Title: Section 1007.7 - Eligibility and Admission

Section 1007.7 Eligibility and Admission

(a) Recipient Eligibility. An individual is eligible for admission to a Medical Respite Program as a recipient if meets the definition of a recipient set forth in section 1007.2(g) of this Part and:

(1) The individual is 18 years of age or older, unless otherwise authorized in the facility’s operating certificate by the department;

(2) The individual has a qualifying medical condition for which they require temporary rest and recuperation and may require access to medical care or other supportive services to support recuperation;

(3) The individual is able to perform activities of daily living with no or minimal assistance, or receives assistance on an interim or part-time basis from a local social services department, an outside agency, or other formal organization and such assistance is able to be provided in the facility;

(4) The individual is self-directing (i.e., is capable of making choices about the individual’s activities of daily living, understanding the impact of the choice, and assuming responsibility for the results of the choice), or receives supervision or direction on an interim or part-time basis as part of a plan of care in which the responsibility for making choices about activities of daily living is assumed by a self-directing individual, including but not limited to a local social services department, an outside agency, or other formal organization;

(5) The individual is able, with direction, to take action sufficient to ensure self-preservation in an emergency; 

(6) The individual does not require hospital inpatient, observation unit or emergency room level of care, or a medically indicated emergency department or observation visit or skilled nursing home level of care; and

(7) The individual does not pose a risk of safety to themself, other recipients or staff, as determined in the reasonable discretion by the medical respite program operator.

(b) Admission.

(1) An operator must admit, retain and care for only those individuals who do not require services beyond those the operator is authorized to provide.

(2) An individual must cooperate in the medical respite program’s assessment and be determined assessed as eligible for admission by the medical respite program.

(3) An operator shall obtain documentation from the referring entity or person of the medical need for medical respite.

(4) Admission Agreement. Each recipient must sign an admission agreement in order to be admitted to a medical respite program. A signed copy, together with a copy of the medical respite program’s code of conduct and rules, and the recipient’s rights shall be provided to the recipient. The admission agreement, at a minimum, shall specify:

(i) The effective date of the agreement;

(ii) Any rules of the program related to hours of open operation and visitation;

(iii) That the medical respite program shall discharge the recipient at such time as the recipient no longer qualifies for medical respite services;

(iv) The discharge planning process, which shall be consistent with the requirements set by the department;

(v) That the medical respite program shall be permitted to discharge a recipient immediately, notwithstanding the discharge planning process requirements in section 1007.8 of this Part,  in the event that the recipient’s behavior poses an imminent risk of death or serious physical harm to the recipient or others, or repeated behavior of the recipient which directly impairs the well-being, care or safety of the recipient or any other recipient or which substantially interferes with the orderly operation of the medical respite program. Details of any such discharge shall be made a part of the recipient’s record pursuant to section 1007.14(c) of this Part;

(vi) That the recipient’s waiver of any provision of the admission agreement is null and void;

(vii) The recipient’s right to terminate the admission agreement and vacate the medical respite program at any time; and

(viii) Any other provision specified by the department.

(5) If the recipient is sight-impaired, hearing-impaired, has limited-English proficiency or is otherwise unable to comprehend English or printed matter, the operator shall ensure that the information in the vital documents, including the admission agreement, the code of conduct, and the facility rules and recipient rights information, are made available in a manner comprehensible to the recipient, including, as appropriate, translation of the documents into commonly spoken languages other than English or through the use of an interpreter.

(c)  Assessment. Prior to admission, the medical respite program shall assess or arrange for the assessment of each referred individual for eligibility for admission to the medical respite program.

(d)  Service Plan. The medical respite program shall develop a service plan based on the needs identified during a recipient’s assessment and revise the service plan as needed based on the recipient’s reassessment which shall be performed, as needed, but no less frequently than every two weeks, to ensure the recipient’s needs are addressed by the service plan.