CARE CENTER

ADMISSION PROCEDURE

When a person is interested in becoming a resident at the Care Center, his/her name must be placed on the Social Service consideration list. This is done by supplying basic information to a social worker (this is called a record of inquiry) and completing an application.

Crawford County Care Center shall admit only those residents whose nursing care and physical needs can be met by the staff and facility. A person must be willing to be admitted, unless there is a guardian who is responsible for making such arrangements.

The prospective resident or responsible party must provide all medical information and all financial information prior to being considered for admission. If the person is accepted as a resident, arrangements for admission will be made with the Care Center admissions/social worker.

Upon admission, the nursing staff will complete a nursing assessment. Information will be obtained such as allergies, medication the person has been taking, bowel/bladder habits, sleeping patterns, vital signs (blood pressure, temperature, pulse, respirations). An admission bath will also be given to allow staff to evaluate overall skin condition. Our rehab department ( Speech Therapy, Physical Therapy, Occupational Therapy) may also need to do an assessment depending on physician orders.

ACTIVITIES

The activity department offers physical, cognitive, sensory, spiritual and intergenerational activities throughout the facility daily. Groups and individuals from the community also offer their time and talents to the residents. The activities are geared to coincide with the current season. The activity department also takes residents on outings to keep everyone connected to the community.

Religious services are provided to meet the needs of all denominations and are planned throughout the week. Activity calendars are posted in each room as well as outside the multi-purpose room. Extra copies are available from any activity staff.

ADVANCE DIRECTIVES

Crawford County Care Center will comply with the resident Self-Determination Act (OBRA 1990) and the Pennsylvania State law regarding Advance Directives consistent with reasonable medical practice.

Crawford County Care Center’s written Advance Directive Policies will be distributed to and reviewed with each resident and/or responsible party upon admission to the facility.

As part of our admission procedure, each resident will be asked if they have executed an Advance Directive. Documentation will be completed and copies of the executed directives will be placed in the resident’s medical record. If a resident already has a living will, please provide a copy to the Social Service Department. However, the Admission Advance Directive will still be completed.

Residents who have not executed an Advance Directive will be informed of their right to accept or refuse medical or surgical treatment and about Advance Directives. Crawford County Care Center will distribute written material provided by State and Federal Agencies.

Crawford County Care Center will not discriminate against any individual regardless of whether or not they possess an Advance Directive.

Crawford County Care Center will conduct educational in-services for our staff and community regarding Advance Directives.

AMBULANCE SERVICE AND FUNERAL HOME

Every resident must choose a funeral home upon admission and have an ambulance membership. If no preference is declared, Hathaway-Tedesco Funeral Home will be listed as the funeral home and Meadville Area Ambulance Service as the ambulance. The resident or family may change this at any time by notifying Social Services.

AUXILIARY

Family members, friends or anyone from the community is invited to join the Crawford County Care Center Auxiliary. The auxiliary plays an important role in making your loved one’s stay here enjoyable.

The auxiliary sponsors monthly birthday parties, bingo, summer picnics and many outings. They also purchase special items for our residents. The auxiliary is involved in fundraisers and Chinese auctions to support their endeavors.

Please consider becoming a member and playing an important role in the life of our residents. Contact the Activity Director with any questions.

BEHAVIOR MANAGEMENT PROGRAM

It is the policy of the Crawford County Care Center to use behavior management to enhance the quality of life of residents, families and staff at the facility. Behavior management is a system for identifying and evaluating residents whose behaviors are in some way detrimental either to themselves or to others at the facility. Generally, these are behaviors that:

1. Risk the safety or well-being of the resident or others,
2. Adversely affect the quality of life of the resident or others,
3. Interfere with the resident’s optimal functioning or adaptation to the facility, or
4. Interfere with the staff’s ability to care for the resident.

As part of our normal operation, each resident is evaluated upon admission and as needed thereafter to determine whether there are any behavioral issues we might address under this program. We then develop a plan of intervention to shape the resident’s behavior toward more productive or positive behaviors.

Our interventions rely primarily on positive reinforcement by staff of more desirable behaviors by the resident (e.g. praise for cooperating with care) or on changes in staff behaviors (e.g. approaching the resident more slowly). For example, we may implement scheduled toileting for a resident who soils himself, or we may encourage interaction in a resident who tends to isolate himself in loneliness. In some cases, (e.g. with disruptive behaviors), behavior management may enable us to guide the resident toward more positive behaviors, and, at the same time, reduce or eliminate psychoactive medication or chemical and physical restraints.

In general, the intervention plan will be developed by our Behavior Management Team and carried out by our staff members. When medically necessary and appropriate, the physician may write an order for a consulting psychologist or psychiatrist to assist us. We also have available a licensed professional counselor to talk with residents and make recommendations.

CLOTHING AND LAUNDRY

New residents will need to bring multiple (5-8) changes of clothing as it takes several days for personal clothing to go through the laundry process and be returned to the resident. Crawford County Care Center has an industrial laundry. Therefore, all clothing should be of washable fabric. We are not responsible for damage to wools or delicate fabrics.

Do not put any clothing in the resident’s closet. All clothing should be given to the nurse aide in order that all clothing be recorded on the resident’s personal belongings sheet and be labeled with the resident’s name. ALL clothing must be labeled with the resident’s name. When bringing in additional clothing, Put items in a bag with the resident‘s name marked clearly on the outside of the bag and give it to the Nurse or a Social Worker. They will take it to be marked.

Families may choose to do their resident’s laundry at home or in the facility in the resident’s personal laundry room using your own supplies. All clothing still needs to be labeled. If the family prefers to sew in the labels, labels are available at the receptionist’s desk for the family’s convenience.

Families choosing to do their own laundry must provide an appropriate closed container in which to store the dirty laundry. The container should fit under the resident’s sink in their bathroom.

Dry cleaning of any resident articles must be taken outside the facility by the family at the resident’s expense.

CONTACT PERSON / POWER OF ATTORNEY

It is required that each resident have two contact people listed. The second person is listed in case staff is unable to contact the first person. It is preferred that the contact person have a power of attorney. The contact person listed will be updated of any changes in medication, doctor orders, room changes and various other circumstances. It is imperative that phone numbers and addresses be kept current. Due to HIPAA (your protected health information), only the contact person will be given medical updates because this is considered to be protected health information.

If the resident has legally declared a power of attorney, the facility must have a copy of the power of attorney papers. It must be a document with the state required format.

DOCTOR APPOINTMENTS AND CONSULTS

The attending Physician will visit the resident at the Crawford County Care Center as the resident’s condition requires. Regulations require a physician to visit every 30 days while covered by insurance and every 60 days thereafter.

It is the family’s responsibility to transport the resident to all other doctor’s consults and/or appointments, if they are able. The family makes the appointment with the physician and then notifies the floor nurse of the appointment date and time. This allows the staff to have the resident ready to be picked up. The family transports and accompanies the resident to the appointment. Then, when the family brings the resident back to the facility, they will return the pink consult sheet completed by the doctor to the floor nurse.

If the family is unable to provide transportation for the resident, then the family must make alternative arrangements with Crawford County Care Center. However, the family will be asked if they can meet the resident at the appointment and accompany the resident during the consult. Every attempt should be made by the family to meet the resident at the doctor’s appointment. The family must return to the floor nurse the pink consult sheet completed by the doctor. Crawford County Care Center does NOT transport residents to any appointments outside of Crawford County.

EQUIPMENT AND PERSONAL PROPERTY

Personal equipment of any kind - including electrical appliances, chairs, wheelchairs, and walkers, need to be inspected by maintenance, labeled with the resident’s name, and recorded on the resident’s personal possessions sheet prior to their use. This should be done immediately upon bringing these items into the facility. During business hours, bring these items to the receptionist. After normal business hours, please leave them at the nurses’ station.

Please do not bring extension cords into the facility for your family members. Regulations prohibit their use in the facility.

GUEST TRAYS

Meal trays will be available for guests of Residents.

1. Guest trays are to be ordered at the Business Office at least one hour prior to the meal.
2. Payment and handling of money for the guest trays take place in the Business Office. Meal tray cost is $3.50 per tray.
3. If orders for trays occur outside of business office hours, order and payment can be given to the floor nurse.
4. The guest trays are from the regular menu as served to the residents at that meal.
5. The only limit on guest trays is based on the availability of space and food. If there is insufficient space or food, guest trays are allotted to those with the earliest request.
6. Residents may use a special room in the facility for guests, if a room is available.
7. Holiday guest trays are available. Residents will be encouraged to notify in advance the Nutritional Service department of the number of guests expected. The number of guests will be limited for the holidays, and will be determined by the Dietary Manager based on the historical pattern and production capabilities of Nutritional Services. Last minute guest trays will be honored if possible.

HAIR CARE

Hair care is provided at no additional cost. The barber visits the facility on a monthly basis. The beautician is in the facility two to three days a week. The ladies may have their hair washed and set approximately every two weeks and cut monthly. Permanent waves are given once every ninety days, if desired. Any additional services desired must be requested through the receptionist and paid for at the business office in advance.

INCONTINENCE CARE

The goal of the Crawford County Care Center is to keep the resident dry and clean by regularly toileting and changing the resident as needed. The routine use of adult disposable incontinence briefs is not recommended due to the potential for skin breakdown and urinary tract infections. In rare instances, after there has been a thorough nursing assessment, residents may be a candidate for the use of reusable/washable briefs.

INFECTION CONTROL AND PREVENTION PROGRAM

Crawford County Care Center’s primary goal in infection control and prevention is to protect our residents, our staff and visitors.

Visitation is encouraged; however, family and visitors should be aware of the nursing home resident’s susceptibility to infection and refrain from visiting if they have a communicable disease. The facility personnel will help screen visitors who are obviously ill.

Hand washing is strongly recommended before and after visiting our residents.

During an outbreak (e.g. flu season), visitors will be reminded to refrain from visiting if they are ill.

METHOD OF PAYMENT

Arrangements for method of payment must be finalized at time of admission. Contact Social Services or the business office for the current daily rate. If the prospective resident has insufficient personal assets, then the resident or person acting on his/her behalf must make application for nursing home benefits at the Department of Public Welfare at the County Assistance Office (814) 333-3400. Eligibility for Medical Assistance is determined by the Department of Public Welfare on assets such as checking and savings accounts, life insurance policies, stocks, bonds, property.

MEDICARE, OTHER INSURANCE AND SOCIAL SECURITY CARDS

Crawford County Care Center needs to have a copy of a resident’s medical/insurance cards upon admission. These include Social Security, Medicare and any other health insurances. If you bring in the originals, copies can be made in the business office

NUTRITION SERVICES

The Nutrition Services Department provides nutritious, balanced meals with home-style cooking and presentation. We encourage residents to have their meals in our beautiful dining room and enjoy socializing along with the great food.

Our department can provide regular and therapeutic diets to meet the individual needs of our residents. A registered Dietitian is available for consults. Menus are posted on the bulletin boards on each wing weekly.

OUTINGS (Leave of Absence)

Outings can be a wonderful break for the residents. Family members and friends may take their loved one out of the building for visits to home, parties, out to eat, doctor appointments, etc. However, please talk with nursing before taking any resident out of the building. You must sign the resident out and state the expected time of return. If a resident is receiving therapy, outings must be scheduled around the therapy time. A resident is permitted to be out overnight, however, he/she is limited to 30 days per year. A resident cannot stay out of the facility overnight during a Medicare, Part A stay.

PHYSICAL RESTRAINTS

Physical restraints are any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual can not easily remove which restricts freedom of movement or normal access to one’s body. Physical restraints include, but are not limited to, side rails, lap buddies, lap trays, waist restraints, merry walkers and seatbelts. It is the goal of the Crawford County Care Center to achieve and maintain an environment free of physical restraints, to allow the residents to live in the least restrictive setting possible, and to preserve the dignity and autonomy of all of our residents.

All new residents and/or their responsible party will have the risks explained along with effective alternatives that are utilized in this facility if the resident has safety needs/concerns.

PERSONAL PROPERTY

All personal items brought in must be labeled with the resident’s name clearly marked. This includes items such as: television, personal chair, lamp, radio, family photographs, razor, personal blankets, etc. as well as resident’s glasses, dentures and hearing aides. Please notify nursing when bringing in any of these items, as they need to be documented on the personal possessions sheet. Crawford County Care Center does not accept responsibility for any lost or stolen items.

PLAN OF CARE

A Care Plan meeting is scheduled within 14 days of admission (and held every 90 days after that) for each resident. An interdisciplinary team meets to review the resident’s plan of care. Residents and families are invited and encouraged to attend. Invitations are sent out by the Social Service Department. Families are asked to call ahead to schedule a meeting time. Please note that several families attend on the same day so the meetings must be limited to 15 minutes. Please be aware that any concerns can be discussed with the appropriate staff when they arise. The concern does not need to wait until the care plan meeting.

REHABILITATION SERVICES

Our goal in therapy is to return each resident to his/her highest level of function. Individual treatment plans are developed by licensed, registered physical therapists, occupational therapists and speech-language pathologist. Licensed, registered physical therapy and occupational therapy assistants are also on staff to ensure each program is carried out to the maximum potential of each resident.

Our comprehensive rehabilitation approach, combined with interdisciplinary team meetings, yield a high return for short term rehab and successful integration back into the community. For the long-term resident we strive to maintain functional skills for maximum independence and remain actively involved in the ongoing changed in their lives.

RESTORATIVE CARE

Restorative care refers to the nursing interventions that promote the resident’s ability to adapt and adjust to living as independently and safely as possible. This concept actively focuses on achieving and maintaining optimal physical, mental, and psychosocial functioning. Generally, restorative programs are initiated when a resident is discharged from the formalized physical, occupational or speech therapy. A resident may also be started on a restorative program when he/she is admitted with restorative needs, but is not a candidate for skilled therapy services.

Restorative programs include such activities as walking, transferring, dressing, grooming, eating, swallowing, exercising and communication to improve or maintain function in physical abilities, activities of daily living and prevent further impairment.

Crawford County Care Center has two levels of restorative care. The first level of restorative care is provided by Restorative Aides, who have been formally trained to provide specialized restorative programs. The second level is provided by general nursing staff; these programs are less formal and are usually performed during routine nursing care. The staff at both levels are well trained in restorative techniques that promote resident involvement in the activity. Both programs are supervised by a licensed nurse, specializing in restorative care.

RAZORS

It is the policy of the Crawford County Care Center to not allow the use of straight razors. Residents are to provide their own personal electric razor. Please make sure to label the razor with the resident’s name or ask staff to engrave it.

RESIDENT ROOM PHONES

If a resident wishes to have a private telephone in their room, the resident or responsible party must request an Alltel form from the business office or a social worker. The form must be completed by the resident or responsible party and returned to the business office. The business office will take care of contacting Alltel. The phone will have a private individual number just as though the resident lives in his or her own house or apartment. The phone must be provided by the resident.

The monthly telephone bill is a private responsibility and must be paid from the resident or family’s personal funds. The nursing home does not pay for telephones or services in rooms. There are telephones provided by Crawford County Care Center in community areas which are available for resident use.

RIGHT TO TRANSFER and ROOM CHANGES

Room changes are sometimes a necessity for various reasons. If the resident or the responsible party has a concern about the room or roommate compatibility, they can contact the Social Service department. Crawford County Care Center reserves the right to transfer a resident within the facility, when necessary. This includes transfers to the Supportive Care Unit for the resident’s safety/wellbeing or the safety of others. The resident and/or the resident’s representative will be notified of a potential room change.

SMOKING AND ALCOHOL POLICY

Crawford County Care Center is a SMOKE FREE / TOBACCO FREE FACILITY. On admission, all residents must sign an agreement not to smoke or chew tobacco during their stay at Crawford County Care Center. All staff and visitors must smoke/chew outside the facility in the gazebo or in their vehicles. There is to be no smoking under the covered patios.

Alcoholic beverages are not permitted unless they are offered at social functions within the facility or are ordered by the resident’s physician.

SUPPORTIVE CARE UNIT

The Supportive Care Unit is a secure wing within the facility dedicated to residents requiring special care. The goal of the unit focuses on the needs of the confused, the cognitive impaired, the wandering, or those with special emotional or behavioral issues.

Entering and exiting the Supportive Care Unit requires a numeric pass code. Only staff members are permitted to use the pass code due to resident safety issues. Visitors are welcome to visit on the unit anytime, however they will need to use the bell to ring for assistance. The black doorbell is located outside the unit doors on the right side. Push the black button and wait a few seconds and then push the door open. To exit the unit, just ask any available staff and they will assist you. Staff members are not permitted to give visitors the pass code.

TELEVISION

One television cable is available in each room at no additional charge. The facility does not provide the television. Roommates are to share the television. Televisions are to be turned off no later than 11:00PM. There are televisions available in the family lounge and the activity room for our resident’s enjoyment.

VEHICLE POLICY

Residents are not permitted to have their vehicles on facility property. Safety and liability reasons prohibit our residents from driving during their stays at the Care Center.

VISITING HOURS

There is a 24-hour visiting privilege; Visitors are to use the front entrance. The doors will be locked from 11:00 pm to 7:00 am. If you need to visit during these hours due to an emergency, there is a buzzer located at the front entrance which will alert staff that someone is in need of assistance to enter.