a recognized system of accounting used to accurately reflect details of the business. The facility shall: (1) Be administered on a sound financial basis consistent with good business practices. (2) Specify its refund policies as part of the admission contract. (3) Specify that no administrator, consultant, staff member or representative shall: (a) Pay any commission, bonus, rebate or gratuity to.any organization., agency,physician, staff orother person for referral of any resident to the facility.' (b) Request or accept any renumeration, rebate, gift, benefit or advantage of any form from any vendor or other supplier because of the purchase, rental or loan of equipment, supplies or services for the facility or resident not consistent with normal business practice. PERSONNI L STANDARDS The administrator of this facility shall operate the facility in accordance with the existing Monroe County Personnel. Policies and Procedures. MIP DT ETARY STANDARDS This facility shall have written policies and procedures for p.rov.i d:i.ng proper nutritional care of its residents. This facility wLll. not have services of a third party. (1) The following requirements shall be met: (a) The administrator'or a person designated by the administrator shall be responsible for the total dietary service and the day to day supervision of dietary service staff. .(b) The designated person shall be responsible for: coordinating dietary services with other services; developing work assignments; food purchasing; and orientation, training and supervision of dietary employees. (c) The person designated by the administrator shall perform his/her duties in a safe and sanitary manner; be knowledgable of foods that meet regular diets, and participate in appropriate continuing inservice education: (d) Duty assignments for dietary staff_, shall be posted in the kitchen area. (e) Therapeutic diets as prescribed by,the physician shall be in the resident's record and served as ordered. (f) Regular diets shall meet nutritional needs of rasid.ents in accordance with the current recommended Dietary Allowance of the Food and Nutrition Board, National Research Council, adjusted for age, sex and activity. Therapeutic diets shall meet these nutritional standards to the extent that'is medically possible. (g) Thedietary allowance shall be met by the uses of standarized recipes offering a variety of foods adapted to the food habits, preferences and physical abilities of the residents. (h) An up to date manual approved by HnS shall be used as the standard reference in planning .regular_ and therapeutic diets. (i) Dated menus shall be planned.at least one week an advance for regular and therapeutic diets; and corrected as served and kept on file for six months. (j). Supp].ies of non-perishable food 1=0 meet: nutritional needs of residents for one (1) week period shall be on hand. (k). Food shall be served attractively at safe and palatable temperatures. All re idents shall be. r_ncouraaed to eat aL- tables in dining areas. A supply of appropriate cat=ing ware shall be on hand to serve all residents. (1) All.matters pertaining to food service sha].'l comply with the provisions of Chapter 10-1.3, 'Florida Sanitary Code. RIGHT TO HEARING Any applicant who is dissatisfied with the decision rendered by the Department of Monroe County Social.Services, has the riaht to request a review of their case by the Social Services Executive Director. This review shall be done -within five (5) working days after the request is received from the -applicant. If the Director's review does not resolve the applicant's complaint, the applicant then has the right to request, a Fair Hearing. FAIR HEARING PROCEDURE Within ten (10) days after a. complaint is received from an applicant, a hearing will be held.in the office of the County Administrator. The purpose, 'of this hearing will be to. allow the applicant a fair opportunity to voice his/her complaint before a hearing committee. This committee will consist of. the County Administrator, the Clerk of the Board of Monroe County Commissioners,'and one (1) County Commissioner. The final decision will be reached by the hearing committee.