Admissions Policy of Senior Health Care Solutions, LLC d/b/a Senior Health Care Solutions in Admissions at Any Affiliated Entity Managed

Policy:

The facility will maintain an admissions policy governing admissions to the facility to ensure fair and impartial admission practices.

Definitions:

“Composite distinct part” means a distinct part consisting of two or more noncontiguous components that are not located within the same campus.

“Campus” is defined as the physical area immediately adjacent to the provider’s main buildings, other areas and structures that are not strictly contiguous to the main buildings but are located within 250 yards of the main buildings.

Policy Explanation and Compliance Guidelines:

1. The facility must

a. Not request or require residents or potential residents to waive their rights as set forth in applicable state, federal or local licensing or certification laws, including but not limited to their rights to Medicare and Medicaid; and

b. Not request or require oral or written assurance that residents or potential residents are not eligible for, or will not apply for, Medicare or Medicaid benefits.

c. Not request or require residents or potential residents to waive potential facility liability for losses of personal property.

2. The facility must not request or require a third party guarantee of payment to the facility as a condition of admission or expedited admission, or continued stay in the facility. However, the facility may request and require a resident representative who has legal access to a resident’s income or resources available to pay for facility care to sign a contract, without incurring personal financial liability, to provide facility payment from the resident’s income or resources.

3. In the case of a person eligible for Medicaid, a nursing facility must not charge, solicit, accept, or receive, in addition to any amount otherwise require to be paid under the State plan, any gift, money, donation, or other consideration as a precondition of admission, expedited admission or continued stay in the facility. However,

a. A nursing facility may charge a resident who is eligible for Medicaid for items and services the resident has requested and received, only if:

• • • That service is not defined in the State plan as “nursing facility services” (services required as part of the daily rate);
    • The facility informs the resident and the resident’s representative in advance that this is not a covered service to allow them to make an informed choice regarding the fee;
    • The resident’s admission or continued stay is not conditioned on the resident’s requesting and receiving that service.

b. A nursing facility may solicit, accept, or receive a charitable, religious, or philanthropic contribution from an organization or from a person unrelated to a Medicaid eligible resident or potential resident, but only to the extent that the contribution is not a condition of admission, expedited admission, or continued stay in the facility for a Medicaid eligible resident.

4. States or political subdivision may apply stricter admissions standards under State or local laws than are specified in this section, to prohibit discrimination against individuals entitled to Medicaid.

5. A nursing facility must disclose and provide to a resident or potential resident, prior to time of admission, notice of special characteristics (such as rehabilitation, dementia or a mechanical vent unit) or service limitations of the facility such as a religious affiliation that guides its practices and routines which must be communicated to any potential resident.

6. A nursing facility that is a composite distinct part must disclose in its admissions agreement its physical configuration, including the various locations that comprise the composite distinct part, and much specify the policies that apply to room changes between its different locations.

7. The facility may charge an applicant or resident for services while his or her Medicaid eligibility is pending. A resident cannot be discharged for nonpayment while their Medicaid eligibility is pending.

8. The facility must accept as payment in full the amounts determined by the state for all dates.

9. Title III of the ADA prohibits discrimination “on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation.” 42 U.S.C. § 12182(a). Personal care facilities and skilled nursing centers are public accommodations. 42 U.S.C. § 12181(7).

10. The Pennsylvania Human Relations Act declares it unlawful to “[r]efuse, withhold from, or deny to any person because of his . . . handicap or disability . . . either directly or indirectly, any of the accommodations, advantages, facilities or privileges of such public accommodation. . . .” 43 P.S. § 955(i)(1). A nursing facility is a public accommodation under the PHRA as it “is open to, accepts, or solicits the patronage of the general public. . . .” 43 P.S. § 954(l). See also 43 P.S. § 954(p.1)(the PHRA definition of disability that mirrors the ADA definition of disability).

11. Following the signing of the Consolidated Appropriations Act of 2023, Congress eliminated the requirement that medical providers receive a DATA-waiver to prescribe Buprenorphine to patients with Opioid Use Disorder and removed limits on the number of patients that a prescriber may treat. A skilled nursing facility may also be permitted to dispense and administer medication used to treat Opioid Use Disorder to all patients with a valid prescription from an outside physician.

12. Nondiscrimination: Senior Health Care Solutions, their officers, agents, and employees, shall not engage in any referral or admission practice which constitutes disability discrimination in violation of applicable state and federal law, including, but not limited to, the ADA, PHRA, and Consumer Protection Law.

(a) Pursuant to updated Drug Enforcement Administration (DEA) guidance, Senior Health Care Solutions will allow any medical provider on staff that has a DEA registration number for controlled substances to prescribe medications used to treat Opioid Use Disorder, as needed. Further, as appropriate, Senior Health Care Solutions will facilitate dispensing and administering such prescriptions for any patients with Opioid Use Disorder, and not deny admission based on such prescriptions.

(b) As long as a person is not currently engaged in illegal drug use, Senior Health Care Solutions will not deny a patient referral or admission because the patient has Opioid Use Disorder or is prescribed a mediation used to treat Opioid Use Disorder, they will not be denied.