WELCOME
Welcome to East Cascade Retirement Community. Our team of friendly and caring professionals are here to serve you.
Resident-Centered Approach
We serve and honor our residents, providing skilled around-the-clock care. Offering personalized service, we provide short-term rehabilitation after surgery, respite services for caregivers, and long-term care for those needing the expertise of licensed nurses.
Geriatric Nurse Practitioner
Our highly skilled Medical Director Christine Delamarter serves as a primary care provider and offers convenient access for immediate medical attention.
On-Site Therapy Services
Combining expertise with encouragement, our team of licensed physical, occupational and speech therapists are conveniently on-site to provide comprehensive rehabilitation and restorative services.
Meals & Dining
Special diets are prepared according to your doctor’s orders under the guidance of our Dietary Manager and a Registered Dietician. We invite families to dine with residents by purchasing a meal ticket from the front office at least one hour prior to meal time.
Activities & Events
What’s your hobby? With a full schedule of concerts, movies, games, cooking, scenic drives and exercise activities, there’s never a dull moment at East Cascade. To develop individualized activities, we encourage residents to share with us their interests.
OUR MISSION
Enhancing the lives of those we serve
East Cascade Retirement is dedicated to providing quality long-term care. Our goal is to improve the lives of those we serve by creating and maintaining an environment that nurtures resident-directed care. We also strive for a positive, fair and creative work environment for our employees that respects diversity, new ideas and conscientious work.
East Cascade Retirement
175 NE 16th St.
Madras, Oregon 97741
541-475-2273
Eastcascade.com
ADMISSIONS
RESIDENT ADMISSION GUIDELINES
We are happy to welcome you as a Resident of East Cascade Retirement.
The following are a few guidelines that we ask you to be aware of and agree to follow:
• All Residents are admitted by a Primary Care Physician (PCP).
• Any Resident who is responsible to pay for their care will have the current room/board rate discussed with them prior to admission. We normally require 30 days advance payment. Changes to the current room/board rate can be made with 30 days advance notice.
• After initial payment, a statement will be sent prior to the end of each month identifying the room/board due for the next month, plus any incidental charges due from the prior month. Payment is due by the 5th of each month. Failure to pay in a timely manner may result in a notice of intent to discharge the Resident. If you have any questions or circumstances arise that prevent your compliance, please contact the Business Office Manager or the Executive Director.
• Assignment of room and bed will be made based upon bed availability. Changes may be made to meet Resident needs. Medicare Residents admitted to private rooms will be expected to move into a semi-private room should they remain in the facility after coverage by Medicare has ceased unless they choose to pay the Private Pay rate.
• Residents and/or Responsible Party will be notified prior to any room/bed change with the reasons for relocation, except in the event of an emergency or imminent danger. Residents and/or Responsible Party have the right to appeal a room change.
Important Documents:
• Durable Power of Attorney – Healthcare & Financial (if applicable)
• Guardianship (if applicable)
• Advance Directive (if applicable)
• Medicare Card
• Other insurance card
• Medicaid ID (if applicable)
• Info regarding pre-paid funeral or preference
If a Resident and/or family does not indicate a choice, when a Resident passes away we will utilize Bel-Air Colonial Funeral Home. State law prohibits us from retaining the deceased beyond a very short time period, so we must contact funeral home to take the body. Families are still able to make arrangements with other providers later. We will notify the responsible family member of transport.
ADMISSION POLICY
The admission of a Resident shall be consistent with the rules and regulations of the department of Human Services, Seniors and Peoples with Disabilities Division (hereinafter referred to as “Division”), Oregon Administration Rules (OAR 411-86-040), governing the licensure of nursing homes and subject to the approval of the Administrator and Director of Nursing. East Cascade does not discriminate against any person on the basis of race, color, national origin, disability, or age in admission, treatment, or participation in its programs, services and activities, or in employment.
CONDITIONS
• East Cascade Retirement will not accept Residents whose care needs cannot be met by facility staff and available resources.
• No person will be admitted to East Cascade Retirement except on order of a local physician or nurse practitioner.
• Admission medical information shall include a statement concerning the diagnosis and general condition of the Resident, a current medical history and physical, or a medical summary. Other medical information, orders for mediations, diet, and treatments shall also be provided on the day of admission.
• No one will be admitted to a bed in any location other than those locations shown in the most recent floor plan filed with the Division and under which the license was issued.
• East Cascade Retirement will not admit an individual who is mentally ill or mentally retarded unless the division or local representative has determined that such placement is appropriate, as documented in their PASSAR screening.
• No maternity cases will be admitted.
• A person who has been discharged usually has the right to return within 180 days by asking for re-admission. Admission at that time is dependent of space available, and ability to meet the needs of the Resident.
PROCEDURE FOR ADMISSION
No admission will be made without prior arrangement. The following procedures must be completed prior to admission:
• Admission paperwork should be completed prior to, or upon, entry. If the Resident is unable to complete the admission paperwork, a personal representative may make arrangements to do so for them.
• A tour of the facility will be given, if desired.
• Confirmation that a local doctor or nurse practitioner intends to be the Resident’s primary care provider.
• Financial assistance, if needed, in place.
• PASSAR screen has been completed and indicates that the resident is appropriate for nursing home placement. Upon admission the first month’s advance payment is due and payable to East Cascade Retirement’s business office (excluding Medicare) unless other arrangements have been made.
RATES
If you’re joining us after a hospital stay, you likely have coverage through Medicare or private insurance.
If you’re joining us after living at home or from another long-term care facility, you may be eligible or covered under Medicaid, which requires approval from a caseworker or verification of pending application before admission.
Or you may be in a private pay situation, which requires arrangement for payment at the time of admission.
Private Pay
Private Room - 1 Bed ____________________
Semi-Private Room - 2 Beds _____________________
Rates do not include pharmacy, specialty equipment, oxygen, incontinent products, wound care supplies, and other non-routine supplies. When possible, we will provide advance notice of services or supplies not covered.
REQUIREMENTS FOR MEDICAID ADMISSIONS
Residents who are covered by Medicaid at the time of admission will be informed of their required financial participation. Payment is required by the 5th of each month. If payment is not made by the 5th, East Cascade Retirement will initiate action to become the designated payee for Social Security and other retirement income.
Residents who make a new application for Medicaid coverage while at East Cascade will be required to begin paying the amount of monthly income less $__________for personal use and allowable Medicare and/or other insurance premiums, by the 5th of each month. After the Medicaid determination is finalized, if the resident has overpaid their participation, credits will be applied to the next month’s participation.
IMPORTANT INFORMATION FOR MEDICARE PATIENTS
WHO APPLY FOR STATE-ASSISTANCE (MEDICAID)
Some Residents at East Cascade under Part A of Medicare do not carry supplemental insurance to cover the costs not covered by Medicare; some individuals may be eligible for state-assistance (Medicaid) to pay for charges not covered by Medicare.
If you or someone on your behalf applies for Medicaid, please let us know immediately. We welcome Medicaid coverage but there are some potential issues you need to know about.
We understand that this can be a confusing process. If you are applying for Medicaid, we can help you navigate the options. Please feel free to talk with our Executive Director, Business Office Manager, or Social Services Director.
MEDICARE FACT SHEET
Medicare is the federal government’s health insurance for people aged 65 or older and some people with disabilities. Medicare covers some services in a nursing facility. Medicare does not cover long-term care costs.
Medicare has two parts:
Part A - Hospital Insurance, and
Part B - an optional medical insurance for which you pay a monthly premium that covers many outpatient services.
Part A helps pay for:
• Hospital Care
• Skilled Nursing or Rehabilitation Care (in a skilled nursing facility)
• Home Health Care
• Hospice Care
Part A provides up to 100 days per year in a skilled nursing facility if you have a 3-day qualifying stay in a hospital and require services meeting the definition of “skilled” in the Medicare guidelines.
Part A pays 100% for days 1-20; there is a co-pay for days 21-100 ($___________per day).
Most Medicare co-insurance plans pay the co-pay.
We are knowledgeable on the criteria for “skilled” care and are required to inform you at least 48 hours in advance if/when your Medicare coverage may end. In many cases, you have a right to appeal a denial of service.
Part B insurance primarily covers outpatient services but may cover some services while a person is a Resident in a nursing facility. For example, someone who does not have a 3-day hospital stay prior to admission and is “private pay” for their room & board, can have therapy services billed under Part B. We will let you know if there are services that Part B will pay for in advance of providing a service.
If you have questions, we will attempt to answer those for you. However, it is always best to contact your Medicare Intermediary to get information directly from the source. You will receive an Explanation of Benefits (EOB) for all services billed to Medicare. Call 1-800-638-6833 for contact information in your area.
Residents who have been covered under Medicare Part A Skilled Nursing Facility benefits and either exhaust their benefits or no longer qualify under Medicare guidelines but remain in the facility after receiving a Medicare Denial Letter may be required to move from the Medicare room to a semi-private room, regardless of pay source.
RESIDENTS RIGHTS
SERVICES
TRANSPORTATION &
MEDICAL APPOINTMENTS
East Cascade Retirement provides scheduling and transporting of Residents to medical appointments.
We prefer to provide this service rather than Residents or families scheduling appointments.
Residents and/or families do have the right to schedule appointments for the Resident; if you do schedule any appointments, please inform the Charge Nurse in writing so that we can have the Resident ready for their appointment. We also need to know if the family is planning to transport; if you are expecting the facility to arrange transportation, we need a minimum of 72 hours notice and, in some cases, more time, to coordinate the trip.
If a Resident or family schedule an appointment and we are not informed in advance, the Resident may not be ready in time and/or the appointment may need to be re-scheduled due to lack of lead time on transportation.
In some cases, there may be a charge for transportation, especially for out-of-town trips. We will attempt to let you know in advance if there is a cost for the transportation – Medicare & Medicaid typically do not pay for transportation costs.
THERAPY SERVICES
Therapy services are designed to help Residents recover from injuries or surgical procedures by regaining lost mobility or strength as well as learning safer ways to perform activities of daily living. Many Residents benefit from the therapeutic activities and return to their prior living arrangement.
Therapy services are also designed to assist Residents in maintaining level of function. Many Residents receive therapy services to help prevent falls, recover from illness, and return to prior level of function.
Physical, Occupational and Speech services are available as appropriate.
East Cascade Retirement contracts with Aegis Therapies Services, who provide therapists to work in our facility. All the therapists are licensed and very experienced and skilled in working with the elderly.
Depending on the Resident’s diagnosis, the type, amount, and frequency of therapy will vary. Some Residents may receive up to 2-3 hrs per day, 5 days per week. In order to cover all the Residents involved in therapy, some may receive therapy on weekends.
Family members are encouraged to meet the therapists and to observe sessions. Residents and family are encouraged to ask questions in order to understand the benefits of the various activities.
PHARMACY
Policy: East Cascade Retirement will inform Residents and/or their responsible party of their right regarding the provision and dispensing of prescription and non-prescription medications at the time of admission and as needed thereafter.
Procedures:
1. Prior to admission and as circumstances permit, private-pay Residents and/or responsible party shall be informed that:
a. We only accept medications from home in the correct and original pharmacy-issued container and only until supply arrives from pharmacy. Any medication brought in will be returned to you.
b. The Resident/responsible party has the right to select a pharmacy to fill prescriptions on their behalf.
c. There are conditions that must be met in order to accept medications from the elected pharmacy (e.g., pills must be sent in bubble-packs; have resources for after-hours filling of prescriptions).
d. If the elected pharmacy cannot deliver meds to ensure the Resident receives meds at times prescribed, we may order up to a 7-day supply from PROPAC/PAYLESS to ensure continuity.
2. All prescription and non-prescription medications shall be under the control of authorized facility personnel from the time of admission forward, unless the Primary Care Physician or other appropriate physician authorizes a Resident to keep non-prescription or prescription medications at their bedside. Some Residents may be placed on a self-med program to evaluate their ability to manage medications before going home. Residents must be alert, oriented and demonstrate the ability to safely use medications and follow the prescribed dosage and times for self-administration.
East Cascade Retirement uses PROPAC/PAYLESS Pharmacy, which provides multiple services to us in addition to filling prescriptions, such as monitoring Residents overall medication use, watching for side-effects, and identifying potential or actual risks of drug interactions.
3. Residents whose stay is not covered under Medicare Part A should provide us with information regarding prescription insurance programs, such as Medicare Part D or other private insurance, so that such information can be provided to the pharmacy for billing purposes.
4. Private-pay Residents/responsible family member will receive a bill directly from the pharmacy they select to fill prescriptions. All questions regarding the bill should be directed to that pharmacy.
5. Questions regarding type of medication ordered by the physician can be directed to the Resident’s charge nurse or Resident Care Manager.
OVER-THE-COUNTER and SUPPLEMENT MEDICATION
East Cascade Retirement supplies the following Over The Counter / Supplement Medication for dispensing. If a resident is admitted with a medication that is not on the list above, the Licensed Nurse will request the Primary Care Provider evaluate the medication to change to one of the house stock medications and/or evaluate for medical necessity for continued use. If medication cannot be changed or discontinued, a five-day supply will be requested from the pharmacy until other arrangements can be made with family.
HOUSE SUPPLY of STOCK MEDICATIONS
Metamucil Powder
Geri-dryl 25mg
Aspirin 81mg Chewable
Senna S 50mg/8.6mg
Glucose Gel 40%
Aspirin 81mg EC
Senna 8.6mg
Guaifenesin 400mg
Iron 325mg
Loratadine 10mg
Ibuprofen 200mg
Ear Wax Drops
Milk of Mag 1200mg/15ml
Imodium 2mg
Enema Mineral Oil
Omeprazole 20mg
Ranitidine 75mg
Vitamin D 400 IU
Bisacodyl Suppository 10mg
Docusate Sodium 100mg
Docusate Sod 250mg
Bisacodyl Tabs 5mg
APAP 500mg Tablet
Vitamin D 1000 IU
Antacid Lanta Liq
APAP 500mg Liq 8 oz
Folic Acid 400mg
Cranberry Tab 425mg
APAP 325mg/Supp
Calcium 600mg w/200 IU Vit D
Vitamin B-12 500&1000mcg
APAP 325mg Tablet
Vitamin C 500mg
Natural Tears
Multi w/ Minerals
Aspirin 325mg EC
Melatonin 1,3 & 5mg
Acidophilus Non-refrig
Med Pass
PERSONAL MAIL
Whether you are here for a short stay or a long-term situation, we’d like to ensure you receive your mail. The mailing address is: East Cascade Retirement Community 175 NE 16th St. Madras, OR 97741
Please be aware that if you contact the US Post Office to have your mail forwarded to you from your home address to East Cascade Retirement, when you leave the facility you cannot request a forward back to your home address. The Post Office considers East Cascade Retirement a business and mail cannot be forwarded from a business to another address. Better options may include:
1. Instruct the Post Office to temporarily hold your mail.
2. Arrange for a family or friend pick up your mail at home and bring to you.
If you do forward your mail to East Cascade, you may have to wait until the forward expires to get your mail sent to your home again, or contact all senders to inform them of your change in address.
TELEPHONE
• Call a Resident:
Dial 541-615-1930
Communicate to the CNA which resident
you are calling for and they will assist you.
• Call East Cascade Retirement:
Dial 541-475-2273
Follow prompts
HAIR SALON
We offer an on-site hair salon. The stylist provides affordable hair cuts, curls, and more. The salon is located on the First Floor and appointments can be made directly with the stylist.
Residents may also choose to have staff cut or trim their hair, at no cost, by staff with the understanding that employees are not professional beauticians or barbers and will not guarantee the quality of their services.
PETS IN THE FACILITY
1. Household pets such as dogs and cats are permitted to visit in the nursing facility under the following conditions:
a. Pets must be clean and disease-free, plus flea and tick-free.
b. Immediate environment of the pets must be kept clean.
c. Pets not confined in enclosures must be handheld, under leash control, or under voice control.
d. Pets that are kept in the facility or are frequent visitors shall have current vaccinations as recommended by a licensed veterinarian (including but limited to rabies, distemper-parvo virus combination, and Bordetella); documentation verifying vaccinations and freedom from disease shall be maintained in the activity department.
2. Pets are not permitted in food preparation or storage areas, in the dining room or other areas where residents customarily eat their meals, or in any area where their presence would create a significant risk or annoyance to residents.
3. The Executive Director, Director of Nursing, or Activity Director may determine which pets may be brought into the facility. Family members may bring resident’s pets to visit provided they have approval and offer reasonable assurance that the pets are clean, disease-free, and vaccinated as appropriate. Visiting pet’s musts be on a leash at all times.
4. Non-domestic, exotic pets are prohibited from permanent stays in the facility. The facility reserves the right to determine which non-domestic pets shall be permitted in the facility. Skunks, foxes, and raccoons are entirely prohibited.
These procedures are in accordance with OAR 411-86-0340.
VISITORS
East Cascade Retirement permits residents to receive visitors subject to the resident’s wishes and the protection of the rights of other residents in the facility. We recognize the resident’s need to maintain contact with the community in which he or she has lived or is familiar. Therefore, the resident is permitted to have visitors as he/she wishes. The facility will not restrict, limit, or otherwise deny visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation or disability.
Visitors may include, but are not limited to:
a. Spouses (including same-sex and transgender spouses);
b. Domestic partners (including same-sex and transgender domestic partners);
c. Other family members; and
d. Friends.
The resident has the right to deny visitation at any time. If a resident chooses to withdraw consent for visitation by an individual, the name of that person and the date of withdrawn consent shall be documented in the resident’s medical record.
For Security, our doors lock from 9pm to 7am to protect the safety of our residents and staff. Visitors wishing to see a resident may request access by calling the nurses station at 541-475-2273 or by pressing the doorbell.
Overnight guests are not allowed, except with verbal and/or written permission from East Cascade Retirement’s Executive Director.
SMOKING
Policy: East Cascade Retirement Community ensures the health and safety of all residents, visitors, and staff by providing a safe and supervised environment for residents.
In line with this commitment, East Cascade Retirement Community has adopted a NON-Smoking Policy on the company’s campus. Objective of this policy is to provide a smoke-free environment on all the company’s campus, in order to achieve healthier and pleasant workplace, safeguard non-smokers from the risk to health of passive smoke and protect the company’s campus from increased risk of fire.
Smoking is the leading cause of preventable death in the United States. Smoking and secondhand smoke are known causes of lung disease, heart disease, and caner. East Cascade Retirement Community recognizes the hazards caused by tobacco use and exposure to secondhand smoke.
Procedures:
- Smoking is not allowed on any part of the company’s campus.
- No use of tobacco products, including cigarettes, smokeless tobacco, electronic cigarettes, and any ignitor is permitted within the facilities or on the campus of East Cascade Retirement Community.
- Resident’s will be informed of the East Cascade Retirement Community tobacco-free policy at the time of admission and will be required to sign a statement of acknowledgement.
- East Cascade Retirement Community will assist any resident who is wanting to quit smoking to the best of our ability by helping them access smoking cessation programs and materials.
- Any resident at East Cascade Retirement Community that is observed using tobacco, electronic cigarettes, or any ignitor on the campus will be given a 30-day eviction notice.
MEDICAL MARIJUANA
& MARIJUANA USE
East Cascade Retirement recognizes and supports Residents’ Rights as a fundamental component in the operation of the facility. However, due to the many issues that can arise with the use of marijuana, we have taken a position to not permit use of marijuana by Residents while residing at the facility or on the grounds. This includes smoking, ingesting food items containing marijuana, pills, supplements, etc. Residents and/or responsible family member will be informed prior to or at the time of admission regarding our policy so that they can make an informed decision whether to reside at the facility or not.
Residents and/or responsible family members may be asked prior to or at the time of admission if the Resident possesses any marijuana. If so, they will be given an opportunity to send it away or destroy it in the presence of a licensed nurse or other department supervisor. Subsequently, identification of marijuana in the Resident’s possession will result in confiscation and lock-up of the product and will be returned to the Resident at the time of discharge.
Residents who use marijuana away from the facility will be assessed and may be given the choice to work with staff to transfer to a facility where the use of marijuana is permitted, or a coordinated discharge to home.
FIREARMS
Policy: East Cascade Retirement prohibits the possession and use of firearms and ammunition on the property and within the facility.
Procedures:
• Upon admission, the Resident or responsible family member will be informed in writing of the facility’s policy prohibiting the possession or use of firearms and ammunition on the property or within the facility, and the consequences.
• The facility will not store any firearms or ammunition on the property or within the facility. Any confiscated firearms or ammunition will be turned over to the police or other law enforcement department for disposal.
• This prohibition applies to Residents, family members, visitors, employees, and contractors/vendors.
EMERGENCY PREPAREDNESS PROGRAM
DISCHARGE PROCEDURES
We want to make discharge from East Cascade Retirement as smooth as possible. This may depend on the circumstances and timing of the departure.
Generally, the staff will coordinate your discharge. We will contact your primary care provider, your family and, if appropriate, the facility to which you are going. We will also contact other healthcare providers (home health, equipment rental company, etc.) if ordered. We prefer to have all of the necessary arrangements completed before you leave. We will communicate to you/your family when everything is in place.
Normal discharge time is before noon on the day of your departure; exceptions should be arranged with your Charge Nurse. The staff will assist you by packing your personal items and making sure you are dressed and prepared to leave at the correct time. Please note: Supplies and equipment that ECRC has provided for your use while here are generally not sent home with you, though some exceptions may apply and the staff will take care of that determination.
If you have any questions, please be sure to ask the staff. We want to assist in any way possible to ensure your discharge is handled professionally and correctly.
When a Resident leaves ECRC temporarily (transfer to hospital), we will place a lock on the door of private rooms to protect personal belongings. As long as the room is not needed, we will hold the room. If we are faced with turning away another admission while holding a room, we will box the Residents’ personal belongings and store them so that the room can be used.
DISCHARGE/TRANSFER
Policy: East Cascade Retirement transfers or discharges residents only when such action meets the needs of the resident or is at resident/responsible party request.
Procedures:
1. Discharge/transfer may occur under the following circumstances and with the primary care physician’s order:
a. when the care plan goals have been reached, or
b. when the Resident is medically stable and requests, or
c. when the facility is no longer able to meet the needs of the Resident and a more suitable environment has been found for the Resident, or
d. when a physician directs that the Resident should be transferred to the emergency room or any healthcare provider for evaluation, or
e. other circumstances when the physician orders that the Resident is to be discharged or transfer.
2. Discharge/transfer may also occur under the following circumstances without the primary care physician’s order:
a. in the event of a medical emergency and the primary care physician or other physician is not available and the charge nurse believes that transfer to an emergency room is appropriate under the circumstances, or
b. the Resident or responsible family member requests and agrees to sign an Against Medical Advice discharge form, or
c. the Resident or responsible family member requests and chooses not to sign an Against Medical Advice discharge form, or
d. the Resident or responsible family member fails to make payment to the facility per agreement, or
e. the staff have determined after competent and professional assessment that the Resident is a danger to self or others and to remain in the facility endangers others and an appropriate placement has been arranged for the Resident.
3. Discharge/transfer may occur in the event of an emergency or disaster involving the facility and a competent decision is made to evacuate the facility.
4. Residents who are discharged/transferred from the facility retain the right to return to the facility under certain circumstances, based upon availability of space.
BED HOLD
Policy: East Cascade Retirement shall inform resident/legal representative upon admission and at time of a transfer for hospital or therapeutic leave of the bed hold policy.
Definitions:
Hospital Leave – A resident who is on leave or temporarily discharged to a hospital and has expressed an intention to return to the facility under the terms of the admission agreement for bed hold, shall not be denied readmission unless at the time readmission is requested the resident requires services unavailable at the facility and/or does not meet admission criteria.
Therapeutic Leave – A resident who is on leave for non-medical reasons such as a visit with family/friends or a trial home stay in anticipation of discharge.
Procedures:
Private Pay:
Resident/legal representative may elect to hold the bed during a therapeutic or hospital leave to guarantee the same placement upon return. The facility will hold the bed indefinitely at no charge.
Residents Eligible for Medicare Part A:
Medicare does not make bed hold payments for hospitalizations or therapeutic leave. The facility will hold the bed indefinitely at no charge.
Notification
A. Resident or Legal Representative will be notified of the bed hold policy at the time of admission via the admission agreement.
B. East Cascade Retirement will send a copy of the bed hold notification with the resident going on therapeutic leave or out to hospital with the resident.
East Cascade Retirement Bed Hold:
If resident is temporarily absent from East Cascade Retirement for hospital treatment, therapeutic treatment or to participate in a therapeutic rehabilitative program, East Cascade Retirement will hold resident’s bed in accordance with the following provisions:
The bed will be held indefinitely for any absence from the facility due to hospitalization or therapeutic leave/home visit regardless of pay or type until the resident is discharged from the facility.
A resident/family member/legal representative may choose to waive their right to the bed hold by contacting Social Services and giving notice not to hold the bed. The resident then will be discharged and will need to re-apply for admission should he/she wish to return to East Cascade Retirement.