DEWITT REHABILITATION NURSING CENTER, INC. "SUPERIOR CARE IN THE HEART Of THE CITY"

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1 DEWITT REHABILITATION NURSING CENTER, INC. ANV "SUPERIOR CARE IN THE HEART Of THE CITY" 211 Eo4t79*-St Mew Yorh, MY (212) or 1372 Fax: (212)

2 ADMISSION INFORMATION PACKAGE TABLE Of CONTENTS Information on the Facility 1-3 Medicare Program, 4 Payment Rates 5 Medicaid Documentation 6 Medicaid Rent Retention Program 7 Provided Services 8 Sample Activities Calendar 9-12 New Services from our Activities Dept 13 Sample Menu 14-15

3 DEWITT REHABILITATION AND NURSING CENTER Welcome to DeWitt Rehabilitation and Nursing Center, a 499-bed skilled nursing facility conveniently located at 211 East 79 th Street, between 2 nd and 3 rf Avenues in New York City. DeWitt is committed to providing the highest quality of care and quality of life to all our residents. This facility provides accommodations for both short and long term residents with 24-hour skilled nursing services; attending physicians and nurse practitioners. Highlights of the services we offer include:. SHORT TERM REHABILITATION Residents coming to DeWitt for short term rehabilitation have their own units where they reside with others who also plan to return home. They are separate from long term floors. We accept rehab residents as young as 21 and have a high percentage of patients coming to us from local hospitals after such procedures as hip and knee replacements. Our staff provides encouragement and motivation for residents as they begin their journey through rehab back to home. Unlike many other skilled nursing facilities, our rehab is always done individually -1:1 ~ never in groups. These individualized therapeutic programs allow us to maximize residents*progress and help clinicians focus on their needs and problem areas. At DeWitt, our dedicated Rehabilitation Department has a well deserved reputation of combining knowledge and hard work to ensure successful results for our short term residents so they can eventually return home; the rehab also enhances the quality of life of our long term residents. The Rehab Dept is staffed with a Physiatrist (Rehab Medicine Physician) and well trained Physical and Occupational therapists and a Speech and Language Pathologist who have expertise in treating a variety of complex medical conditions, orthopedic conditions such as total joint replacement and spinal surgeries, stroke or other neurological disorders to name a few. The Rehab department employees approximately 40 licensed therapists. New residents are assessed by the Physiatrist and a physical therapist who design an individualized treatment plan to meet the needs of that patient. Our short term restorative rehabilitation program offers a wide range of programs from gradual reconditioning to a more intensive physical, occupational and speech therapy to assist in activities of daily living, strengthening techniques, ambulation, balance, negotiating steps and transfer training to facilitate a timely recovery and return home. Our main goal is to assist residents in becoming as mobile as possible, to regain independence and/or enable residents to achieve their highest level of practical functioning and enjoy a more fulfilling life. 1

4 We are proud to discharge hundreds of residents back to their homes each year upon completion of short term rehab stays,. MEDICAL SUB-ACUTE SERVICES DeWitt offers a medical sub acute floor with enhanced services for residents with more complex medical needs including wound care. Due to increased demand for services, DeWitt recently introduced a second wound care floor. The Sub acute medical unit provides care for individuals with:. Tracks, including weaning where applicable. Bipap/Cpap Machine for COPD Exacerbation or Sleep Apnea. Wound Care. Infusion (IV) Therapy. PICC lines. LONG TERM CARE DeWitt also provides accommodations for round-the-clock skilled nursing care for residents who choose to make their home here on a permanent basis.. HOSPICE For those who desire such services, DeWitt has two on-site hospice providers: Continuum and VNS Hospice. Residents/families may select whichever they prefer. The hospice team provides another layer of care for their patients. Hospice works with the DeWitt staff to meet the physical, emotional and spiritual needs of the resident with advanced illness and his or her family. Hospice provides services by physicians, nurses, social workers, chaplains, companions including extended counseling for families. Hewitt also provides its own Palliative Care services.. SOCIAL SERVICES Social Workers at DeWitt assist in discharge planning including making referrals to homecare and community agencies and ordering equipment They also maintain ongoing relationships with residents and their families, offering counseling, guidance and support. Social workers are part of an interdisciplinary team that ensures residents' rights and needs are addressed on all levels. 2

5 . RECREATION The De Witt Activities Department provides a wide range of programs on and off the units. Activities are designed to appeal to residents of all ages and abilities. Entertainment includes outside performers, classic movies, out-trips to places like Radio City Music Hall; barbecues in our outdoor courtyard, exercise programs, ice cream socials.. WE ALSO PROVIDE The facility also cares for residents with peg feeding (including weaning services as applicable) and those requiring respiratory care. Pain management is provided for all residents with pain issues. In addition to 24 hour skilled nursing care, Dewitt provides:. Attending Physician assigned to each resident. Nurse Practioners. Dietary Services. Infection Control Department. Case Management Department for liaison to insurance providers. On site Psychiatrist. Psych Associates for individual counseling. Televisions available for rental. Direct TV. Phone Service in all rehab rooms. Outdoor courtyard with tables and umbrellas for activities and family visits. Wireless internet access throughout the building. Computers available for residents' use. Business Office to prepare Medicaid applications as requested We accept Medicare, Medicaid, private pay and all major insurances mcluding: Cigna, Healthnet, Oxford, HealfJifirst, Hip, Aetna-U.S. Healthcare, GHI, Blue Cross, United Healthcare, VNS Choice and Touchstone to name a few. For consideration as possible admission, kindly forward a PRI (patient review instrument) and screen for review. If the referral is for someone in the hospital, contact your hospital social worker to forward these forms. If patient is at home, please contact a nursing service such as VNS ( ) to come to the home and complete the form. Our fax is For more information or tours please contact the Admissions Office at ext

6 THE MEDICARE PROGRAM Medicare is a federal health insurance program designed for individuals who are generally 65 years or older and have a social security number. For specific requirements of Medicare for eligibility, please contact your local social security office. Medicare Part A covers inpatient hospital services and the services of certain other health care providers such as Skilled Nursing Facilities. DeWitt Rehabilitation and Nursing Center is a Skilled Nursing Facility. A maximum of 100 days are provided in a benefit period within Medicare A guidelines. Part A: Resident must meet "skilled nursing criteria," for coverage. The following are examples of "skilled nursing criteria" for Medicare coverage: a. Restorative physical and/or occupational therapy five days a week (not maintenance therapy) b, Tube feeding: naso-gastric, gastrostomy, jejunostomy c. Stage 3 and 4 decubitus ulcers requiring daily treatments d, Daily intravenous hydration or antibiotics The individual care plan shall be reviewed on an ongoing basis and evaluated to determine, if the services rendered would continue to qualify for Part A coverage,., Part A Coverage: 1. Part A covers in full days 1 though 20 for a semi-private room. * 2. Part A covers all EXCEPT a required co-payment for days Amount of co-payment changes annuallycheck with (he DeWitt Business Office at Ext for current co-payment amount. 3. The resident may have co-insurance or secondary insurance, which may cover the daily co-payment, The admissions office will verify if the secondary insurance applies days is the maximum Part A will cover, but the above-mentioned guidelines must continue to be met for continued coverage. 100 days is not guaranteed. 5. Upon termination of Medicare benefit period or when benefit days are exhausted, the resident or responsible party will be billed for the full room rate plus Pharmacy and Rehabilitation as per the admission agreement. Thus the resident's status becomes private pay or Medicaid pending. 6. In order to renew benefits, the resident must be discharged to home for a period of at (east 60 consecutive days (not requiring inpatient care under Part A in a SNF or hospital) 7. Medicare covers a semi-private room (2, 3, or 4 to a room). We reserve therightto bill for a private room differential; contact Admissions, (Ext. 1334) for the amount of the differential. PART B COVERAGE: 1. Your private physician will bill Medicare Part B for facility visits, 2. You may be responsible for the 20% portion (if you have no secondary insurance). The above holds true as long as the Resident is considered "Medicare Qualified" as outlined in the Federal Guidelines. 4

7 DEWITT REHABILITATION AND NURSING CENTER LIST OF CHARGES EFFECTIVE JANUARY 1 st, 2013 TYPE DAILY 31 DAYS 30 DAYS SEMI-PRIVATE (2,3,4 Beds to a room) $ $13, $12, PRIVATE (IBed) $ $14, $13, PRIVATE (1 Bed on 16 th Floor) $ $14, $14, SPECIAL PRIVATE (Rooms 1661 and 1606) $ $14, $14, Physical Therapy, on either a staff or feefor-service basis, as prescribed by a physician, administered by or under the supervision of a licensed and currently registered physical therapist: Occupational Therapy, on either a staff or fee-for-service basis, as prescribed by a physician, administered by or under the supervision of a qualified occupational therapist: Speech Pathology Services, on either a staff or fee-for-service basis, as prescribed by a physician and administered by a qualified speech pathologist: Audiology Services, on a fee-for-service basis, as prescribed by a physician and administered by a qualified audiologist: Pharmacy Charges: ANCILLARY CHARGES Billing is based on 15 minute units at $40 per unit. Billing is based on 15 minute units at $40 per unit. Billing is based on 15 minute units at $40 per unit. $125 for an audiology evaluation. Hearing aid costs vary on the type required. (Estimates can be requested in advance of authorization.) If a resident is not covered under Part D Medicare, or other private insurance, the pharmacy vendor will bill the resident or responsible party and seek payment for prescription drugs furnished to the resident at the pharmacy vendor's usual and customary rates, mcluding applicable copayments.

8 MEDICAID LCsted^belo\v c^e^d^^ by perxrn&tfyplying'form DOCUMENTATION Medicaid/ c<m^e^^icm/. PROOF OF IDENTIFICATION 1. Social Security card 2. Medicare card 3. Medicaid card 4. U.S.A. Birth Certificate or U.S.A. Passport or Naturalization Papers 5. Marriage Certificate (if married) 6. Divorce papers (if divorced) 7. Death Certificate of Spouse (if widowed) 8. Veteran Information (Honorable Discharge/Enlistment papers) 9. Private Health Insurance (Card and Current Paid Bill) PROOF OF INCOME 1. Award letter from Social Security 2. Private pension or Union paycheck stub showing GROSS AMOUNT 3. Last 4 weeks of paystubs in consecutive order (if still employed) 4. Veterans award letter (showing income benefit) 5. Income tax returns for the last two years 6. Banking information *(checking, savings, money market, passbook, and closed accounts) 7. Investment Income Dividends-Annual Statement* 8. Life insurance policy showing CASH VALUE from the insurance company. 9. Real estate income from rent PROOF OF RESIDENCE 1. Lease or rent receipt 2. Current market value of property and maintenance costs (if home owner) 3. Utility bills (telephone, cable, electric, gas, etc) TOR COMMUNITY MEVICAW CONVERSION: 1. Six months of banking information (instead of 36 months) 2. All of the above listed documents TOR SPOUSAL CASE: 1. Please contact the DeWitt Business Office directly office* a ext to-fivu^outhom) mawy y&wyofbaa>ik&^ thl&'tune'. For any additional information regarding the Medicaid program, please contact the DeWitt Business ext

9 MEDICAID RENT RETENTION PROGRAM *What is rent retention? Rent retention is a Medicaid 'program for short-term rehabilitation Medicaid or Medicaid eligible residents. *How can Medicaid eligibility be determined? Medicaid eligibility can only be determined prior to admission with the business office in receipt of a l l the necessary Medicaid documents. *How long can the apartment be maintained? If i t has been determined that a resident is Medicaid eligible or has an active Medicaid number the sponsor may retain a portion of the resident's income for use of maintaining the apartment and utilities for up to six months for the rehabilitation period. *How much income may be retained fox the monthly expenses? Medicaid allowable monthly income changes annually. Check with our Business Office (ext. 1380) for current amount. Who determines the appropriateness of discharge within six months? If you are unsure i f your relative is appropriate for discharge within the six month period, speak with your social worker and physician to determine i f placement should be permanent. Who can help me with this program? Representatives from the social service staff and/or the business office will assist you. Please contact them as soon as your family member is admitted to ensure' program participation. 7

10 SERVICES PROVIDED AT DEWITT REHABILITATION AND NURSING CENTER Services included in the Applicable charge: 1. Board, including therapeutic or modified diets, as prescribed by a physician 2. Lodging; a clean, healthful, sheltered environment, properly outfitted 3. Twenty-four hour per day nursing care 4. The use of all equipment, medical supplies and modalities of the Nursing Home, as needed in the everyday care of the Resident except for services covered by Medicare Part B 5. Fresh bed linens, as required, changed. For incontinent residents, bed linens or appropriate substitutes will be changed as often as required 6. Laundry services for launderable personal clothing 7. Non-prescription Medications 8. Prescription Medications *** Are covered under Medicare Part A for the first 100 days. Private pay residents will be billed privately for medications starting on day General household medicine cabinet supplies 10. Supervision and assistance when necessary, with the activities of daily living, including toileting, bathing, feeding and ambulation 11. Services in the daily performance of their assigned duties by members of the facility's"staftconcerned with resident care 12. Use of the customarily stocked equipment, including but not limited to crutches, walkers, wheelchairs or other supportive equipment, including training in their use when necessary, unless such item is prescribed by a physician for regular and sole use by a specific resident. 13. Activities program, including a planned schedule of recreational, motivational, social and other activities, along with the necessary materials and supplies to make the Resident's life more meaningful 14. Social Work services as needed 15. Physical Therapy, as prescribed by a physician, administered by or under the direct supervision of a licensed and currently registered Physical Therapist. 16. Occupational therapy, as prescribed by a physician, administered by or under the supervision of a qualified Occupational Therapist 17. Speech pathology services, as prescribed by a physician, administered by a qualifies! Speech Pathologist. *** The above 3 therapies will be covered under Medicare Part B for the first 100 days. There after private pay residents will be charged a copayment of 20%, of the rate set forth by DeWitt Rehabilitation & Nursing Center 18. Dental services, as administered by or under the direct supervision of a licensed dentist 8

11 1 Sunday 2 Monday 3 m UNIT PROGRAMS AT 10:30: ONE TO ONE ROOMVISITS. 3RD FL.1 PROGRAM AT 10:15: JEWISH SERVICE. 1 7TH Ft.. PROGRAM AT 10:30: GIASSIGAL MUSIC FORUM. 1 7TH FL. PROGRAM AT 2:15: HOLIDAY MOVIE; 3RD FL. PROGRAM AT 10:00: ROSARY; 10:15: CATHOLIC SERVIGE UNIT PROGRAMS AT 10:30: 1:1 VISIT 3RD FL. PROGRAM AT 2:30: PROTESTANT SERVIGE. 1 7TH FL. PROGRAM AT ;30; TRIVIA GAME & MOVEE CLUB. 1 7TH FL. PROGRAM AT 10:30: BIBLE STUDY & EXERCISE PROGRAM. 1 7TH FL. PROGRAM AT 2:00: RESIDENT COUNCIL. 1 7TH FL.. PROGRAM AT 2:30: ARTS & GRAFTS PROGRAM. "\7TH FL. PROGRAM AT 6:30: AROMA. THERAPY GROUP. "Tuesday UNIT PROGRAMS AT 10:30: DAYROOM & ONE TO ONE ROOMVISITS 1 7TH FL. PROGRAM AT 10:30: WORLD TRAVEL:.EGYPT. 1 7TH FL. PROGRAM AT 2:30: ARTS & GRAFTS AND COOKING PROGRAM. UNIT PROGRAMS: MUSIC APPRECIATION - 1 5TH FL. & 1 1TH FL. - 6:00; 5TH FL. SI 4-TH FL. - 7:00. UNIT PROGRAMS AT 10:30: DAYROOM AND ONE TO ONE ROOMVISITS ' 1 7TH FL PROGRAM AT 10:30: CURRENT EVENTS DISGUSSION., 3RD FL. PROGRAM AT 2:30: SING-A-LQNG PROGRAM. 17TH FL. PROGRAM AT 6:30; FEATURE FILM: "MOTHER AND CHILD". Thursday 6 UNIT PROGRAMS AT 10:30: DAYROOM PROGRAMS & ONE TO ONE ROOMVISITS. 17TH FL. PROGRAM AT 10:30: BINGO GAME. 1 7TH FL. PROGRAM AT 2:30; LIVE MUSICAL ENTERTAINMENT. UNIT PROGRAMS: LIVELY REMINISCING GROUP: 15TH FL. 3= 1 1TH Ft. - 6:00; 4TH FL. &BTH FL. - 7:00. UNIT PROGRAMS AT 10:30: DAYROOM PROGRAMS &. ONE TO ONE ROOMVISITS. 1 7TH FL. PROGRAM" AT 10:30: HORSE RAGING GAME. ' 7 17TH FL. PROGRAM AT 2:15:" FEATURE FILM: "SUSSTOF* 3RD FL. PROGRAM AT 7:GOi. FRSE^T NIGHT LIVE MUSIC. IVEWm KPHAB & ISTTIRSING CENTEIR ACTIVITIES

12 Saturday 8 Sunday 9 Monday 10 Tuesday 11 Wednesday v 12 Thursday 13 Friday 14 UNIT PROGRAMS AT 10:30: ONE TO ONE VISITS. ' 3RD FI_ PROGRAM AT 10:15: JEWISH SERVICE. I 7TH FL. PROGRAM AT I 0:30: GREATTVE "WRITING GROUP. 17TH FL. PROGRAM AT 2:30: BINGO GAME. 17TH FL. PROGRAM AT 5:00: COMPUTER LESSONS.(RESERVATION.REQUIRED). 3RD FL. PROGRAM AT 10:00: ROSARY; 10:15: CATHOLIC SERVIGE UNTT PROGRAMS AT 10:30: 1:1 VISITS 3RD FL. PROGRAM AT 2:30: PROTESTANT SERVICE. 1 7TH FL. PROGRAM AT 2:30: TRIVIA GAME & MOVIE CLUB. UNIT PROGRAMS AT 10:30: DAYROOM PROGRAMS & ONE TO ONE 'VISITS. * 1 7TH FL. PROGRAM AT 10:30: BIBLE STUDY AND EXERCISE GROUP. 1 7TH FL. PROGRAM AT 2:30: ARTS & GRAFTS PROGRAM. ' * 17TH FL. PROGRAM AT *&:30: AROMA THERAPY GROUP... UNTT PROGRAMS AT 10:30: DAYROOM PROGRAMS & ONE TO ONE VISITS. 1 7TH FL PROGRAM AT 10:30: WORLD TRAVEL AMSTERDAM. 1 7TH PROGRAMS AT 2:30: ARTS & GRAFTS AND COOKING PROGRAM. UNIT PROGRAMS: MUSIG APPRECIATION - 15TH FL & 11TH F L -6:00; 4TH FL. & 5TH FL. - 7:00. UNIT PROGRAMS AT 10:30: DAYROOM & ONE TO ONE ROOMVISITS. 1 7TH FL. PROGRAM AT 10:30: GURRENT EVENTS DISCUSSION. 3RD FL. PROGRAM AT 2:30: SING-A-LONG. 1 7TH FL. PROGRAM AT 6:00: FEATURE FILM: "THE OTHER GUYS". UNIT PROGRAMS AT 10:30: 17TH FL. PROGRAM AT 10:30: BINGO DAYROOM PROGRAMS & ONE TO ONE ROOMVISITS GAME 1 7TH FL. PROGRAM AT 2:30: MUSICAL ENTERTAINMENT. UNIT PROGRAMS: UVELY REMINISCING GROUP: 15TH & HTH FL.- 6:00; 4TH & 5TH FL UNIT PROGRAMS AT 10:30: DAYROOM PROGRAMS & ONE TO ONE ROOMVISTTS. 1 7TH FL.. PROGRAM AT 10:30: HORSE RAGING GAME. 1 TH FL PROGRAM AT 2:15; FEATURE FILM: "BYE BYE BIRDIE". 1 7TH FL PROGRAM AT 7:00: FRIDAY NIGHT LIVE MUSIC. E = - SAMPLE i 10

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15 MEWSmVICTS FROM OUR ACTIVITIES VEPAHTMTMT GET DEWITT!!! We are proud to offer our residents a new computer lab on the seventeenth floo Come on up and surf the web!!! LET THE MOVIES COME TO YOU!!! Relax and enjoy a movie shown in your own room. Choose from our library of 150 videos. See any activities staff person for more information. ***For a complete scheduled activities, see any activities staff person or call extension

16 FALL/ WINTER 2013 CYCLE I WEEK I FACILITY: DeWitt Rehab & Nursing Center APPROVED BY: Cranberry Juice Choice of Oatmeal or Assorted Cold Cereal Scrambled Eggs Orange Pineapple Juice Choice of Cream of Wheat or Assorted Cold Cereals Pancakes with Syrup and Margarine Orange Juice Choice of Farina or Assorted Cold Cereal Hard Boiled Egg Assorted Breakfast Muffins Apple Juice Choice of Cream of Wheat or Assorted Cold Cereal Scrambled Eggs with Vegetables Orange Juice Choice of Oatmeal or Assorted Cold Cereal French Toast with Syrup and Margarine Crisp Bacon Cranberry Juice Choice of Cream of Rice or Assorted Cold Cereal Scrambled Eggs Breakfast Ham Orange Juice Choice of Farina or Assorted Cold Cereal Hard Boiled Egg Lentil Soup Roast Pork Loin with Brown Gravy Whipped Potatoes Green Beans Chilled Applesauce Cream Of Celery Soup Baked Chicken Breast with Supreme Sauce Yellow Rice Scandinavian Vegetable Fruited Gelatin Chicken Noodle Soup Fresh Baked Ham with Natural Gravy Fresh Sweet Potatoes Wax Beans & Pimento Home Styles Custard Tart New England Clam Chowder Baked Ziti with Tomato Sauce Tossed Salad with Dressing Gelatin with Topping Cream of Mushroom Soup Roast Beef with Gravy Potatoes Au Gratin Garden Peas Chocolate Eclairs Beef Vegetable Soup Fish Primavera Fried Potatoes Coleslaw Sliced Peaches Chicken Escarole Soup Spaghetti with Meat Sauce Italian Mixed Vegetables Fresh Baked Iced Carrot Cake Garlic Bread with Margarine Beef Barley Soup Carbonera & Tri-Colored Pasta Tossed Salad with Dressing Fresh Fruit in Season Dinner Roll with Margarine Vegetable Soup Meatloaf with Brown Gravy Whipped Potatoes Buttered Carrots Fresh Baked Lemon Cake Corn Chowder Sliced Turkey Breast Wild Rice Mixed Vegetables Fresh Fruit in Season Cream of Tomato Soup Veal Marsala Fettucini Noodles Green Beans & Pimiento Orange Sections Minestrone Soup Chicken Cacciatore Rice Pilaf California Vegetables Fruit Cocktail Split Pea Soup Macaroni & Cheese Breaded Wingettes Stewed Tomatoes Sherbet Cream of Asparagus Soup Roast Chicken Candied Yams Cut Green Beans Home Style Tapioca Pudding NIGHT SNACKS Danish Graham Crackers Yellow Cake Custard Pudding Mini Danish Yellow Cake Cookie^ialso Diabetic) iwiches Diabetic Pudding Assorted Sandwiches Juice - Milk Diabetic Applesauce Assorted Sandwiches Juice - Milk Crackers Assorted Sandwiches Juice - Milk Diabetic Pudding Assorted Sandwiches Juice - Milk Crackers Assorted Sandwiches Juice - Milk Diabetic Pudding Assorted Sandwiches Juice Milk, Coffee, Tea and Decaffeinated Beverages are available at each Meal

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