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Applications for Applicants
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here for Admissions
Applications
for
Physicians
Admissions
Applications
Physicians
for Short-Term Care:
Application
to temporarily reside at The Birches Residential Care has been made
by one of your patients. Through the provision of residential care
in a supportive small home environment, The Birches serves residents
over 60 years of age who are undergoing post-surgical rehabilitation
with the guidance of home-health medical staff. We can provide assistance
with ADLs and medications management, plus our staff is trained to
aid residents in completing physician-prescribed programs of rehabilitative
exercise, but we cannot provide nursing care. We respectfully request
your approval before accepting this applicant for care at The Birches.
In order for your patient to be admitted to The Birches, they will
contact you to give consent for the release of their medical records
and schedule a TB test or CXR if these have not been taken within
the past six months. Using the link below, you can download and print
all documents in the Physician’s section for short-term care.
The application is password-protected, so please call us at your convenience
so that we may provide you with the password to access our application
data. Before your patient can be admitted to The Birches, we are required
by our licensing agency to have in-file:
1.physician’s orders including current
medications,
2.medical history,
3.physical exam documentation,
4.tuberculosis clearance,
5.ambulatory status,
6.a listing of all food and medication allergies,
7.diagnoses, and
8.diet orders.
9.If a current H&P is available,
it would be very useful to us
in serving this patient.
Additionally, the State requires that we maintain in-file written
physician’s orders giving the specific symptoms or diagnosis
for which each prescription or OTC medication is prescribed, the minimum
interval at which medication may be taken, and maximum number of dosages
per day. Please provide these if your patient is taking PRN medications.
CLICK
HERE TO ACCESS PASSWORD-PROTECTED
PRIMARY CARE PHYSICIANS’ MEDICAL APPRAISAL PACKAGE
FOR SHORT-TERM CARE FORMS
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Physicians
for Long-Term Care:
Application
for long-term residency at The Birches Residential Care is being made
to us by one of your patients or by that patient’s responsible
person. The Birches Residential Care serves residents over 60 years
of age through the provision of fine quality residential care in a
supportive small home environment. We can provide medications management
and assistance with ADLs, and our staff is trained to aid our residents
in completing physician-prescribed programs of rehabilitative exercise,
but we cannot provide nursing services.
We respectfully request your approval before accepting this applicant
for care at The Birches. Please call us to discuss your patient’s
needs and to receive the password for your complete set of appraisal
forms. As required by our government licensing agency, all of the
following must be in-file before the client may reside with us at
The Birches:
1. physician orders including diet orders,
2. medical history and physical exam documentation,
3. tuberculosis clearance, ambulatory status,
4. a listing of all food and medication allergies,
5. diagnoses,
6. current medications, and
7. if a current H&P is available, it will
be useful to us in serving this patient.
8. Your review and approval of the care plan
we will draft will be appreciated.
The Department of Social Services requires that before a resident
in our facility may take either prescription or OTC medications on
a PRN basis, written physician’s orders specifying the specific
symptoms or diagnosis for which each medication is prescribed, the
minimum interval at which medication may be taken, and maximum number
of dosages per day.
CLICK
HERE TO ACCESS PASSWORD-PROTECTED
PRIMARY CARE PHYSICIANS’ MEDICAL APPRAISAL PACKAGE
FOR LONG-TERM CARE FORMS
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Admissions
Application for Applicants
Applicants
for Short-Term Care:
Thank
you for your interest in The Birches Residential Care. We will
be very pleased to receive your completed application for short-term
residency here with us. Please call us to discuss your needs. If we
determine that you are a good candidate for short-term residential
care at The Birches, we will ask you to first contact your
M.D. to (1) make a tuberculosis testing appointment, and (2) authorize
the release of your medical records to us, and (3) request that
your physician contact us at his or her earliest convenience. We will
request that the physician visit our website; complete and send to
us a medical appraisal necessary for your admission. Next, (4) print
all documents in the Applicant section; complete, sign, and send them
to us. Once you have telephoned your primary care physician
to authorize the release of your medical information, your doctor
can complete the medical application package and submit it to us.
Your application must be complete, and you must be tested
and cleared for active, communicable tuberculosis prior to admission
to The Birches or any other residential care facility. The
purpose of the application packages from you and your doctor is to
provide us with information that will permit us to ascertain whether
we are capable of caring for you. Then, the process is as follows:
1. Please do not come to The Birches without a scheduled appointment.
We will review your completed application and your physician’s
medical appraisal with our consulting nurse and/or therapist; and
if you are a candidate for care at The Birches Residential Care, we
will contact you to arrange an afternoon during which you can see
our facilities first-hand, and we can get acquainted with you at our
home;
2. If you need additional help with your own home during your surgical
recovery, The Birches may be able to assist you in a variety of ways.
These very special services will be further discussed during your
visit.
3. If our facility meets with your approval, we will execute a rent-plus-services
agreement, and you will make advance payment for your stay. The Department
of Social Services allows us only to work only with month-to-month
contracts, so your stay must be for a minimum of one month. If you
need or desire to stay on for a few more days or weeks with us, we
will re-examine the situation as soon as we become aware of your need,
and determine whether we can accommodate you.
4. Please pack all that you need (clothing, medications, and toiletries.
SEE LIST ENTITLED “BEFORE MOVE-IN”) and bring it with
you to the hospital on the date of your surgery, if possible. If not,
pack your bags in advance and make arrangements for pick-up at your
home with us, or a friend or relative. Your surgery will take place,
and you will more than likely stay in the hospital for two or three
days afterward; then, upon medical discharge, our staff will pick
you up and privately transport you to our facility.
5. We will unpack and organize your clothing and belongings, and your
medications. Please note: you must be able to manage your own medications
to be eligible for short-term care at The Birches. We will generate
inventory lists of those items of personal inventory for which The Birches
will accept responsibility.
6. When your case manager (usually a home-health nurse or physical
therapist, chosen by your doctor and sent to our facility to work
with you during your rehabilitation) has examined you, he or she will
write a care plan detailing instructions for your entire stay.
IMPORTANT NOTE: The Birches’ charter and professional obligation
is to carry out your physician’s and therapists’ instructions
to the letter. If for any reason you cannot comply fully and willingly
with these or any other physician’s instructions, do not seek
admission to The Birches. The Birches care staff is trained
in all aspects of care following this type of surgery, and will provide
you with top-quality assistance with your needs until you can function
independently and return home.
7. Your surgeon will want to see you about four weeks after your surgery.
We will be happy to escort you to this appointment.
CLICK
HERE TO ACCESS PASSWORD-PROTECTED APPLICANTS
SHORT-TERM ADMISSIONS FORMS
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Applicants
for Long-Term Care:
Thank
you for your interest in The Birches Residential Care. We will
be very pleased to receive your application for residency here. The
purpose of the application is to obtain sufficient information so
that we may ascertain that we can provide adequate care for you or
your loved one. Thank you in advance for your cooperation and efforts.
The process is as follows:
(1)Please phone your primary care physician to authorize the release
of your medical records to us at your earliest convenience,
(2)Arrange to have a tuberculosis test simultaneously, unless you
have had one with negative results in the past six months, and
(3)Ask your doctor to phone us to receive his or her section of the
application.
(4)We then spend an afternoon getting acquainted with you at our home;
(5)We review and discuss this appraisal with our consulting nurse
and/or physical therapist; and
(6)We generate a formal needs and services plan for you, which is
reviewed and approved by yourself(ves), the doctor in charge, and
The Birches.
If acceptable
to all parties when the above are completed, we then:
(7)Jointly review guidelines pertaining to our facilities,
(8)Jointly review what personal furnishings may accompany you or your
loved one,
(9)Confirm a date and pick-up time to move in,
(10)Execute a contract and all applicable releases,
(11)For long-term clients, the first month’s rent is due and
payable upon move-in, plus a non-refundable administrative fee for
processing the application.
(12)Within two weeks after a long-term client moves in, we will share
with you the task of unpacking, marking and organizing your loved
ones’ clothing and belongings, and generate a list of those
items of personal inventory for which The Birches will accept
responsibility.
Upon
move-in, other items needed from applicant upon move-in are: a DNR
(Do Not Resuscitate Order) if desired, a recent photo of resident,
health care cards, photo I.D. if available, verification that a charge
account has been set up with a pharmacist, two weeks’ supply
of medications, and one week’s continence supplies, if needed.
Please read carefully all the documents within this section before
applying, and please do not deliver your application package to the
facility without an appointment.
CLICK
HERE TO ACCESS PASSWORD-PROTECTED APPLICANTS
LONG-TERM ADMISSIONS FORMS
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