Admission Criteria and Guidelines

1. Adults who are aged 18 years or older with a diagnosis of an acquired brain injury, spinal cord injury or other severe orthopedic injury, neurological disorder, or neuropsychiatric condition. 

2. Adolescents 16 yrs. or older, may be considered for admission with appropriate waiver from Michigan Adult Foster Care Licensing.  Admission will only be considered if the candidate does not have access to a specialty pediatric rehabilitation program best suited to their specific service needs, or to preserve proximity to critical family and / or community support.

3. Need for up to 24 hr. supervision, support, and structure to maintain basic health and safety.

4. Potential to benefit from Medical Alternatives services and to meet the functional outcomes established.

5. Submission of pre-admission documentation or information to adequately conduct intake assessment and determine suitability for admission.

6. Completion of all admission documentation and licensing documents.

7. The individual’s goal is to increase or maintain independence in daily living, self-awareness, productive activity and to integrate into the community at the highest level possible; or, the individual’s level of disability causes him or her to be unable to acquire increased skills, and the person is in need of long-term care in a closely supervised, group home setting.

8. Behaviors that may be dangerous to self or others are able to be managed with behavior treatment, and do not represent a serious risk to health and safety of others living in the home.

9. The individual is not ventilator dependent.

10. Medical condition is stable and medical needs are able to be managed within a group home environment.

11. Documented evidence of funding.

12. Physician’s prescription specifying the need for placement in a group home setting requiring 24-hour supervision.

13. We cannot accept, retain, or care for a resident who requires continuous nursing care. This does not preclude accommodating a resident who becomes temporarily ill while living in the home.

14. We cannot accept or retain a person who requires isolation or restraint.

15. Admission is contingent on the resident’s prospective compatibility with other residents and members of the household.

16. At the time of admission and at least annually, a written assessment plan shall be completed with the resident or the resident’s representative. A copy will remain on file in the home when a sudden adverse change in the residents physical or mental condition occurs, needed medical care will be obtained and the resident representative notified.

17. If a resident is referred and accepted for emergency admission and the licensee agrees to accept the resident a written assessment plan will be completed within 15 calendar days after admission and will be done in accordance with the state licensing rule.

18. At the time of admission, a written resident care agreement will be reviewed and completed. This will be kept on file and reviewed annually or more often if necessary.

19. The resident care agreement is the document established between the resident, or the resident’s representative, or the resident’s responsible agency and the licensee which specifies the responsibility of each party. The following items can be found in the resident care agreement: Fee for service, description of additional costs, transportation fee and a description of transportation services.

20. House rules will be provided to the resident upon admission and reviewed annually or sooner if needed.  A copy of the Person Served Handbook will also be provided. Supported Community admissions will receive a copy of the Person Served Handbook.

21. A written copy of the discharge policies and procedures along with a home refund policy will be provided.

22. Medical Alternatives does not handle funds for resident’s but will follow rules if such occasion does present itself with the Part II of the funds and valuable sheet.

23. A current health care appraisal will be obtained upon admission and annually. For emergency admission one must be obtained within 30 days for an emergency admission.

24. The residents and resident representative allow the program to contact physicians and to utilize all information to assist the residents. 

25. A copy of Resident Rights and Responsibilities will be provided upon admission and reviewed annually.

26. The amount of personal care, supervision, and protection that is required by the resident is available in the home – 24-hour supervision and transportation.

27. The kinds of service, skills and physical accommodations that are required of the home to meet the resident’s needs are available in the home – barrier free.

28. Physician prescription specifying what services are needed.

29. While residing in the program the residents are protected by the following resident’s rights:

    1. Shall not be discriminated against on the basis of race, religion, color, national origin, sex, age, handicap, marital status, or source of payment.

    2. Shall not be denied or restricted in exercise of his or her constitutional rights, including the right to vote, the freedom to practice the religion of his or her choice, the right to freedom of movement and freedom of association.

    3. A licensee shall not change the residency of a resident from one home to another without the written approval of the residents designated representative or responsible agency.

30. The program will maintain a current license and abide by all administrative rules.

Estimated Length of Stay/Admission:

Estimated length of stay/admission is determined by the treatment team evaluation of therapy process and goal outcomes. This is reviewed at least annually and documented by an updated prescription.

Transition Criteria

1. Person Served meets the outcome goals as specified in their rehabilitation plan and has improved skills to a degree sufficient to be able to be served in a supported independent living program without the need for 24 hr. care, or in a lesser restrictive environment. Typical outcome goals include sufficient improvements in self-care, managing a household, managing personal nutrition and food preparation, behavioral self-management, ability to maintain personal health and safety, managing one’s personal and business affairs, making effective use of strategies to compensate for cognitive and behavioral impairments, or becoming competitively employed or otherwise engaged in volunteer work, sheltered work, school, or other meaningful, productive day activity.

2. Behavioral sequelae are sufficiently self-managed to not present a danger to self or others.

3. Availability of a lesser restrictive placement setting to accomplish transfer.

4. Discharge/follow-up plan is in place prior to exit from the program.

5. Person Served is not capable of maintaining entry criteria.  An alternative placement site/service provider will be identified prior to exit from the program.

6. Completion of all discharge planning and documentation.

Discharge Criteria and Guidelines

1. Medical Alternatives will maintain the resident in the home if the following criteria are met:

   1. The amount of personal care, supervision and protection required by the resident is available in the home.

   2. The kinds of services and skills required of the home to meet the resident’s needs are available in the home.

   3. The resident’s needs are compatible with other residents and members of the household.

   4. The program determines placement to be inappropriate.

2. A 30-day written notice will be given prior to discharge from the home. The notice shall state the reason for discharge. A copy of the written notice will be provided to the resident and the residents designated representative. Exceptions to the 30-day written notice are:

   1. Substantial risk or an occurrence of self-destructive behavior.

   2. Substantial risk or and occurrence of serious physical assault or destruction of property.

1. When such basis or a discharge exists, 24-hour prior verbal notice followed by a written notification will be given.

2. The reason for the proposed discharge, including the specific nature of the substantial risk.

3. The alternatives to discharge that have been attempted by the licensee.

4. The location to which the resident will be discharged, if known.

5. And a copy shall be provided to the licensing authorities.

1. The program will make an attempt to plan a discharge planning meeting and provide the necessary documentation to ensure for an appropriate transition. There may be a cost for making copies of records outside of the discharge planning process.

2. When there is a sudden adverse change in the residents physical or mental condition occurs, needed medical care will be obtained and residents representative will be notified.

3. The following resident rights are guaranteed by the licensing act and administrative rules:

   1. Shall not be discriminated against based on race, religion, color, national origin, sex, age, handicap, marital status or source of payment.

   2. Shall not be denied or restricted in exercise of his or her constitutional rights, including the right to vote, the right to practice the religion of his or her choice, the right to freedom of movement ad freedom of association.