CENTER AGREEMENT
- 1. To provide personal care, and such services as may be required for the health, safety, good grooming, and well-being of the members.
- 2. To arrange for transfer of the members to the hospital of choice in case of emergency, and immediately to notify the members family of such transfer
- 3. To provide medical care as indicated by member’s private physician except when such care is inappropriate for the licensing guidelines of the center.
AGREEMENT OF PATIENT OR RESPONSIBLE PARTY
- 1. To provide such personal clothing and effects as needed or desired by the member, such as spending money.
- 2. To be responsible for ambulance and hospital charges.
- 3. To be responsible for providing medical information, medications, and other treatment aids as necessary, and to follow
- 4. To pay basic rate agreed upon with Clarity of Mind Adult Day Program at a specified time.
WAIVER
Clarity of Mind Adult Day Program will not be liable or responsible for any and all claims and damages or for damages to or loss of property, arising out of or attributed, directly or indirectly, to the operations or performance of Clarity of Mind Adult Day Program, under this agreement, accept such claims as directly arise out of negligent acts of Clarity of Mind Adult Day Program, or its agents or employees.
SCHEDULES
Clarity of Mind Adult Day Program is opened Monday through Friday from 8 am. to 4:30 pm. Sometimes there are unforeseen circumstances in Which Clarity of Mind Adult Day Program will not be able to Open due to inclement Weather, natural disasters, emergencies, etc. In such cases, All members will receive a phone call no later than 8 am of the day of the emergency.
On the following Holidays Clarity of Mind Adult Day Program will not open:
| MEMORIAL DAY |
LABOR DAY |
| INDEPENDENCE DAY |
THANKHSGIVING |
| INDEPENDENCE DAY |
THANKHSGIVING |
| DAY AFTER THANKSGIVING |
CHRISTMASDAY |
| DAY AFTER CHRISTMAS |
All members are highly encouraged to attend the program five days a week but if that is not possible we ask that you at least make a minimum commitment of two days out of the Five days a week.
TRANSPORTATION
If members are not able to provide their own transport to and from Clarity of Mind Adult Day Program, transportation will be provided to them to the program and back home. If a member has an appointment they must go to during the hours of the program they are to notify Clarity of Mind Adult Day Program AT LEAST THREE (3) DAYS IN ADVANCE.
FINANCIAL AGREEMENT
The member or responsible party agrees to pay a daily rate of for services, as determined by Clarity of Mind Adult Day Program guidelines, and Clarity of Mind Adult Day Program will accept this arrangement in full consideration for the care and services rendered. Charges will be billed on a weekly basis and payment will be made within 3days. Charges are billed after services are rendered; therefore, a refund policy is not in effect.
- 1. l have received a copy of “Rights for the Elderly.
- 2. l have received a copy of “Rights for the Handicapped.
- 3. l have received a copy of “Client Code of Conduct.
- 4. I have received a copy of Medication Requirements
- 5. l have received a copy of Complaint Procedures
- 6. I have received a copy the Fire Evacuations Procedures
- 7. I have received a copy of the USDA food Program Information
- 8. I have received a copy of the Information regarding Advance Directives.