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HomeMy WebLinkAboutCarmel_Permitting_JSR_2_2_2021_w_Exhibits February 2, 2021 City of Carmel Building and Code Enforcement Attention: Mr. Nicholas F. Mishler Re: Willow Haven Senior Homes – 2080 W 106th Street: Home with Services Establishment: Permit Application Number: B-2020-01329 Dear Mr. Mishler, I am the architect for the referenced Willow Haven Senior Homes project. This letter references your email dated on December 15, 2020 to our client, James Miles (Exhibit A) concerning Willow Haven Senior Homes located at 2080 W 106th Street. Per your email, you requested confirmation on the structure being a Class 1 or Class 2 structure. As a result an email was sent to the Division of Fire and Building Safety | Plan Review Branch of the Indiana Department of Homeland Security. Attached is the correspondence (Exhibit B) that provides the email confirmation that Willow Haven Senior Homes is a Class 2 structure as determined by the correspondence received from the Department Chief, Mr. Alan Blunk. Further, it has been confirmed with Todd Hite, Program Director, Health Care Engingeeing, Division of Acute and Continuing Care of the Indiana Department of Health that the project does not require review because Willow Haven Senior Homes is an unlicensed Home with Services Establishment (Exhibit C & Exhibit D w/ notation). Therefore, my client would like to move forward with the next steps in the permitting review process so that we are able to upload the permit documents for review as a single family residence. Please notify us of the correct process and/or link as soon as possible in order to move the permit process forward. Thank you for your assistance and consideration. Very truly yours, Jane Rohde, AIA, FIIDA, ACHA, CHID Principal Enclosures. cc: James Miles, Owner: Willow Haven Senior Homes Shernise Richardson, Project Manager: JSR Associates, Inc. Lauren Erickson, Office Manager: JSR Associates, Inc. ---------- Forwarded message --------- From: Mishler, Nicholas F <nmishler@carmel.in.gov> Date: Tue, Dec 15, 2020 at 5:12 PM Subject: RE: Group Home @ 2080 W. 106th St. To: james@willowhavenseniorhomes.com <james@willowhavenseniorhomes.com> Cc: Hohlt, William G <WHohlt@carmel.in.gov>, Jesse, Christina <cjesse@carmel.in.gov> Good afternoon- I have attached the State of Indiana public notice that I referred to in our conversation. If you look at the “Notice” section at the bottom, I don’t believe a 10-bedroom home meets this criteria (no more than 2 tenants). Therefore I think this building would be considered a Class 1 structure and would need state approval. If you have any questions, let me know. Nick Mishler Commercial Permitting Coordinator City of Carmel Building and Code Enforcement (317) 571-2489 EXHIBIT A 1 Jane Rohde From:Blunk, Alan <ABlunk@dhs.IN.gov> Sent:Friday, January 29, 2021 5:59 PM To:Jane Rohde Cc:Shernise Richardson; James Miles; Ishola-Gbenla, Dauda; Callahan, Sean; Mays, Rex; Guedel, Justin K; Kemp, Carolyn; Burgess, Craig Subject:RE: Follow-up on Willow Haven Senior Homes - Home with Services Establishment: Project No. 419791 Attachments:Group Home Reasonable Accomodation Request - Willow Haven.pdf; 29012_WillowHaven_Code Sheet_Reference Plan_01_25_ 2021.pdf Hello Jane, Based on the information and attachment provided and below understandings, the IDHS would classify this facility as a Class 2 structure, and therefore it would not be required to be filed with the State of Indiana DHS Plan Review section in accordance with 675 IAC 12-6-2: 1.The structure only contains one or two dwelling units. 2.The structure will contain no more than two tenants. The entire structure is being possessed by one group of individuals and individual rooms are not rented out. The landlord does not assign bedrooms and the determination whether additional occupants will occupy the structure is left to the tenants or their representatives. 3.The structure is intended to be used for non-transient residential occupancy. 4.The presence of employees is limited to providing supportive living services (services limited to supporting the regular use and enjoyment of the structure for residential purposes). 5.The structure does not contain nonresidential areas that are not traditionally found in a dwelling unit. The project may be required to be submitted to local jurisdiction. Please follow up with your plan reviewer with a return email stating that you would like to withdraw your project if that is your desire. Thank you, Alan L. Blunk RA CPE CBI FI FII | Plan Review Section Chief Division of Fire and Building Safety | Plan Review Branch Indiana Department of Homeland Security 302 West Washington Street, Room E-245 Indianapolis, IN 46204 Tel: 317-232-6422 EXHIBIT B 2 Email: ablunk@dhs.in.gov Web: http://www.in.gov/dhs/3658.htm From: Jane Rohde <jane@jsrassociates.net> Sent: Wednesday, January 27, 2021 12:11 PM To: Blunk, Alan <ABlunk@dhs.IN.gov> Cc: Shernise Richardson <shernise@jsrassociates.net>; James Miles <james@willowhavenseniorhomes.com>; Ishola-Gbenla, Dauda <DIshola- Gbenla@dhs.IN.gov>; Callahan, Sean <SCallahan@dhs.IN.gov>; Mays, Rex <RMays@dhs.IN.gov> Subject: RE: Follow-up on Willow Haven Senior Homes - Home with Services Establishment: Project No. 419791 RE: Willow Haven Senior Homes – located at 2080 W 106th St, Carmel, IN 46240 / Project No: 419791 Dear Alan, Thank you for the list of questions in response to the inquiry for determination of Class 1 versus Class 2 for our project – Willow Haven Senior Homes located at 2080 W 106th St. Carmel, IN 46240. Please find below responses to the questions in bold. 1. Is the structure a townhouse or does it only contain one or two dwelling units? One Dwelling Unit 2. Is the structure intended to be used for non-transient residential occupancy? Yes 3. Is the presence of employees limited to providing supportive living services (services limited to supporting the regular use and enjoyment of the structure for residential purposes)? Yes 4. Does the structure contain nonresidential areas that are not traditionally found in a dwelling unit? No 5. Are individual rooms intended to be rented out? No a. If individual rooms are rented out, how many rooms are available? N/A 6. If individual rooms are not rented out, describe how the structure will be occupied. a. Will the structure be rented out to a single group of residents as a whole, with full use and enjoyment of the entire structure? (i.e. Not rented out on an individual room basis, with shared common space) Residents are living in one dwelling unit as a household. The residents live in the single family residence together as one group or family with full use of the home. Payment is made for the caregivers that are providing assistance with activities of daily living (ADLs) on a 24/7 basis. The following statute applies to residents with dementia living within one dwelling unit as one group, as provided pursuant to IC 12-28-4-7 for the intellectually and developmentally disabled: DWELLING, SINGLE-FAMILY. A RESIDENTIAL BUILDING CONTAINING ONLY 3 ONE (1) DWELLING UNIT AND NOT OCCUPIED BY MORE THAN ONE (1) FAMILY. PURSUANT TO IC 12-28-4-7, A GROUP HOME FOR THE MENTALLY ILL SHALL BE TREATED AS IF IT WERE A SINGLE-FAMILY DWELLING, UNLESS THE GROUP HOME WILL BE LOCATED WITHIN THREE THOUSAND (3,000) FEET OF ANOTHER GROUP HOME FOR THE MENTALLY ILL, AS MEASURED BETWEEN LOT LINES. PURSUANT TO IC 12-28-4-8, A GROUP HOME FOR NOT MORE THAN TEN (10) DEVELOPMENTALLY DISABLED INDIVIDUALS WHICH IS ESTABLISHED UNDER A PROGRAM AUTHORIZED BY IC 12-11- 1.1-1(E)(1) OR IC 12-11-1.1-1(E)(2) SHALL BE TREATED AS IF IT WERE A SINGLE-FAMILY DWELLING. (Source: https://www.carmel.in.gov/Home/ShowDocument?id=8611) This description applies to residents with dementia and serves as a precedent for a single family residence to be shared by up to 10 residents living together and receiving services within a household, small house, or group home. See attached determination letter from Mr. Michael P. Hollibaugh, Director, Department of Community Services in the City of Carmel that confirms the “City’s definitions for “Group Homes” and “Family” lay a foundation for accommodation of the frail elderly as protected and eligible to reside in a Group Home. Further, the attached states that group homes by law are considered a residential not a commercial use and that residents with Alzheimer’s and dementia are considered disabled. It is acknowledged by Mr. Hollibaugh that the Carmel Unified Development Ordinance (UDO) allows Group Homes in residential areas pursuant to Indiana law, is acknowledged and agreed the frail elderly with Alzheimer’s and dementia are a protected class, therefore eligible to reside in a Group Home. Although this is a zoning determination it is reflective of the building type utilized for this type of setting serving residents with dementia. b. Will the structure be rented to no more than two separate groups of residents, who each possess a unique portion of the structure? (e.g. one group per dwelling unit) The home is one dwelling unit and will include one group of residents, who will be receiving assistance with Activities of Daily Living (ADLs). c. Other, explain. N/A Thank you for your consideration and please let me know if you have any questions. I can be reached at 410-978-2112 or jane@jsrassociates.net. Jane JANE@JSRASSOCIATES.NET | WWW.JSRASSOCIATES.NET LINKEDIN / FACEBOOK / INSTAGRAM 4 From: Blunk, Alan <ABlunk@dhs.IN.gov> Sent: Monday, January 25, 2021 10:59 AM To: Jane Rohde <jane@jsrassociates.net> Cc: Shernise Richardson <shernise@jsrassociates.net>; James Miles <james@willowhavenseniorhomes.com>; Ishola-Gbenla, Dauda <DIshola- Gbenla@dhs.IN.gov>; Callahan, Sean <SCallahan@dhs.IN.gov>; Mays, Rex <RMays@dhs.IN.gov> Subject: RE: Follow-up on Willow Haven Senior Homes - Home with Services Establishment: Project No. 419791 Hello Jane, It was nice to talk with you about code compliance issues with these types of facilities. In order for us to make a determination on Class of structure (1 vs. 2) for the current proposed project under consideration, we would like to obtain some additional information. Please answer all of the following questions for the project. 1. Is the structure a townhouse or does it only contain one or two dwelling units? 2. Is the structure intended to be used for non-transient residential occupancy? 3. Is the presence of employees limited to providing supportive living services (services limited to supporting the regular use and enjoyment of the structure for residential purposes)? 4. Does the structure contain nonresidential areas that are not traditionally found in a dwelling unit? 5. Are individual rooms intended to be rented out? a. If individual rooms are rented out, how many rooms are available? 6. If individual rooms are not rented out, describe how the structure will be occupied. a. Will the structure be rented out to a single group of residents as a whole, with full use and enjoyment of the entire structure? (i.e. Not rented out on an individual room basis, with shared common space) b. Will the structure be rented to no more than two separate groups of residents, who each possess a unique portion of the structure? (e.g. one group per dwelling unit) c. Other, explain. Thank you, Alan L. Blunk RA CPE CBI FI FII | Plan Review Section Chief Division of Fire and Building Safety | Plan Review Branch Indiana Department of Homeland Security 302 West Washington Street, Room E-245 Indianapolis, IN 46204 Tel: 317-232-6422 Email: ablunk@dhs.in.gov 5 Web: http://www.in.gov/dhs/3658.htm From: Jane Rohde <jane@jsrassociates.net> Sent: Monday, January 25, 2021 9:06 AM To: Blunk, Alan <ABlunk@dhs.IN.gov> Cc: Shernise Richardson <shernise@jsrassociates.net>; James Miles <james@willowhavenseniorhomes.com> Subject: Follow-up on Willow Haven Senior Homes - Home with Services Establishment: Project No. 419791 RE: Willow Haven Senior Homes – located at 2080 W 106th St, Carmel, IN 46240 / Project No: 419791 Hello Alan, Thank you for the conversation and clarification on the process to seek a determination on our project being a Class 1 or Class 2 structure. We are seeking a determination from the State on the designation. Please find attached a cover sheet with site plan, reference building plan, and code sheet for reference. Thank you for your assistance. If you need any additional information or have any questions, I can be reached at jane@jsrassociates.net or on my cell phone: 410-978-2112. Thank you for your consideration. Jane Rohde JANE@JSRASSOCIATES.NET | WWW.JSRASSOCIATES.NET LINKEDIN / FACEBOOK / INSTAGRAM From: Blunk, Alan <ABlunk@dhs.IN.gov> Sent: Thursday, January 21, 2021 2:20 PM To: Jane Rohde <jane@jsrassociates.net> Subject: RE: Follow-up on Willow Haven Senior Homes - Home with Services Establishment 419791 1 Jane Rohde From:Hite, Todd <Thite@isdh.IN.gov> Sent:Monday, January 11, 2021 2:06 PM To:Jane Rohde; Hensley, Lisa Cc:James Miles; Shernise Richardson; Lauren Erickson; Blunk, Alan Subject:RE: Follow-up on Willow Haven Senior Homes - Home with Services Establishment Attachments:Acceptable Practices Guidelines.docx Jane, After talking to the Division Director of Long Term Care, it appears there is more than just medication management that would require a facility to meet the requirements of Residential care as noted in 410IAC 16.2-5. I was provided that attached document that explains what can be performed in an unlicensed “assisted living “ facility. If the Willow Haven Senior Home will not be providing care that would require licensing then a review by our office would not be required. I have not been able to confirm with DHS how to change the review thru their process. I suggest contacting Alan Blunk @ 317-232-6407 on your concerns on the building type being residential. Todd W. Hite | Program Director, Health Care Engineering Division of Acute and Continuing Care office: 317-233-7166 • fax: 317-233-7157 thite@isdh.in.gov health.in.gov Confidentiality Statement: This message and any attachments may be confidential. If you are not the intended recipient, please 1) notify me immediately; 2) do not forward the message or attachment; 3) do not print the message or attachment; and 4) erase the message and attachment from your system. From: Jane Rohde <jane@jsrassociates.net> Sent: Sunday, January 10, 2021 1:23 PM To: Hite, Todd <Thite@isdh.IN.gov>; Hensley, Lisa <lhensley@isdh.IN.gov> EXHIBIT C 2 Cc: James Miles <james@willowhavenseniorhomes.com>; Shernise Richardson <shernise@jsrassociates.net>; Lauren Erickson <lauren@jsrassociates.net> Subject: Follow-up on Willow Haven Senior Homes - Home with Services Establishment **** This is an EXTERNAL email. Exercise caution. DO NOT open attachments or click links from unknown senders or unexpected email. **** Hello Todd and Lisa, I wanted to thank you for your time this past week to review the status of the Willow Haven Senior Homes submittal to the Indiana State Health Department. Can you provide an update of the status or any suggested next steps? We have been working on getting the building permit approved, and with the current situation of being non-licensed and the Department of Homeland Security follow-up are appreciative of your guidance and advice. Thanks very much and look forward to hearing from you soon. Jane JANE@JSRASSOCIATES.NET | WWW.JSRASSOCIATES.NET LINKEDIN / FACEBOOK / INSTAGRAM NOTE: Willow Haven Senior Homes is not an assisted living – residential care or comprehensive care facility. It is a Home with Services Establishment and will be unlicensed and not perform any care that requires a license and review by the Indiana Department of Health. ASSISTED LIVING – RESIDENTIAL CARE – COMPREHENSIVE CARE FACILITIES The following is provided (by the Indiana State Department of Health, Long Term Care Division) in order to furnish some basic guidelines about the different levels of care that may be found in Indiana. It is intended to provide information about acceptable practices at each level of care as well as information about how each type of facility may be staffed and what reimbursement mechanisms are in place. This document is based on the licensed residential care rules, as well as other existing laws and rules. Assisted Living Facility Assisted Living is a term used by the public to refer to either a licensed or an unlicensed facility. As used herein, it refers to an unlicensed facility. In general, if a facility provides medical care it must be licensed as a residential facility. If the facility does not meet the definition of health facility as found in Indiana law ¹, it is not licensed or regulated by the Indiana State Department of Health. In order to use the term “assisted living” to describe itself, a provider must file certain disclosure information with the Family and Social Services Administration and its contacts with residents must meet certain statutory requirements. Acceptable Practices that may be performed in an unlicensed facility include the following: (1)Mobility – using one hand or steadying (one-person minimal assist). Residents who are wheelchair bound but independent except for slight (one person) assistance in transfer are acceptable. It is not acceptable if a resident who cannot bear any weight must be lifted to move from a sitting to a standing or other sitting position. (2)Dressing – using one person to assist is permissible, including help with fasteners, over-the- head, etc. for those who are arthritic is permissible. It is not acceptable if a resident must be totally dressed. (3)Bathing – using one person to assist is permissible, including helping with soaping a washcloth, washing backs and feet, assistance in leaving the tub or shower area, etc. It is not acceptable if a resident must be totally bathed. (4)Eating – using one person to assist in cutting meat, opening milk cartons, etc. is permissible. It is not acceptable if a resident must be fed. EXHIBIT D ______________________________ ¹ “Health facility” means a building, a structure, an institution or other place for the reception, accommodation, board, care, or treatment extending beyond a continuous twenty-four (24) hour period in a week of more than four (4) individuals who need or desire such services because of physical or mental illness, infirmity, or impairment. IC 16-18-2-167 (a). (Certain exemptions apply, for example, care given by family members or other licensed entities.) Assisted Living Facility – Continued Acceptable Practices (Continued) (5) Toileting – using one person to provide limited assistance with care before and after use of the toilet, commode, bedpan or urinal, changing a pad or soiled clothing is permissible. It is not acceptable if a resident is incontinent and needs total assistance. Resident cannot be lifted on or off toilet although slight assistance is permissible. (6) Medication Administration – medications cannot be stored in central location, nor can they be set up in medication boxes except by a third party (home health agency, pharmacy, family member, etc.). Residents can be assisted with:  Opening a bottle  Administering eye drops (steadying only, not touching the bottle or applying pressure)  Applying topical creams and ointments (steadying only)  Providing reminders for insulin (note: facility can publish list of steps so that assistance can be provided in reading the list for the process while the resident self-administers the insulin)  Unlocking the box in the resident’s room where medications may be secured to prevent misappropriation. The key to any such box must be kept in the resident’s room.  O² - assistance can be provided in filling the tanks and changing tubing on the tanks, but not with actual oxygen flow – resident or family member must be able to flip a switch for administration and change the flow of oxygen  Catheters – no Foley care of any type; one can assist in steadying or provide limited assistance in emptying of catheter bag  Provide and apply Band-Aids but cannot change dressings  CPR and first aid administration are left up to the individual facility. Although these facilities are not subject to ISDH regulation, ISDH recommends that there be at least one person on duty at all times who is trained in CPR. It is appropriate to administer basic first aid. Staffing Requirements – There are no staffing requirements for unlicensed assisted living facilities. Reimbursement – Private Payment Sources. Note: Home health agencies can go into licensed or unlicensed facilities to provide medical care if an individual resident contracts with the home health agency. Residential Care Facility A Residential Care Facility is licensed and can provide some health care services. Acceptable Practices include the following: (1) Assistance with self-maintained exdwelling and indwelling catheter care and intermittent catheterization for a chronic condition. (2) Prophylactic and palliative skin care including application of creams or ointments for treatment of minor skin problems. (3) Routine dressing that does not require packing or irrigation, but is for abrasions, skin tears, closed surgical wounds, and chronic skin conditions. (4) General maintenance care of ostomy including routine change of bag with care and maintenance of surrounding tissue. (5) Restorative nursing assistance including passive and/or active assisted range of motion. (6) Toileting care will include assistance in use of adult briefs and cues for bowel and bladder training. (7) Routine blood glucose testing involving a finger-stick method. (8) Enema and digital stool removal therapies. (9) General maintenance care in connection with braces, splints and plaster casts. (10) Observation of self-maintained prosthetic device. (11) Administration of subcutaneous or intra-muscular injections. (12) Metered dose inhalers, nebulizer/aerosol treatment self-administered by a resident and routine administration of oxygen after a therapy regimen has been established. Staffing Requirements – In general, the facility must have sufficient staff to meet the needs of the resident. Specific staffing requirements in rule are as follows:  The administrator must be licensed by the Indiana Health Facility Administrator’s Board.  There must be one awake staff person with current CPR and first aid certificates on-site at all times.  If fifty (50) or more residents regularly receive residential nursing services and/or administration of medication, at least one (1) nursing staff person (an RN, LPN or certified nurse aide) must be on-site at all times. At least one (1) additional nursing staff person for every additional fifty (50) residents.  An employee providing more than limited assistance with activities of daily living must be either a certified nurse aide or a home health aide.  Medication must be administered by a RN, LPN, or qualified medication aide (QMA).  Food service menus must be approved by a dietician and a dietician must, at a minimum, provide consultant services.  If a facility controls, handles and administers medications, the facility must use a consultant pharmacist as specified in 410 IAC 16.2-5-6(c)(2).  An Activities director that meets the requirements specified in 410 IAC 16.2-5-7.1(c).  Person designated to maintain medical records. Reimbursement – Private Pay, State-Funded Room and Board Assistance Program, Assisted Living Medicaid Waiver. Comprehensive Care Facility A facility licensed as a comprehensive care facility is what people typically refer to as a nursing home. It can provide a higher level of nursing services than can a residential facility and has more statutory requirements to meet, both in state law and the federal Medicare/Medicaid laws. Acceptable Practices include the following: (1) Intravenous feedings (2) Enteral feeding (3) Nasopharyngeal and tracheostomy aspiration (4) Insertion and sterile irrigation and replacement of suprapubic catheters (5) Application of dressings to wounds that require use of sterile techniques, packing, irrigation, or that are infected or otherwise complicated (6) Treatment of Stage 2, 3 and 4 pressure ulcers or other widespread skin disorders (7) Heat treatments which have been specifically ordered by a physician as part of active treatment and which require observation by nurses to adequately evaluate the process (8) Initial phases of a regimen involving administration of medical gases Staffing Requirements – In general, the facility must have sufficient staff to meet the needs of the resident. The facility must also have:  A licensed administrator  A physician medical director  An RN director of nursing  RN or LPN staffing – one-half hour (.5) licensed nurse per hour per resident per day averaged over a one (1) week period  Charge nurse (RN or LPN) for each shift – For facilities of less than sixty (60) residents, the director of nursing may also serve as a charge nurse  RN for at least eight (8) consecutive hours/day seven (7) days a week  Medication administration by RN, LPN or QMA  Dietician on at least a consultant basis with minimum number of hours determined by number of residents  Consultant pharmacist  Activities director  Social worker (requires fifteen [15] minutes time per/resident/week by social worker)  Person designated to maintain medical records  Quality assessment and assurance committee Reimbursement – Private Pay, Medicare/Medicaid (if certified).