Resident Agreement C. IN THE EVENT THE MONTHLY SUM REFERENCED ABOVE IS NOT PAID ON OR BEFORE THE 10TH DAY OF ANY MONTH, THE RESIDENT WILL BE ASSESSED WITH A LATE FEE OF $100.00. THE FAILURE TO ASSESS THE LATE FEE WILL NOT CONSTITUTE A WAIVER OF THE RIGHT TO ASSESS FUTURE LATE FEES.
D. Person to Person Care Center reserves the right to increase the rates stated above by giving thirty (30) day written notice to the Resident.
E. Person to Person Care Center is responsible for arranging for social and leisure activities, local transportation, arranging appointments for medical, dental, nursing or medical health services, 24-hour staff, food preparation and dietary standards are required by F.S. 400.413 (3). Transportation to medical, dental, or health services will be the responsibility of the Resident unless the facility agrees.
F. The Resident shall give Person to Person Care Center a thirty (30) day written notice prior to terminating their Contract. In case of death or discharge due to medical reasons, the notice of termination requirement will be waived and a prorated refund shall be given. Should the Resident be requested to relocate from Person to Person Care Center by Person to Person Care Center, a forty-five (45) day written notice will be given
G. A prorated refund based on the daily rate for any used portion of payment beyond the termination date will be given to the Resident. Person to Person Care Center will send an itemized written H. L deductions list of any costs for such actually costs incurred and/or damages to the premises as well as any refunds due after and/or to the or damages, within forty-five (45) days to your last known address calendar days address of of your responsible party. You will respond in writing, within fourteen (14) This provision is notification, applicable to contest any of the damages included on the written itemized list. reasons, transfers when a Resident terminates or vacates the facility because of medical termination date is to the a nursing date home, death, facility closure or transfer of ownership. The facility may clear the unit will be vacated and cleared of all personal belongings. The items at a rate equal the unit and charge the Resident or his or her estate for moving and storing the unit. Person to Person to Care the actual costs to the facility, not to exceed 20% of the regular rate for the clear, move and store belongings Center will provide 14 days advance written notice of its intent to claimed within forty-five prior to charging Resident. If the Resident's possessions are not (45) days after notification, the facility may dispose of them.
H. nation, The refund to or the Resident shall be made forty-five (45) days subsequent to written notice of the unit is vacated in the case of death or discharge due to medical reasons, forty-five (45) days after facility intends to make and cleared of all personal belongings. If after a Contract is terminated the Resident a claim against a refund due the Resident, the facility shall notify the reasonable or time responsible party, in writing, of the claim and shall provide said party with a period of no less than fourteen (14) calendar days to respond.
I. Funds due to the Resident and all property held by the Person to Person Care Center shall be until such time as the funds and property are disbursed to the Personal appointed Representative of the Resident's Estate, spouse or adult next of kin. In the event there is no duly Personal Representative, Person Care the person receiving funds or property will hold Person to (2) years Center harmless from claims and third parties. Funds not disbursed within the two will be deposited in the Aging& Adult Service Trust Fund.
J. daily In case rate a Resident must be paid has to to be reserve admitted to a hospital, nursing home or other health care facility, the gives the Resident's bed unless the Resident or Responsible Party notice of the Resident's non return and all Resident property is removed from the unit. Until such notice is received, the agreed upon rate may be charged by Person to Person Care Center
K. discontinuance If the facility discontinues shall be refunded operation, any advance payments for services beyond the date of closure, whether to the Resident or as provided herein within seven (7) days of or not such refund is requested.
L. provide Person to 24-hour Person Training Center is not affiliated with a religious organization and does not nursing care or 24-hour nursing supervision.
M. for Person Residents to Person Care Center respects the rights of the Resident as outlined in the Bill of Rights of Adult Assisted Living Facilities.
N. The Resident respect the agrees to abide by all facility rules, policies and procedures, pay the monthly rate on property and privacy of others, and not leave the facility without signing the sign out log.
O. ADMISSION, RETENTION & DISCHARGE POLICY: Medical and personal information will ASSESSMENT to the facility upon admission. Medical information must be on the HEALTH FOR ASSISTED LIVING FACILITIES FORM #1823 - There is no rate progression based on levels of care.
- Person to Person Care Center will accept for admission any paying adult who does not need more than supervision or assistance taking medications, ambulation, dressing, eating, toileting and bathing. They must also.
- Be free from communicable disease
- Be able to participate in social and leisure activities
- Be able to communicate their needs
- Be able to evacuate the facility with assistance in an emergency
- Not need nursing or convalescent care for more than seven days
- Not be a threat or danger to themselves or others
- A Resident may remain at Person to Person Care Center so long as they continue to meet their financial obligations and the above admission criteria.
- Upon determination by the Administrator or Health Care Provider that the Resident needs services beyond those that the facility is licensed to provide, the Resident, or resident’s representative, or agency acting on the Resident’s behalf, shall be notified in writing that the Resident must make arrangements for transfer to a care setting that has services needed by the Resident. In the event the Resident has no person to represent him/her, the facility shall refer the Resident to the Social Service Agency for the placement, provisions as outlined in F.S. Section 429.26 shall be effective.
P. Person to Person Care Center will not charge for any supplies, services or accommodations that it has agreed by this Contract to provide as part of the monthly rate. The Resident or representative will be furnished, in advance, an itemized written statement setting forth additional charges for any services, supplies or accommodations available to the Resident not covered under the Contract. An Addendum will be added to this Contract to reflect the additional services, supplies or accommodations not provided hereunder. Such Addendum must be dated and signed by Person to Person Care Center and the Resident or Resident’s legal representative and a copy given to the Resident or Resident’s representative.I have read and received a copy of the Admissions Package which contains the following:
- Resident Contract
- Copy of the Resident Bill of Rights
- The Ombudsman Brochure
- House policies and procedures
- Admissions Retention and Discharge Policy
- Agreement to Arbitrate
I understand that all notices in this contract will be in writing. Do Not Resuscitate Order & Advanced Directives Policy: Purpose: To establish the guidelines of addressing DNROs Definition: A Do Not Resuscitate Order (DNRO) is a form or patient identification device developed by the Department of Health to identify people who do not wish to be resuscitated in the event of respiratory or cardiac arrest. Procedure: a. Person to Person Care Center, LLC will provide residents with a copy of Form SCHS-4- 2006- Health Care Advance Directives-The Patient's Right to Decide April 2006, regarding advance directives for patient or patient's responsible party to read. b. Person to Person Care Center, LLC does not provide residents with a DNRO. However, information about how a DNRO, if a resident or guardian decide, can be found at: http://www.doh.state.fl.us/demo/trauma/DNRO/Form1896.pdf or your health care provider c. Each resident of Person to Person Care Center will have documentation in their record indicating whether or not he or she has executed a DNRO. If a DNRO has been executed, a copy of a resident's DNRO must be in the resident's file on the authorized yellow form and with 2 physician signatures to be valid. This form will be readily available in the event of an emergency and will be sent to the hospital with the patient if the patient requires hospitalization. e. In the event a resident is receiving hospice services and experiences cardiopulmonary arrest, facility staff must immediately contact the hospice provider. The hospice procedures shall take precedence over those of the assisted living facility. Staff: Person to Person Care Center, LLC staff WILL NOT administer chest compressions or provide respiratory assistance to any resident that has a DNRO. Person to Person Care Center, LLC staff will administer chest compressions (CPR) to residents who do not have a DNRO.
