Criteria for Admission

Clark Manor House can best serve the following:

• Individuals who can ambulate 200 feet with or without assistive devices and manage stairs in case of emergency.
• Individuals who are continent of bladder and bowel or can manage incontinence independently.
• Individuals who need/choose assistance with medication.
• Individuals who need minimal assistance with dressing and bathing.
• Individuals who can eat independently (although staff can provide assistance with cutting food, opening containers, etc.)
• Individuals who meet financial eligibility.

NOTE: Individuals with medical conditions/equipment needs may be appropriate for admission. Each situation will be considered individually and will need to be discussed with the Administrator and meet New York Department of Health criteria for an Adult Home.

Admissions Process

A screening of the potential resident by Administrator and an Admission Committee.

Paperwork required:

• DSS-3122 (signed and completed by doctor within 30 days prior to admission)
• Prescriptions for all medications (must accompany the DSS-3122)
• Mental Health Evaluation (if applicable)
• Pre-admission Application (completed by family/responsible party prior to admission)

Responsibilities

Social Services Law makes you responsible for complying
with all reasonable rules of the facility or program
and for respecting the personal property of the other
residents.

You have the responsibility to:

• Treat staff, residents and others with courtesy and respect.
• Respect Clark Manor House property and property of the other residents
• Follow Clark Manor House safety rules and Department of Health regulations.
• Inform staff of any changes in your condition.

Resident’s rights

You have the right to:

• Receive courteous, fair and respectful care and treatment, and not be physically, mentally or emotionally abused or neglected in any manner.
• Confidential treatment of personal, social, financial and health records and privacy` in personal treatment for your needs.
• Exercise your civil rights and religious liberties, and to make personal decisions, including your choice of physician, and to have assistance and encouragement of the Administrator in exercising these rights and liberties.
• To receive a written statement (Admission Agreement) of the services regularly provided by the facility, those additional services which will be provided if you need or ask for them and the charges, if any, for the additional services.
• Authorize those family members, and other adults who will be given priority to visit, consistent with your ability to receive visitors.
• Present grievances or recommendations on your behalf, or the behalf of other residents, to the Administrator, of facility staff, without fear of reprisal or punishment.

Have a question? Email Emmalie at ebeaman@clarkmanorhouse.org.