36C24418Q0128-005.docx
DOCX document 15 KB Posted
- Attached to
- Wilkes-Barre Healthcare for Homeless Veterans
- Solicitation number
- 36C24418Q0128
About this file
36C24418Q0128 Agreement with Sponsor.docx
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 36C24418Q0128-000.docx | DOCX document | |
| 36C24418Q0128-003.pdf | ||
| 36C24418Q0128-001.docx | DOCX document | |
| 36C24418Q0128-002.docx | DOCX document | |
| 36C24418Q0128-004.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
WILKES-BARRE VA MEDICAL CENTER
COMMUNITY RESIDENTIAL CARE HOME PROGRAM
AGREEMENT WITH SPONSOR
Personal Care Homes approved by the Wilkes-Barre VA Medical Center Residential Care Home Program provide room, board, personal care and supervision to veterans who do not require hospital or nursing home care, but, because of medical or psychosocial health conditions, are not able to live independently and have no suitable family resources to provide the needed care. Care is provided in private homes that are inspected and approved by the Wilkes-Barre VA Medical Center. Cost of care is at the veteran’s own expense. The VA does not assume any financial responsibility for payment of charges incurred by the veterans for care at the Personal Care Facility. The collection of monthly charges for the care of the veteran is the responsibility of the owner of the facility.
The proprietor of an approved Wilkes-Barre VA Residential Care Home agrees to the following:
1. An initial inspection of the home by the VA Residential Care interdisciplinary inspection team, including the fire/safety officer, and an annual inspection thereafter.
2. Compliance with VA and State Standards for residential care.
3. Authorize VA staff to contact other agencies or persons regarding suitability of home for residential care.
4. Accept veterans without discrimination on the basis of race, color, age, sex, religion or national origin.
5. Accept case management of the veterans placed for care by either a social worker or nurse representative of the Residential Care Program.
6. Notify the Residential Care Program Case Manager of any admissions to the hospital, changes in health or behavior, incidents, elopements, deaths, and discharges from the home of any resident that is part of the Residential Care Program.
7. Accept the agreed upon rate as full compensation for care and discuss any future rate changes with the resident’s VA Case Manager.
8. Verification that VA employees are not owners, operators, or employees of this VA Residential Care Home.
9. I understand that non-compliance of any of the terms can result in suspension from the program.
| _______________________________________________ | __________________ | |
| SPONSOR’S SIGNATURE | DATE |
NAME OF RESIDENTIAL CARE FACILITY
File details come from the government source that posted it.