Welcome to our facility!  As one of the most experienced assisted living communities in this area, we are professionally staffed to provide a wide range of healthcare services that you may need.  We appreciate the opportunity to tell you about our facility and what services we offer.  Please feel free to ask any questions you may have.

Equal Opportunity has been, and will continue to be, a fundamental principle of the facility, where no person will be subjected to discrimination because of their race, religion, color, sex, age, national origin, disability, veteran status, marital status, or any other protected characteristic as established and defined by Federal and State laws.  The facility is committed to an environment in which each individual is treated with respect and dignity.  Therefore, the company expects that ALL relationships among persons in the facility will be free of bias and prejudice.

Independence and quality of life are only two of the many important elements that make up the total experience of living at our facility.  From the moment you enter our facility, you will be treated with the respect and dignity you expect in your own home.  Our staff is eager to assist you and ensure that they make your stay with us comfortable and pleasant.

GATEWAY ASSISTED LIVING OFFICE: 402-464-6371 (Answered 24 Hours a day)

   

Other numbers:

Department of Health and Human Services (local office)…………………………… (402) 471-0032

Nebraska Health Care Association…………………………………………………… (402) 435-3551

Nebraska Long Term Care Ombudsman……………………………………………… 800-942-7830

Nebraska Department of Health……………………………………………………….(402) 471-2133

Abuse/Neglect Hotline…………………………………………………………………800-652-1999

CUSTOMER SERVICE PHILOSOPHY

1. A RESIDENT AND THEIR FAMILY ARE THE MOST IMPORTANT PEOPLE IN OUR BUSINESS.
2. OUR RESIDENTS ARE NOT DEPENDENT ON US. WE ARE DEPENDENT ON THEM.
3. RESIDENT’S NEED IS NOT AN INTERRUPTION OF OUR WORK. IT IS THE PURPOSE OF IT.
4. A RESIDENT DOES US A FAVOR BY CHOOSING TO LIVE AT THE FACILITY. WE ARE NOT DOING RESIDENTS A FAVOR BY WAITING ON THEM.
5. A RESIDENT IS PART OF OUR BUSINESS, NOT AN OUTSIDER.
6. A RESIDENT IS NOT JUST AN OCCUPANT. A RESIDENT IS A HUMAN BEING WITH FEELINGS LIKE OUR OWN.
7. A RESIDENT IS A PERSON WITH NEEDS AND WANTS. IT IS OUR JOB TO FILL THEM.
8. RESIDENTS DESERVE THE MOST COURTEOUS ATTENTION WE CAN GIVE. THEY PAY OUR SALARY AND ARE THE LIFE BLOOD OF THIS BUSINESS.  WITHOUT OUR RESIDENTS WE WOULD HAVE TO CLOSE OUR DOORS.
9. WE THANK OUR RESIDENTS AND THEIR FAMILIES FOR THE OPPORTUNITY TO BE OF SERVICE TO THEM AND THEIR FAMILIES.

RESIDENT’S BILL OF RIGHTS

It is the policy of the facility to offer tenants living here quality care.  The policies, procedures and rights included in this handbook shall ensure tenants the following:

1. To be treated with dignity and provided care by competent staff;
2. To be an equal partner in the development of the tenant service agreement while retaining final decision making authority;
3. To be informed in advance about care and treatment and of any changes in care and treatment that may affect the tenant’s well being;
4. To be informed in writing of the pricing structure and/or rates of all facility services;
5. To self-direct activities, participate in decisions which incorporate independence, individuality, privacy and dignity and make decisions regarding care and treatment;
6. To choose a personal attending physician;
7. To voice and grievances without discrimination or reprisal and have those complaints/grievances addressed;
8. To examine the results of the most recent survey of the facility conducted by representatives of the Department.
9. To refuse to perform services for the facility;
10. To refuse to participate in activities;
11. To privacy in written communication including sending and receiving mail;
12. To receive visitors as long as this does not infringe on the rights and safety or other tenants in the facility;
13. To have access to the use of a telephone with auxiliary aides where calls can be made without being overheard;
14. To have the right to have a telephone in his/her room at the tenant’s expense;
15. To retain and use personal possessions, including furnishings, and clothing, as space permits, unless to do so would infringe upon the rights and safety of other tenants;
16. To share a room with a person of his or her choice upon consent of that person;
17. To self-administer medications if it is safe to do so;
18. To be free of chemical and physical restraints;
19. To exercise his or her rights as a tenant of the facility and as a citizen or tenant of the United States;
20. To form and participate in an organized tenant group that functions to address facility issues.
21. To review and receive a copy within two working days of their permanent record;
22. To be free from abuse and neglect and misappropriation of their money and personal property; and
23. To be free from involuntary transfer or discharge without 30 days advance written notice except in situations where the transfer or discharge is necessary to protect the health and safety of the tenant, other tenants or staff.

 

ACTIVITIES

A full schedule of group and individual social, spiritual, physical, and recreational activities are planned, provided, and/or arranged for the residents in and out of the facility free of cost unless otherwise noted.  Any additional cost of event tickets or class materials will be published in advance and will be paid for by the individual participants.  All activities and programs are strictly optional although we do encourage participation for residents to obtain the full physical, mental, and emotional benefits.  If a resident has particular interest, they should relate this interest to the Assisted Living Coordinator.  A monthly schedule of all social and recreational programs and events will be distributed.

AUTOMOBILES

Resident shall not store automobiles, recreational vehicles, trailers, boats, or other large personal property items on the property unless specifically approved by the facility. Only emergency repairing of cars will be permitted on the property.  Changing oil, washing and other maintenance may not be performed on the property.

BEAUTY SHOP

The beauty operator is an independent contractor.  If you are interested in utilizing their services, please contact the receptionist.  The cost for these services will need to be paid directly to the contractor.

BEDHOLD

If you are paying privately and you go to the hospital or leave the facility for vacation, your room will be held until you return or until your representative notifies us to release your room and has removed all your personal items from the room.  Your account will be charged the daily rate for each day your room is held as outlined in Finances and Monthly Services Charges Section and Tenant Agreement.  The only exception to this is if you are needing nursing home level of care and choose to reside at Gateway Vista Short-term Rehab facility, you may hold your Assisted Living Unit for up to two months by paying 80% of the daily rate.  After two months, the full daily rate will need to be paid to hold the unit.

If you are Medicaid, your room will be held according to the Nebraska Department of Health and Human Services Medicaid Waiver guidelines.  If Medicaid coverage is terminated, you will be charged the private daily rate until you return or until your representative notifies us to release your room and has removed all your personal items from the room

If discharged, you can be re-admitted to the first available unit you qualify for, assuming you meet the level of care.

If you have questions regarding the bed hold policy, please contact the Business Office.

CATERING SERVICE

The facility staff can offer their expertise and services for your catered functions.  If you are planning a special dinner, party or other function requiring catering services, please contact the Assisted Living Coordinator to make the necessary arrangements.  All catering costs will be the responsibility of the resident requesting such service. (Note:  There is no cost to residents for reserving rooms to host any gathering.  The only costs involved would be for the cost of the food service, set up and/or take-down of tables and chairs, and/or clean-up.)

CHECK CASHING/BANKING

Due to the limited cash kept at the facility office, you are encouraged to cash your checks outside the facility.

 CLUB & ORGANIZATIONAL MEETINGS

We invite and encourage residents to use any of our public rooms for hosting your club or organizational meetings as well as family reunions and get-togethers.  Reservations should be made in advance with the Office.  Please make your reservations early as arrangements are based on a first come, first served basis providing private parties do not overlap with the functions and programs provided by the facility.

CONCIERGE SERVICES

Concierge services are available for residents.  The following are available for your use and convenience at no extra charge unless designated otherwise.

Contact the Office for the following services:

1. Availability of Stamps, Stationery, Envelopes and Greeting Cards.
2. Copying ($ .10 Copy)
3. Mailing packages
4. Fax To Send:         $2/ First Page  $1/ each Additional Page

To Receive:     $1/ Page

7. Personal Service $18.00/ Hour  (i.e. assist with banking, watering plants, etc…)
8. Other services as outlined in the Rate Schedule.

 

CONDUCT

The facility, licensed as an Assisted Living Facility, provides a clean, pleasant environment with 24 hour staffing to provide services to the residents.  The residents are, in turn, expected to conduct themselves in a manner that respects the peace, quiet and privacy of the other residents and their families.  Complaints from other residents could lead to legal action for compliance.  Should such legal action be necessary and lead to eviction, refunds would be as per Resident’s agreement.

 DEPOSIT

A 2000.00 non-refundable deposit is required at the time of move in.  This amount covers carpet cleaning or replacement, painting and other repairs that are made when the unit is vacated.

 

DECORATING PRIVILEGES

Residents are encouraged to decorate their apartment suite according to their own personal choice and preferences, providing any decorating is not damaging to the building.  Before implementing any decoration that may alter the building or unit, you are to secure expressed written consent of the management and any such alteration then become the property of the facility.

In addition, please

• Do not use nails, brads, screws or the like in any of the woodwork.
• Please use small nails (no adhesives) for hanging pictures or items on the wall. Items of excessive weight should not be attached to or hung from walls without the written consent of management.
• Do not use adhesive contact paper on the shelves or in the drawers.
• Please DO NOT use tape, nails or other adhesives on the doors or trim. Each apartment has a hook outside the door for decorations.
• Blinds, doors, or similar structural items of the building are not to be removed without authorization of the office.
• Please do not display any signs or exterior lights or markings on the rented premises, nor attach any items of personal property to the exterior of the building.
• The State Fire Marshall prohibits the following items: electric blankets, multiple plug-ins, extension cords, space heaters, candles, and incense.  You can use surge protectors and “contractors grade (12-14 AWG) extension cords.
• Due to the risk for burns in older adults, we do not recommend heating pads or similar heat producing items. Please see the nursing staff for recommendations.
• All electrical appliances such as toasters, bread machines, electric toasters, and coffee makers are to be kept out of the bedroom.
• The facility will not be responsible for any valuables or money left at the facility in the resident’s possession and is not responsible for any lost, stolen, or misplaced items.

 

If you request assistance with any of the simple decorating tasks, the maintenance department will be available to assist. Fee for maintenance department may occur depending on the amount of time needed to complete the task. If occurrence will result in a cost, the facility will let the tenant know prior to the work being performed. Please call the office to secure this service.

 

DINING ROOM SERVICE

The Dining Room serves three meals every day for assisted living and two meals a day for independent living. The charges for these meals are included in the cost of the rent.  You will be given a monthly menu outlining the menu choices.  Serving times are as follows:

Breakfast:  7:30-9:00 a.m.

Lunch:       11:30-1:00 p.m.

Supper:      5:30-6:30 p.m.

PLEASE NOTE:  Although the facility does not provide therapeutic diets, the facility does provide choices for those who must restrict their diets in any way.

 DINING ROOM ATTIRE

Casual clothing and street attire are appropriate dress for the Dining Room.  However, residents may wear lounging attire to the breakfast meal.

 

DINING ROOM GUESTS AND VISITORS

We encourage you to invite your guests, visitors and family members to join you for dinner.  Reservations are recommended for all guests to allow for proper staffing and meal preparation.  Cost of the guest meal will be at our usual guest meal service charge.  All guest meal charges can be added to your monthly statement, or prepaid at the time you make the reservation.

DINING ROOM TRAY SERVICE

Any resident temporarily ill and unable to dine in the Dining Room may request tray service.  Please telephone the office to order tray service.  They will deliver your tray when the kitchen staff has prepared it.

EMERGENCY PENDENT.

Emergency pendants will be given at time of admission.  If the resident loses or damages the pendant, the resident will be responsible for the cost of the replacement.

ENTRY TO THE FACILITY

The exit door will be locked at approximately 8pm. and unlocked at approximately 8am.

EXPECTATION OF PRIVACY

In order to protect the safety of staff and residents while maintaining the integrity of the premises and property, the facility maintains the discretion to monitor, record, and review the activity in the building, on facility grounds, and of facility equipment.  As a result, no employee, resident, visitor, or anyone else in the building should have any expectations of privacy including but not limited to:

1. 1. Common areas including but not limited to hallways, nurses station, lounges, lobbies, dining areas, and related areas.    Note:  Surveillance of the facility will exclude any” private areas” such as apartments, public bathrooms and locker rooms.
   2. Computer/internet usage and file storage on facility computers

FACILITY RESPONSIBILITIES

The facility is responsible to:

1. Provide the resident with medical, nursing, and personal care services identified in the service agreement which are adequate and appropriate to the resident’s needs pursuant with applicable Federal and State statutes, rules, and regulations.  The facility agrees to exercise such reasonable care as the resident requires; however, this facility is in no sense an insurer of the resident’s safety and welfare.

1. Use the services of and medications ordered by a licensed physician of the resident’s choice whenever necessary, or the services of another licensed physician if your personal physician is not available.  If the physician is not available to treat the resident, the facility shall use its best efforts to arrange for an alternative physician or secure emergency physicians’ services.  The expenses of physician services and medications are the responsibility of the resident and/or resident representative.
2. Arrange for the transfer of the resident to the hospital of the resident’s choice, when this is ordered by the attending physician, and to immediately notify the responsible party of such transfer.
3. Exercise reasonable care when taking the resident away from the facility on facility sponsored outings.  The facility assumes no responsibility for the Resident when the Resident is taken from the facility either temporarily or permanently under any other circumstances.
4. Notify the resident’s physician and resident representative of any significant change in the resident’s physical, mental, or psychosocial condition about which the facility has information, and of accidents involving the resident which results in injury or the need to significantly alter the resident’s treatment.
5. Provide adequately trained staff in sufficient numbers to meet the needs of the residents in this Facility.
6. Assure the rights of the residents are protected.
7. Maintain a building and grounds which meet or exceed local and state building and life safety codes.
8. Serve food which has been prepared in compliance with the Nebraska Food Code.
9. Keep records of account, services provided, and changes in residents’ condition.
10. Provide prompt attention to Resident/family complaints or grievances.
11. Monitor the quality or services provided by this Facility and improve service quality when possible.
12. Investigate and report any alleged Resident abuse, neglect, or misappropriation of Resident funds or property.
13. Evaluate and reevaluate the condition and service needs of the Resident upon admission, as necessary when there is a change of condition, and upon the request of the attending physician

 

FINANCES AND MONTHLY SERVICE CHARGES

Monthly charges are due in full outlined in the service agreement.  Payment can be made at the office.  If you are scheduling an extended vacation or absence from the facility, you should inform the office to arrange the necessary advance payment of monthly rental charges.

A $50.00 monthly late fee will be charged for any account with an outstanding balance of 30 days or older.  In addition interest at the rate of 15% will be charge in addition for outstanding balances in excess of 90 days. Balance adjustments which occur as a result of reconciliation with insurance or Medicare coverages will not result in late fees or interest charges.

FIRE EMERGENCY INSTRUCTION

The fire alarm sounds like a long intermittent horn.  If it goes off, remain in your apartment until you are evacuated by staff or emergency personnel.  If you are in the corridor, dining room or other public area, staff will assist you to a designated evacuation area.

FURNITURE

Resident may bring personal furniture to complete furnishing the Suite.  Love seat, easy chair, television, bookcase, lamp, and end tables would be suggested as appropriate additions

GRIEVANCES

It is the policy of the company to provide for the registration and disposition of grievances by all persons including residents, their responsible party, and or other interested individuals, without the fear or threat of discharge, discrimination, or other reprisal.  To the extent possible, all information will be treated confidentially.  Grievance Report Forms are available at the Social Services office.

The grievance procedure is as follows:

1. The Manager and/or their designee will investigate the grievance within five (5) working days of receipt. The Manager will make a decision and inform person(s) bringing the grievance within (10) working days after the request is received.
2. Persons may also contact the Nebraska Department of Health and Human Services to register a complaint at 402-471-2133, Long-term Care Ombudsman, (800) 942-7830, or HHS Regulation and Licensure Division, PO Box 94986, Lincoln, NE.

 

Anonymous grievances shall be brought to the attention of the facility Manager and addressed to the best of their ability.  Unfortunately, these grievances do not have the advantage of being able to ask for clarifying information.  As a result, individuals are encouraged but not required to identify themselves when surfacing concerns or grievances.

HALLWAYS/CORRIDORS

The hallways and corridors must remain clear at all times of articles for safety and fire prevention reasons.  Therefore, no personal items such as boots, umbrellas, electric carts, etc., are permissible in the hallways and corridors except in the door entry.  Such items should be kept within the private apartments.

HANDYMAN ASSISTANCE

Any resident needing maintenance assistance beyond the normal building maintenance such as needing a picture hung or simple repairs can request the assistance of our maintenance staff.  Fee for work performed by the maintenance department may occur depending on the amount of time needed to complete the task. If occurrence will result in a cost, the facility will let the tenant know prior to the work being performed. Please call the office to secure this service. All scheduling of handyman and or maintenance work must be done through the office.  Please do not attempt to make arrangements directly with maintenance personnel.  See also Maintenance/Repairs.

HEALTH CARE SERVICES/HOME HEALTH CARE

The facility is not licensed to provide complex nursing care or services.  However, our nursing staff has been trained in CPR and First Aide and will be the first responder to any emergency call from a resident.

HEALTH DATA INFORMATION

Residents are requested to regularly review and update their emergency information files in the office to ensure all information such as emergency contacts are current.

HEATING AND AIR CONDITIONING

Every apartment has its own heating and air conditioning equipment and there is a temperature control to adjust the temperature cooler or warmer as needed.  Please do not run furnace or air conditioner with your windows open.  Should you have problems with the temperature, please call the main office any time of the day or night.

HOUSEKEEPING

The facility provides light housekeeping services for residents as part of their daily costs.  If you are in need of additional housekeeping services such as cleaning/organizing your closet or shampooing your carpet, contact the office to have the housekeeping supervisor visit with you to set up a regular or temporary schedule for whatever cleaning is required.

INSURANCE – PERSONAL COVERAGE

The facility is adequately protected with liability and disaster insurance.  The facility’s insurance program does not provide insurance for your personal property or personal liability.  We suggest you consult with your insurance agent regarding your insurance needs, such as a renter’s insurance policy.

KEYS

One complete set of keys will be given to the Resident upon admission.  Additional sets required will be at resident’s expense.

LAUNDRY SERVICE

Washing machines and dryers are located in the laundry room for your use to do your personal laundry.  Flat linens for the bath and bed are provided and laundered by the facility and is included in the cost of the daily fee.  Carts are available in the laundry room for your use to transport personal clothes to and from the laundry room.  Personal laundry services are also available as outlined in the fee schedule.

 

MAIL

On all correspondence, your address should be written as follows:

Your Name

Apt. #  (your apartment number)

225 N 56^th St

Lincoln, NE 68504

The mail will be delivered to the office and staff will deliver it to you in the dining room.

MAINTENANCE/REPAIRS

If your apartment requires repair, please telephone the Office immediately to schedule prompt maintenance repairs.  See also Handyman Services.

MEDICAL EMERGENCY

The facility utilizes an emergency response system/pendent.  This system is available to you in case of an emergency any time of the day or night.  The system should NOT be used for routine needs.  The red light on the face of the pendant lets you know the pendant is working.  For emergency assistance press the blue “PUSH” button on the face of the pendant and hold for 3-5 seconds and staff will respond to your call as soon as possible.

MEDICAID OR MEDICAID WAIVER

The tenant and/or their responsible party are required to contact the Nebraska Department of Health and Human Services to initiate Medicaid and Medicaid Waiver coverage as needed.  If you apply for Medicaid and Medicaid Waiver, you must inform the Business Office in advance.  In the event that Medicaid and Medicaid Waiver do not approve a tenant for Medicaid and Medicaid Waiver, the tenant/responsible party is responsible for payment for the services based upon the private pay rates.  In addition, the resident must pay privately until the date approved for Medicaid Waiver (NOT JUST MEDICAID) by the Nebraska Department of Health and Human Services.  Please note:  Eligibility for Medicaid does not constitute eligibility for Medicaid Waiver.  Therefore, we will not accept Medicaid without approval by Medicaid Waiver. 

NEWSPAPER DELIVERY

You can make arrangements with the newspaper to have it delivered to the facility and staff will then deliver it to your room.  You will be responsible for the cost of newspapers which will be billed directly to you by the delivery service.

OFFICE

The facility offers the following office hours for your convenience.

The Business Office

8:00AM – 4:00 PM—Monday through Friday

Closed Saturday and Sunday

The Assisted Living Director Office

8:00 AM-4:30 PM—Monday through Friday

Closed on Saturday and Sunday

In case of emergency on the weekends or evenings regarding a matter that cannot wait until the normal office hours, contact the nursing staff or call the office twenty-four hours a day.  If it’s a health emergency use your Emergency Response System.

PETS

The facility has a no-pet policy without the express written consent of the facility.  A signed agreement and second security deposit will be required for residents with “approved” pets.  This second security deposit is non-refundable to the resident and will be used to recondition the apartment when the resident vacates.

 

SECURITY

The facility has many security features in place to protect the safety of our residents including locking the doors on nights and weekends and security cameras (as outlined in the Entry to The Facility section), 24-hour staffing, and the emergency arial system.  If you have additional questions and/or concerns, please notify the Office.

SMOKE DETECTORS

Resident will not tamper with smoke detectors provided by the facility and will inform management if resident is aware that a smoke detector provided by the facility is not functioning properly.

SMOKING

In the interest of resident and employee health, the facility maintains a smoke-free environment that prohibits smoking in any public area and/or resident rooms.

SNOW

It is the policy of the facility that when it snows, the snow shall be removed and salt applied to the employee entrances first, followed by the main lobby entrances.  The parking lots will be next followed by all other entrances and areas.  The facility makes every effort to be timely with snow removal but asks for your cooperation and patience in this time-consuming process.

The facility reserves the right to cancel van service in the event of snow and/or ice to protect the safety of the residents.   We encourage residents to exercise great caution in such inclement conditions and leave the facility only if it’s an emergency

SOLICITATION

No soliciting is allowed.  If you are solicited by a salesperson in the building, please contact the office.

SUGGESTIONS

Feel free to offer suggestions to the Management regarding ideas you may have that will enhance apartment living at the facility.

RESIDENT RESPONSIBILITIES

The resident and/or their representative is responsible for:

1. Providing, to the best of their knowledge, accurate, and complete information about present health issues, past illnesses, hospitalizations, medications, and other matters relating to the resident’s health.
2. Reporting changes in the resident’s condition to the staff.
3. Making it known whether they clearly comprehend a course of action and what is expected of them, as well as any concerns about their ability to comply with the proposed course.
4. Following the treatment plan recommended by the physician and the instructions of nurses and health professionals as they coordinate your plan of care and implement the physician’s orders, and as they enforce the applicable facility policies and regulations.
5. Understanding the consequences of treatment plan alternatives and of not following the proposed course of treatment. They accept responsibility for their actions if they refuse treatment or do not follow the instructions of the physician or health professionals.
6. Following facility policies and regulations affecting their conduct and as outlined in this handbook.
7. Respecting the rights and property of others including staff, other residents, and the facility by not behaving in a manner that would jeopardize the health or well-being of others and conducting themselves in a manner that respects the peace, quiet, and privacy of the other residents and their families. They should be considerate of noise levels, visitors, smoking in designated areas, and observing the privacy rights of others.  Resident will refrain from littering, damaging or impairing the use of or the removal of any part of the premises and to prohibit his/her guest from doing the same.
8. Providing the facility with a copy of the resident’s advance directives AND/OR papers appointing their Responsible Party when/if they execute one; and notify the facility of any changes made to his/her authority.
9. Maintaining the standards outlined in the Resident Service Agreement.
10. Provide such personal clothing, personal effects, and appropriate amount of spending money as needed or desired by the resident.
11. Be responsible for hospital charges, physician fees, medications, and other treatments as ordered by the physician and associated transportation.
12. Pay the facility promptly for service charges used as outlined in the Rate Schedule.
13. Assist and cooperate with the facility to ensure the facility receives all third-party payments as soon as possible.
14. Use the highest degree of care to keep the premises safe, clean and sanitary and pay for all damage/loss to premises or property by the resident and/or their family or guests, except for normal wear and tear.
15. Hold the facility harmless for any loss or liability for any personal injury or accident sustained by the resident, their family, agents, or guests, except when the said injury results from the acts of negligence by the facility.
16. In the event the resident requires health care services by another service or agency, the resident/responsible party agrees to keep the facility informed of the services provided and any change in health or service need. The resident/responsible party agree to hold the facility harmless for any financial responsibility resulting from the other service/agency or for any harm caused by the other service/agency.

 

THERAPY

The facility has licensed therapists on staff that can work with you and your physician to develop a customized rehabilitation program to meet your individual needs.  Therapy may include physical, occupational, and/or speech therapy.  If you are interested in therapy services or are having increased difficulty or are having surgery, please contact the nursing and/or therapy staff.

 

 

TIPPING

It is the policy of the facility to strictly prohibit employee tipping for any of the services offered or provided by the facility.  All facility employees have been instructed not to accept tips.  We ask our residents to help enforce this policy by not offering tips to our employees.

TORNADO INSTRUCTIONS.

During bad weather, if evacuation is necessary, facility personnel will direct and guide residents to the designated areas.

APARTMENT TRANSFERS.  Any transfers to another apartment within the facility as a result of a request from the resident will result in a transfer fee of $200 to cover the administrative and maintenance costs of the transfer.

TRANSPORTATION.

The facility provides regularly scheduled transportation as part of your daily rate. The facility residents are to contact the Assisted Living Coordinator to coordinate transportation services unless otherwise indicated below.  The van will pick up residents at the main entrance lobby.  Residents will be picked up for their appointments approximately 15 to 30 minutes prior to the listed appointment time so residents should be ready in the lobby 30 minutes prior to the scheduled appointment time.  If a conflict arises, the van driver shall work with Assisted Living Coordinator for coordination. Van drivers will follow the safety precautions in getting residents on and off of the van/bus.  Any concerns regarding the ability of a resident to independently access the van service shall be directed to Assisted Living Coordinator or the charge person who will address the ability to continue to utilize the van services with the resident and/or their responsible party. Wheel-chair van service is available to the residents for a fee as outlined in the fee schedule.  Any changes or specific transportation requests need to be scheduled with the Assisted Living Coordinator, not the individual drivers.

The van is in operation during the week from 8am to 4 pm.  Residents need to schedule appointments accordingly and according to the schedule.  Residents appointments or transportation needs before or after established times should be scheduled through the office and there will be at a fee, $20.00 round-trip, to the resident as outlined in the fee schedule.

Public transportation is posted on the bulletin board located on the ground floor next to the beauty shop.

TUBERCULOSIS

In the interest of providing a healthy working and living environment for all employees and residents, all staff and residents are required to have an annual Tuberculosis test.

UTILITIES

The gas, water, electrical, sewer, and trash are our responsibility and are all included in your daily rate.

VALUABLES

The facility discourages keeping valuables or large sums of money at the facility and that money, jewelry, and other valuables should be given to my family/responsible party or may be locked in the locked drawer in your apartment.  I understand that the facility will not be responsible for any valuables or money left at the facility in the resident’s possession and is not responsible for any lost, stolen, or misplaced items.

NOTICE OF HEALTH INFORMATION PRACTICES

Effective April 14, 2003 This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Understanding Your Health Record/Information

Each time you visit a hospital, physician, or other health care provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

• basis for planning your care and treatment
• means of communication among the many health professionals who contribute to your care
• legal document describing the care you received
• means by which you or a third-party payer can verify that services billed were actually provided
• a tool in educating heath professionals
• a source of data for medical research
• a source of information for public health officials charged with improving the health of the nation
• a source of data for facility planning and marketing
• a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve
• Understanding what is in your record and how your health information is used helps you to ensure its accuracy; better understand who, what, when, where, and why others may access your health information; and make more informed decisions when authorizing disclosure to others

Your Health Information Rights

Although your health record is the physical property of the health care practitioner or facility that compiled it, the information belongs to you. You have the right to:

• request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522
• obtain a paper copy of the notice of information practices upon request
• inspect and obtain a copy of your health record as provided for in 45 CFR 164.524
• amend your health record as provided in 45 CFR 164.528
• obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528
• request communications of your health information by alternative means or at alternative locations
• revoke your authorization to use or disclose health information except to the extent that

Our Responsibilities

This organization is required to:

• protect the confidentiality of your health information
• provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
• abide by the terms of this notice
• notify you if we are unable to agree to a requested restriction
• accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will mail a revised notice to the address you’ve supplied us.

We will not use or disclose your health information without your authorization, except as described in this notice.

 

EXAMPLES OF DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH OPERATIONS

Below are examples of how your health information may be used.  It is not intended to be all-inclusive but rather examples of typical uses of that information.  Specific questions should be directed to the Administrator or Social Services Designee of the facility.

1. We will use your health information for treatment.

For example: Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment. Information may be provided to your physician by phone, fax, or photocopies.  We will also provide your physician or a subsequent health care provider with copies of various reports that should assist him or her in treating you.

2. We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

3. We will use your health information for regular health operations

For example: Members of the medical staff, the risk or quality assurance manager, or members of the quality assurance team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.

Business associates: There are some services provided in our organization through contacts with business associates. Examples include physician services in the emergency department and radiology, certain laboratory tests, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Directory: Unless you notify us that you object, we will use your name, location in the facility, phone number, general condition, and religious affiliation for directory purposes. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name and to other residents. Your name will be posted next to your door and on the facility directory, unless you notify us that you object.  Pictures may be taken to be placed in the medication administration record and scrapbooks.  In addition, when you are using our transportation service, your name and medical appointment destination will be located on the facility sign-up sheets.

Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.

Communication with family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.

Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Funeral directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Marketing: We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you. The facility distributes a newsletter on a monthly basis and we may include personal history with birth date, unless you notify us that you object

Fundraising: We may contact you as part of a fund-raising effort.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers’ compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

The following uses and disclosures may not require authorization, or the opportunity to agree or object:

1. Uses and Disclosures Required by Law
2. Uses and Disclosures for Public Health Activities
3. Disclosures about Victims of Abuse, Neglect or Domestic Violence
4. Uses and Disclosures for Health Oversight Activities
5. Disclosures for Judicial and Administrative Proceedings
6. Disclosures for Law Enforcement Purposes
7. Uses and Disclosures about Decedents
8. Uses and Disclosures for Cadaveric Organ, Eye or Tissue Donation Purposes
9. Uses and Disclosures for Research Purposes
10. Uses and Disclosures to Avert a Serious Threat to Health or Safety
11. Uses and Disclosures for Specialized Government Functions
12. Disclosures for Workers’ Compensation

For More Information or to Report a Problem

If have questions and would like additional information, you may contact the Manager of the facility.  If you believe your privacy rights have been violated, you can file a grievance with the Manager or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.

CONCLUSION

We hope you enjoy your stay with us.  If you have any questions regarding the information in this handbook or anything else, please do not hesitate to contact the Manager or any member of our staff.