WHAT TO BRING
On the day of admission the Resident will need to bring the following if applicable:
- Medicare card
- Medicaid card
- Insurance cards
- Prescription card
- Power of Attorney papers
- Guardianship papers
- Do Not Resuscitate (DNR)
- Do Not Intubate (DNI)
- Health Care Proxy
- Living Will
Please plan to come to the facility one hour prior to the scheduled admission time to meet with our Admission Clerk.
CLOTHING FOR RESIDENTS
The Chautauqua County Home likes Residents to feel as comfortable as possible. Residents should bring clothes that are comfortable, practical and attractive. Bring a variety of clothing and footwear. Clothing is changed daily (or more often if needed) and is laundered once a week, therefore, it is necessary to bring a sufficient supply. Any clothing or items brought in for the Resident should be given to staff at the Nurses' Station so that the clothing can be properly labeled by the Laundry Department and listed on the Resident's inventory sheet. The following list may be used as a guide.
- 9 Pair of pants and shirts
- 9 Dresses or dusters
- 4 Sweaters
- 9 Pair of socks or knee-highs
- 9 Pair of underwear
- 9 T-shirts
- 9 Slips, bras etc.
- Pajamas or nightgowns (hospital gowns are provided).
- Terrycloth robe
- Jacket / coat.
The Chautauqua County Home will provide each Resident with laundry service unless the family prefers to launder the clothes privately. Delicate fabrics and articles requiring dry cleaning are not recommended and will be the Designated Representative’s responsibility.
Clothing fabrics commonly referred to as “permanent press” launder well and retain a neat appearance. Clothing in general should be easy to fasten, i.e., large buttons, front closing.
Toiletries such as shampoo, tissues, razors, lotion, toothbrush and paste are supplied.
Advance Medical Directives
The Chautauqua County Home is committed to giving each Resident all the information needed to make informed choices concerning medical care. Each Resident will be informed upon admission, both orally and in writing, of Chautauqua County Home policies regarding Residents Rights, including the right to make advance medical directives and what care will be given in the absence of clear direction by the Resident.
The right to make advance medical directives gives the Resident time to plan ahead for his or her health care. An advance medical directive assists health care professionals, relatives or an adult speaking on the Resident’s behalf, to make decisions about treatment based on the Resident’s expressed wishes when the Resident is no longer able to do so. The Chautauqua County Home will honor and implement the advance medical directives of Residents. Such advance medical directives are purely voluntary. We will not discriminate against any Resident for any reason, including whether or not they have made an advance medical directive.
Only the Resident may make health care decisions for himself until such time as decision-making capacity has been lost. Every Resident is presumed to have decision-making capacity unless a physician determines otherwise. Only in the event that a Resident loses the capacity to make informed decisions does the substituted decision-making of the Resident’s Health Care Agent become authoritative.
An advance medical directive information packet with a sample Health Care Proxy form will be provided to each Resident or Designated Representative upon admission to the Chautauqua County Home. This printed information sets forth each adult’s rights under state law to make advance medical directives.
Types of Advance Directives
Health Care Proxy:
In New York State, any adult can assure that his wishes concerning medical treatment will be honored if he becomes unable to decide for himself, through the appointment of a Health Care Agent. A Resident can appoint any other adult he chooses (other than his own professional caregivers) to act as his Health Care Agent. In making the appointment, the Resident may convey total discretion, or limit the decision-making power with which the Health Care Agent may consent or refuse medical treatment on the Resident’s behalf.
The Health Care Agent’s authority to make decisions for the Resident begins if and when the Resident loses decision-making capacity as determined by the Attending Physician. Unless the Health Care Agent knows the Resident’s wishes about receiving artificial nutrition and hydration, the Agent will not have the authority to refuse those measures if they become medically indicated. The document must be signed by the Resident and by two witnesses.
Do Not Resuscitate Orders:
Another form of advance medical directive available in New York State is a Do Not Resuscitate Order written by a physician at the request or consent of the Resident. This recognizes a Resident’s right to refuse cardio-pulmonary resuscitation, in advance, in the event of a cardiac or respiratory arrest. Unless such an order is in place, everyone is presumed, under the law of New York State, to consent to cardio-pulmonary resuscitation.
If a Resident has lost decision-making capacity without having requested a Do Not Resuscitate order and if he has an appointed Health Care Agent, the Health Care Agent may consent to a Do Not Resuscitate order. If there is no appointed Health Care Agent, the Do Not Resuscitate law lists potential surrogate decision-makers, in order of priority, who may be designated by the Attending Physician to consent to a Do Not Resuscitate order. This substituted decision making is based on the wishes of the Resident, if known, or on the Resident’s best interests.
The brochure, Deciding about CPR: DO-NOT-RESUSCITATE ORDERS (DNR) A Guide for Patients and Families, is available at the Social Work Office.
BED-HOLD AND READMISSION
Medicaid regulations provide that the bed of a Medicaid recipient who has been in the County Home for a minimum of thirty (30) days and who can meet other applicable requirements will be reserved for the Resident for fourteen (14) days, in a twelve month period, if the Resident is hospitalized for an acute condition and if it is expected that the Resident will be able to return to the County Home within the fourteen (14) day period. The Resident or Designated Representative may elect to pay for a bed reservation beyond the 14 days at the basic daily rate. The Resident may be entitled to re-admission upon the first availability of a bed in a semi-private room when the Resident no longer requires hospitalization.
Medicare does not reserve the bed when the Resident is absent from the facility; the Resident and/or Designated Representative have the option of reserving and paying for the bed themselves.
Private pay Residents transferred to the hospital can reserve their bed at the basic daily rate.
Priority for admission is given to Residents whose bed reservation has been terminated.
Communication between the Resident, family members, and staff is necessary for a successful transition and pleasant stay at the Chautauqua County Home. Questions regarding a medical concern should be directed to the Charge Nurse or Supervisor on the Resident’s unit. Other questions may be directed to the Social Worker.
A complaint should be discussed verbally with the Department Head or, if the complaint deals specifically with nursing care, brought to the attention of the Charge Nurse. In addition, the Social Work Office and Administrator will receive complaints, whether verbally or in writing, and will refer for appropriate action. Any complaint that cannot be resolved at the Department Head level will promptly be brought to the attention of the Administrator for review and resolution.
If complaints are not handled to the Resident’s satisfaction or if the Resident believes he has been abused, neglected or if property has been stolen contact:
N.Y.S. Department of Health Hotline
Office of Health Systems Management
The following groups serve as Advocates for Residents:
Chautauqua County Office for the Aging
Hall R. Clothier Building
Mayville NY 14757
Commission on Quality Care
For Mentally Disabled
99 Washington Ave
Albany NY 12210
The Chautauqua County Home accepts all Residents without regards to race, color, creed, national origin, sex, age, disability or handicap, source of payment, marital status, sexual preference or blindness.
Individuals believing they have been discriminated against should contact the nearest Regional Office of the New York State Department of Health for Assistance.
584 Delaware Avenue
Buffalo, NY 14202
COMPREHENSIVE CARE PLAN MEETING
Comprehensive Care Plan meetings are scheduled at regular intervals during the Resident’s length of stay. Concerns, suggestions and issues will be addressed at these meetings. It is strongly recommended that the Resident and Designated Representative attend. If unable to attend the meeting, it is advisable to outline any concerns, suggestions and issues in writing and submit to the Social Work Department prior to the meeting for discussion at the meeting.
GUEST MEAL TRAYS
Guests may order a meal to share with a Resident by ordering a guest tray through the Resident Personal Account Office. Holiday guest trays are available. Signs are posted in the front lobby with details.
ITEMS FROM HOME
Residents are encouraged to personalize their room and may bring items such as family pictures, stuffed animals, television, radio, throw pillows, quilt/afghan, scrapbooks, or photo albums. Residents may also bring hobbies such as needlework, cards, books, and crossword puzzles, etc.
The Maintenance Department will assist the Resident in hanging items on the walls. The Maintenance Department must approve all electrical devices for safety.
The Chautauqua County Home will provide each Resident with laundry service unless the family prefers to launder clothes privately. Delicate fabrics and articles requiring dry cleaning are not recommended. Dry cleaning is not included in the Chautauqua County Home rate and is not a service that is coordinated by the facility. The following is a list of the laundry days for each unit. All clothes are laundered, pressed and mended (if needed) and returned to the unit on the assigned day.
LEAVE OF ABSENCE
The Resident may leave for personal outings if permitted by the Attending Physician. Please make arrangements with the Charge Nurse. Residents receiving Medicare Part A benefits will be financially responsible for the daily basic rate for overnight visits. Medicaid allows for 18 overnight visits per twelve-month period provided the Resident has been in the facility for 30 consecutive days.
Personal mail, packages, and flowers, which are sent to the Resident, will be delivered daily. Business mail can be forwarded to the Resident’s Designated Representative or handled by the Billing/Business Office upon request. Residents may purchase postage through the Resident Personal Account Office. A mailbox is located in the lobby. Assistance is available for those requesting it such as opening mail or addressing envelopes.
Breakfast is served in bed. The large meal is served for lunch and a lighter meal served for dinner. Menus are posted on each unit and alternates are available.
Guest meals are available. Arrangements can be made through the Resident Personal Account Office Monday through Friday.
Medicare is a National Insurance program designed and run by the federal government for the elderly and disabled.
Medicare provides hospital and medical insurance for most people over the age of 65, for people of any age with permanent kidney failure and for people who have been entitled to Social Security Disability benefits for at least two years. Medicare’s hospital insurance (Part A), which is paid for as part of Social Security payroll deductions, covers up to 90 days of inpatient care and up to 100 days of skilled nursing facility care in any one benefit period, as well as some home health and hospice care. Medicare’s medical insurance (Part B), paid for in monthly premiums, covers doctors services, outpatient hospital services, laboratory fees and more.
Residents admitted to the Chautauqua County Home may be eligible for Medicare Part A benefits if the Resident was in the hospital three days (not counting the day of discharge), admitted to a skilled nursing facility directly from the hospital or within 30 days of hospitalization from the community and meets skilled criteria as defined under Medicare guidelines. Medicare Part A will pay the first 20 days in full and will pay days 21 to 100, less a co-payment, provided there is still need for skilled services. Custodial care is not covered under Medicare Part A. The Finance Office can advise Residents of their financial responsibility and the services Medicare Part A or Part B will pay. The Chautauqua County Home will notify the Resident or the Designated Representative on the day of admission with regards to Medicare eligibility for Medicare Part A benefits. For more information on Medicare benefits call (800) 633-4227 for a free booklet or to speak with a Medicare representative.
Medicaid is an assistance program for low-income people administered by individual states under federal law and is financed through federal, state and local taxes. Unlike Medicare, Medicaid is a program available only when there are no other means to pay for medical expenses. The Chautauqua County Home Social Work Department or Business Office will help determine if and when the Resident will need to apply for Medicaid.
If it is expected that the Resident’s private resources will not exceed the nursing home stay, the Resident should consult with an attorney prior to transferring any sums of money or property. Transferring money or property could jeopardize future Medicaid eligibility.
Medicaid may pay Medicare’s deductibles and co-payments for those who qualify. Information about Medicaid and current resource levels may be obtained by contacting the Department of Social Services.
Newspaper delivery, for an additional fee, can be arranged by contacting the Resident Account Office.
Pets are welcome visitors at the Chautauqua County Home. Please follow the guidelines below when bringing pets to visit.
In order to assure the safety of Residents and staff, all dogs visiting the Chautauqua County Home must be on a leash. Other pets must be in an appropriate carrier.
When bringing the pet in to visit, the owner of the pet assumes all responsibility for any unforeseen problems that may occur while the pet is visiting in the Chautauqua County Home.
Animals must be in good health, free of fleas and other parasites and have up to date vaccinations.
The Administrator reserves the right to not allow a pet to visit or to put restrictions on visiting if a problem occurs relating to safety or Infection Control Policy.
Upon admission the staff physician will be the Resident’s Attending Physician. The Attending Physician will visit at least once every thirty (30) days for the first ninety (90) days after admission and at least once every other sixty (60) days thereafter and more often when medically indicated.
The Chautauqua County Home contracts with medical professionals for most services. All contracted professionals are licensed, have a current registration certificate, and certificate of insurance. Residents retain the right to choose their own fee-for-service providers, however, if the Resident chooses to use a consultant not affiliated with the Chautauqua County Home the Resident must obtain prior approval from the Attending Physician.
All Residents automatically become members of the Residents’ Council. The Residents’ Council affords the opportunity for Residents to actively participate in decisions affecting their everyday lives.
The Residents’ Council meets monthly to discuss issues, program recommendations, policies, concerns and suggestions. Changes in Chautauqua County Home procedures, rate changes, etc. are generally addressed at Residents’ Council. Meeting dates and times are posted on the units. For more information, please contact the Activities Department.
RESIDENT PERSONAL ACCOUNT
Resident Personal Account is an optional and convenient way to have funds accessible. The Resident may charge services to the account. Such services may include hair styling, purchases of clothing, purchases from the Country Store, etc. The Resident may opt to have his Social Security check deposited to the account and has the option of the Chautauqua County Home managing finances such as becoming Representative Payee. Any deposits or withdrawals from this account may be made during the Resident Personal Account Office hours, which are posted by the door. If the Resident needs to make a deposit or withdrawal from the account the Resident may go to the Resident Personal Account Office and a representative will collect or disburse the requested funds. If the Resident is unable to go to the Resident Personal Account Office, a representative from that office will come to the Resident’s room and collect or disburse the requested funds. The Social Worker or Designated Representative can also assist the Resident in making transactions. An authorization is required for all withdrawals.
For your convenience, a lockbox is located on the wall outside the Resident Personal Account Office. The lockbox is available for deposits and payments outside regular business hours. If you would like a receipt, please mark “receipt requested” on the envelope and a receipt will be mailed or given to you the following business day. If a receipt is not requested, the receipt will be filed in the Resident’s Personal Account file.
As a Health Care facility, it is the Chautauqua County Home’s responsibility to provide a healthful, comfortable and productive work and living environment. Medical evidence clearly shows that smoking is harmful to smokers. Research also indicates that long term exposure to second-hand smoke may seriously threaten the health of non-smokers. In the best interest of the general health of all Residents, staff members and visitors, it is the policy of the Chautauqua County Home to be a smoke-free facility. Residents who desire to quit smoking are encouraged to discuss smoke cessation programs with the Attending Physician.
Telephones are located in the visitors lounge, lobby, and on each nursing unit for Resident use. Telephones are wheelchair accessible and useable by Residents who are visually and hearing impaired.
A large screen television is located in the Day Room. In addition, televisions are located on each unit in the TV room. Residents may have a television in their room if they desire. The Maintenance Department inspects all electrical devices for safety.
Cable television service is available for an additional fee. Chautauqua County Home personnel can make arrangements for installation. A cable guide is included in this handbook.
It is not recommended that cash or other valuables be kept in the room. A personal account may be established through the Resident Personal Account Office. Residents are encouraged to send valuables home with family for safe keeping. A locked box is available upon request.
Upon discharge (including death) prompt removal of personal belongings is appreciated. Because of limited storage space personal belongings should be retrieved within one week of discharge and will be released, upon the signing of a release form, to the Designated Representative, Legal Representative or Next–of-Kin. Upon death, the Chautauqua County Home staff will make an inventory of all personal belongings.
The Chautauqua County Home is not responsible for lost or damaged items of any kind including but not limited to cash, jewelry, eyeglasses, hearing aids or dental prosthesis, unless the Resident has given such items to the Chautauqua County Home for safekeeping or unless the loss is due to the gross negligence and/or willful misconduct of the Chautauqua County Home.
Visitors are therapeutic to Residents. The effects are long-lasting and greatly appreciated. Visiting hours are from 11:00 a.m. until 9:00 p.m. Exceptions are made for special circumstances. Please check with the Switchboard Operator or Charge Nurse prior to entering nursing units during “off” hours. Visitors of all age groups are welcome at the Chautauqua County Home. Family pets are permitted (please refer to the section on pets in this handbook).
The visitors’ lounge is located on the second floor, room 204, and is available for all to enjoy. Residents are encouraged to reserve the room for special events such as birthday parties or family gatherings. Reservations can be made through the Activities Department. Residents and their families may use the room if unoccupied to make private phone calls, have private discussions or to enjoy quiet time.
Volunteers are needed and appreciated by Residents and staff. The following are just some of the areas you can help if you choose to become a Chautauqua County Home Volunteer.
Visit and chat with Residents, help Residents write or read letters, be a partner in a game, personal shopping or take a Resident outdoors. Assistance is also appreciated. At Bingo games, transporting wheelchair bound Residents to activities or being a helping hand at special outings. Some volunteer work can be done right at your home such as making favors, decorations or holiday trinkets.
For more information on how to become a volunteer contact the Volunteer Coordinator or the Activities Director.
Absentee ballots are available to all Residents who wish to exercise their right to vote. To request an absentee ballot or to register to vote contact the Social Work Department.
10836 Temple Road
Dunkirk, New York 14048