Exhibit A
• Resident must be registered with a hospice agency.
• Latest doctor’s medical reports shall be provided to Scott’s House prior to admission.
• A full list of current medications shall be provided.
• Scott’s House Admission Application is submitted to Scott’s House for consideration prior to admission.
• Resident has a short-term life expectancy of less than one month.
• DNR shall be executed and on file.
• The resident desires to be a Scott’s House resident and to be cared for by volunteers.
• The resident does not have a known contagious disease. Scott’s House reserves the right to deny admission to a resident with an active contagious disease.
• The resident’s care needs can be met in a non-medical setting and will not exceed the staff’s capabilities. Scott’s House is not able to provide care for a resident requiring IV medications, a resident who is at risk of aspiration, and a resident with such other conditions or circumstances as determined in the discretion of Scott’s House.
• The hospice provider recommends the admission and agrees upon the plan of care. The plan of care will be with the involvement and consent of the resident and responsible family member or designated patient representative.
• Scott’s House will solely determine order of admission.
• No smoking.
• Resident and resident’s family must have no combative or anger issues.
• No alcohol or illicit substances are allowed on the premises.
• The resident must disclose height and weight. The resident must weigh no more than 200 lbs.
• Resident must be accompanied by hospice agency nurse, and hospice agency nurse shall administer the first medications before leaving facility.
• There must be a discharge plan provided in the event the resident’s condition stabilizes. Scott’s House reserves the right to give the resident seven (7) days written notice of termination of the residency to effectuate alternative living arrangements for any reason, within the discretion of Scott’s House.
• Funeral home information shall be provided.
• Admission hours are 9:00 AM to 9:00 PM.
Revised 1/3/24