HomeMy WebLinkAboutDecision 3570 Memo in Support of Appeal •
TOWN OF YARMOUTH
BOARD OF APPEALS
)
Alvan Hirschberg and Others. )
)
Appeal from August 25, 1999 Decision ) Appeal No.: 3570
of Building Inspector )
)
MEMORANDUM IN SUPPORT OF APPEAL
This Memorandum is filed on behalf of Alvan Hirschberg, John Powers, Robert Pecor,
Barbara Oxholm, Richard Merrow, Jack Crosby,Nancy Winer and Edward Nulton, all of whom
are residents of King's Way. All but Edward Nulton are members of the King's Way Residents
Advisory Committee. They, in turn, represent a broader group of King's Way residents.
The procedural background to this Application is set forth in Exhibit"B" to the Appeal
Application. The purpose of this Memorandum is to focus on the core issue before you tonight:
what is the existing and proposed Assisted Living Facility at Heatherwood at King's Way, and is
it allowed under the Zoning By-Law or any prior decision of the Zoning Board of Appeals
("ZBA")?
THE HEATHERWOOD ASSISTED LIVING FACILITY
Perhaps the best source of information about the existing and proposed Assisted Living
Facility is Heatherwood's own marketing publication. An information brochure entitled
"Heatherwood at King's Way presents Assisted Living Residences" (copy attached as Exhibit
"A") describes the services provided:
"24 hour a day staffing by Certified Personal Care Assistants under the supervision of a
1
Registered Nurse".
"Assistance with your medication".
"Physician consultation by our Board Certified Internist".
"Assistance with bathing,toileting, dressing, dinning and mobility".
The "standard monthly services and amenities" (Exhibit "B") include: "three meals daily.
Diets evaluated by a qualified Dietician"; "Therapeutic diets ordered by a physician at an
additional cost"; "Ability to provide timely assistance to Residents and to respond to urgent or
emergency needs by the presence of a 24-hour per day awake, on-site staff capability...".
The "Assisted Living Price Schedule" and accompanying letter (Exhibit"C") reflect daily
charges of$120.00 to $150.00 per person for a one bedroom unit. The charge for a second
person in the unit is dependent on the level of care provided. On a monthly basis a stay at
Heatherwood costs between $3,600.00 per month and $4,950.00 per month. The rate structure is
based on a daily rate that includes 60 minutes of personal care. Residents have the option of
... purchasing additional services if needed.
Assisted Living Facilities are governed by Chapter 19D which was enacted by the
legislature in 1994 (The "Act"). The Act requires that an Assisted Living Residence provide
assistance with the activities of daily living. An Assisted Living Residence must provide "self-
administered medication management and provide services to residents in accordance with
service plans." M.G.L. c. 19D§2. An Assisted Living Facility, therefore, must be more than a
residence - it must provide personal care services to its residents.
ASSISTED LIVING FACILITIES ARE NOT ALLOWED UNDER THE CURRENT
ZONING BY-LAW
Establishments which provide 24-hour per day personnel with a Licensed Nurse on duty
during the day are classified as "Intermediate Care Facilities, Industry No. 8052" in the Standard
2
Industrial Classification Manual of 1987 (copy attached as Exhibit"D"). This is a subgroup to
Industry Group No. 805 entitled "Nursing and Personal Care Facilities". Under the current
Zoning By-Law Nursing and Personal Care Facilities require a Special Permit in a residential
district. By-Law§202.5 Category P5.
Assisted Living Facilities as described in the Heatherwood publications are therefore not
allowed in the residential district without a Special Permit.
ASSISTED LIVING FACILITIES ARE NOT ALLOWED UNDER THE
1975 OR 1986 VARIANCES AND SPECIAL PERMITS.
In 1975 the Zoning Board granted a Special Permit and a number of Variances to Oak
Harbor Associates to develop what is now the King's Way Site. Under the Zoning By-Law then
in force, business uses were not allowed in the residential district. Section 18.02. Accordingly, a
number of Variances were required to allow the business uses which Oak Harbor proposed. No
... Variance was granted which would allow an Assisted Living Facility . (Copy of 1975 Decision
attached as Exhibit "E").
In December of 1985 the Green Company filed an Application to confirm and change the
1975 Zoning Variances and Special Permits (the "Application"). An Exhibit attached to the
Application gives a detailed list of all the zoning relief sought. (Copy enclosed as Exhibit"F").
The relevant portions of the Application seek the following relief:
"Approval of the connection by enclosed walkways of buildings
containing retirement housing to the community center complex". Section III(E)
"Approval of the type of community center complex proposed by Green,
including modification of building configuration and ground coverage,
modification of the allocations of space among the various functions, and
separation of the golf course "Pro Shop" to a separate building". Section III(F)
3
A further attachment to the 1986 Application entitled"Oak Harbor Green Plans -
Community Building" (last two pages of Exhibit"F") identifies the specific use categories to be
included inside the community facility "to accommodate the needs of retirement housing
residents". Within the requested use categories Green identifies "health and medical facilities"
as one of twenty-one (21) uses to be located within a 20,000 square foot community facility.
At the January 23, 1986 hearing, Board members closely questioned Green's counsel
about the nature and extent of the relief sought. (See pages 18 - 20 of the ZBA minutes attached
as Exhibit"G"). The minutes contain the following exchange:
"Mr. Singer asked under Residents services, health and medical services are
limited, is there any more definition to that, also,there is going to be no nursing
home, this isn't some way of saying nursing home?
Mr. Sweeney - The resident services as described here are the simply re-listing of
those services that were listed in the original Special Permit,just a recapitulation,
nothing more than what was originally permitted is requested. We have
eliminated some (the 10 guest rooms)(parenthetical original).
Mr. Singer- But this health and medical language is new language?
Mr. Sweeney - Yes I apologize for...
Mr. Singer-That's alright. Can you give us any more definition to what those
words mean?
Mr. Green -All of these things in resident services are limited to 20,000 square
feet. Secondly, the health and medical services are keeping of records of what
each person, a diary of their condition is in case there should be an emergency so
that the appropriate doctor or hospital could be called. A place for doctors to have
a clinic or see patients under certain, as a doctor's office, rather than make the
people go all the way into town to visit a doctor. A place for a podiatrist as an
example which is an important element in elderly housing, to be able to come in
and see patients on those occasions when he does come. It's not meant to be a
whole full-fledge community health plan situation. Just to be able to service those
people on an actual basis.
4
Mr. Henderson- Would it be limited to residents?
Mr. Green- Yes. Absolutely."
What Mr. Green described was an office within a community building which would
provide an amenity - a convenience to residents of King's Way or Heatherwood. What is now
proposed is an Assisted Living Facility apart from the community building consisting of over
54,000 square feet providing personal care services for a daily charge. The persons paying for
those services are not required to be residents of King's Way or Heatherwood. This is the sale of
nursing and personal care services open to the public, not an amenity for King's Way or
Heatherwood residents.
It is clear from both the Decision and the Minutes of the 1986 Special Permit and
Variance that what the ZBA intended to grant was a reconfiguration of the physical structure to
include covered walkways and other amenities to make the Site more comfortable for the active
elderly. The term"active elderly" is used repeatedly in the minutes. On page 7 of the minutes
(attached as Exhibit"G") Mr. Green defines "active elderly":
"It is for people who are older, whose family has grown, who don't want to be a
burden to their children, who want to live independently and with dignity and
want to be with their peers and it is definitely not a nursing home".
In 1996 Heatherwood amended its Master Deed to allow a very different type of use,
describing Assisted Living Suites"designed for occupancy by persons who are unable to live
independently and require assistance with every day activities, including dressing, grooming,
mobility and medication". Article 7, Second Amendment of Master Deed of Heatherwood at
King's Way dated May 23, 1996(attached as Exhibit "H"). Clearly, persons who are unable to
live independently, who require the level of service described in the Heatherwood publications
5
and Chapter 19D are not"active elderly"within Mr. Green's definition. As Heatherwood
recognized when it found it necessary to amend its Master Deed,the Assisted Living Suites built
in 1996 were a new and different use.
To summarize, Heatherwood at King's Way and its predecessors never asked this Board
for the necessary zoning relief to operate an Assisted Living Facility, and such relief was never
granted. The "Heath and Medical Facility" which was to have been one of 21 services provided
in the community building, has nothing to do with a separate 54,000 square foot residential
facility to provide personal care and nursing services to the public.
PAST SITE PLAN REVIEWS DO NOT ALLOW ASSISTED LIVING FACILITIES
In 1975, the ZBA granted a Variance (copy attached as Exhibit"E") allowing phased
development of the project. The Board found that requiring:
"preparation and submission of a Site Plan under Section 18:07-4-E and
ti. 18:10-6 for all buildings in the development prior to issuance of or any use by the
Petitioner of the Special Permit requested in the Petitioner's related Application
would involve substantial and unnecessary hardship to the Petitioner". Variance
Decision page 24.
The Board went onto grant a Variance allowing later submission of Site Plans with the
following language:
"The controls established in the By-Law for the siting, landscaping,
screening,parking and utilities of and for all buildings and open space village
developments (Plans subject to Site Plan Review shall show the location and
dimensions of the lot, the exact location and size of any existing or proposed
buildings, streets and ways adjacent to the lot, existing and proposed topography,
drives, parking, landscaping, park or recreation areas, use of structures and land,
screening,water, sanitary sewerage, and storm drainage; and separate plans shall
also show ground floor plans and architectural elevations of all proposed
buildings and signs,to be prepared (except in the case of 1 and 2 -family
dwellings)by a Registered Architect or Engineer if such buildings contain 35,000
cubic feet of space or more (Section 18:10-6-A)) will not be cast aside by the
6
issuance of this Variance; it is a condition of our granting this Variance that all
plans and details required under the By-Law be submitted and reviewed. This
Variance goes only to the timing of the submission" (underlining added).
"Therefore, the Town and its residents should in no way be effected and
the standards and by-law for Site Plan will in no way be undercut". Variance
Decision page 24.
The purpose of the Site Plan Reviews, therefore, is merely to demonstrate that the siting
and location of the buildings complies with the Site Plan Requirements of the 1975 By-Law. Site
Plan Review is not an opportunity to change the allowed use. As the Board knows, a use which
is not allowed under the current Zoning By-Law may be permitted only on Application for
Special Permit or Variance and a full hearing with public notice as required by Chapter 40A.
Accordingly,the fact that the words"Assisted Living" or"Personal Care"may have
appeared in a prior Site Plan Review does not change or expand the uses allowed under the prior
Special Permits and Variances. By approving those Site Plans the ZBA merely certified that they
were in accordance with the 1975 Site Plan Requirements.
CONCLUSION
For the foregoing reasons, the Applicants request that the Board exercise its powers under
Section 14 of Chapter 40A to reverse the Decision of the Building Inspector and grant the
following:
1. Order zoning enforcement action against the existing 19 units at Heatherwood at
Phase II to compel compliance with the Special Permit, Variance and current
Zoning By-Laws;
2. Determine that a Building Permit may not be issued for Heatherwood Phase III
without further zoning relief from the Zoning Board of Appeals; and
7
3. Determine that Assisted Living Units, as defined in Chapter 19B and as proposed
in Heatherwood Phase III is not an allowed use under the current Zoning By-Law
or under any Special Permit or Variance relief applicable to King's Way or
Heatherwood at King's Way.
Respectfully submitted,
ALVAN HIRSCHBERG AND OTHERS
By their attorney,
rncy -L-
hilip . Magnuson)
BBO# 544867
Furman, Cannon&Ross, P.C.
255 Main Street
Hyannis, MA 02601
Date: October 25, 1999 (508) 775-0277
8
Heatherwood
0 at Kings Way
HEATHERWOOD
At KindsWa}y Assisted Living
Residences
--_i'r 4.
Heatherwood at / r
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Kings Way / * r
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6A' —_ _
Union Street
')Exit 8 `
Upper er Cape 6 i 7
Lower Cape
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Directions: 5
• Exit 5 uft Route 6 , 1 I V
• Follow L mon Street to the end and turn right l \� �1 L I� /
unto Route()A. - Lk � 'X �
�'" A
• Follow Route 6_\for one mile. You \\°III see • phi;,.
the Kings Way sign on the left.
• Proceed past the Kings Way gatehouse,take
the first right and then follow signs to F-Ieather voot"I.
Landmarks:
1.Getty Station
2. 1=fiddler's Green Plaza
3. Kings Way Entrance
4.Peterson's Supermarket EXHIBIT
Y
A
4
100 HEATHERWOOD DRIVE AT KINGS'WAY 1-I E AT 1—I
E R\X/O
0 D
CIYARMOUTH PORT, MA 02675 At ����1 �\(/��
I508)162-1362 or 18001 852-036 �/
EOU;L HOUSING
OFFORI UIL111
•
F YA.io j TOWN OF YA R M O U T
BUILDING
,}�� ELECTRICAL
�' 1 1
► ; 11-� Y TE 28 SO(:TFH YARSIU('1'H MIASSACHCSETTS 02664 EXHIBIT
?, ►A,I;, .. c't/4. Telephone 15ott) 398•2231
"1 ..4 .1t,"1.Wig.• - H1
Bt' ILD1N (; U1: PARTMENT ,
. September 15, 1995
Shasnut Bank
77 Main Street
Hartford, Connecticut 06115
and
Goodwin, Procter & Soar
Exchange Place
Boston, MA 02109
Re: Heatherwood at Kings Way, Yarmouth rt MA
Car Sirs: ' ,
You have requested information concerning the status of zoning approvals
for Heatherwood at Kings Way in YaTrmouthport, Massachusetts, including the
proposed expansion of the facility to include 27 addition 1- and 2-bedroom
residential units and an assisted living area for up to 14 residents (the
"Project") .
I am currently the Inspector of >�t,l dings for the Town of Yarmouth and
have been familiar with Heatherwood for 7 years. To the best of my knowledge,
and upon my current review of the files of this office relating to Heather-
wood, I hereby confirm the following as of this date:
1. Tile Special Permits and Variances which authorize the entire Kings
Way Development, including up to 235 residential units within Heatherwocd at
Kings Way, remain in full force and effect. There are, to my knowledge, no
violations to the Special Permits or Variance . Additional site plan review
will be required for any further expansion of Heatherwood at Kings Way.
2. A site plan for the Project was submitted on 8/22 ,1995
and approved by Town Departments on 9/15 , 1995. There are no
other zoning approvals required for the Project..
3. Certificates of Occupancy have been issued for all existing resi-
dential. units at Heather..ccd.-- - ---
I trust the foregoing will meet your requirements.
Very , y yours,
,S:-t ' 2. 4-,--
Forrest E. Vitite
Inspector of F t i ldings
i�
D.,n•K,r ir••.i en•Ac:•
ARDITO, SWEENEY, STUSSE, ROBERTSON & DUPUY, P.C.
•
• ATTORNEYS AT LAW EXHIBIT
MATTACHEESE PROFESSIONAL BUILDING J 25 MID-TECH DRIVE, SUITE C ��
WEST YARMOUTH, MASSACHUSETTS 02673
EDWARO J.SWEENEY JR TELEPHONE(508)775-3433
MICHAEL B STUSSE FAX(508)790-4778 RICHARD A.OALTON
DONNA M ROBERTSON
CHARLES M.SABATT
MATTHEW J OUPUY
RUTH A.MOLAUGHUN
September 8, 1995 CHARLES J.ARDITO, P C
PLEASE REFER TO FILE 40116 . 05
NUMBER
•
•
Mr. Leslie Campbell, Chairman
Yarmouth Board of Appeals
Yarmouth Town Offices
Route 28
South Yarmouth, Massachusetts 02664
Re: Heatherwood at Kings Way - Permit Compliance
Phase II
Dear Mr. Campbell:
In accordance with special permit and variances issued by the
Board of Appeals in Petition No. 1321 as modified by Petition Nos.
2048, 2268, 2448, 2491, 2511, 3096 and 3152, enclosed please find
on behalf of Michael T. Downey, Trustee of The O'Connell
Heatherwood Nominee Trust, the following plans ( six sets) for
review and approval stamp by the Board of Appeals as to permit
compliance:
Heatherwood Phase II revised plans as follows:
Sheet C-1 Title Sheet
Sheet C-2 Proposed Site Plan (8/29/95 )
Sheet C-3 Detail Sheet 1 (7/21/95 )
Sheet C-4 Detail Sheet 2 (7/28/95)
Additional background materials are as follows:
1 . Old Kings Highway Historic District Certificates of
Appropriateness are provided herewith.
2 . Site Plan Review Report with drainage calculations are
provided herewith.
• Mr. Leslie Campbell
September 8, 1995
Page 2
3 . Groundwater Discharge Permit has been previously
submitted.
4 . Water availability Letter has been previously submitted.
5 . The required Open Space for the entire development has
been previously dedicated and documentation provided.
6. Planning Board Release of Covenant has previously been
submitted.
After construction of the 41 units containing 62 bedrooms,
which include six one-bedroom and 21 two-bedroom independent living
units and 14 one-bedroom assisted living units proposed hereby, the
overall Kings Way unit and bedroom count, also including Kings Way
Phase IV Westwoods, will be as follows:
(Total Units Permitted) Units Bedrooms
Admiralty Heights ( 19) 19 41
Heatherwood (235 ) 156 256
Kings Way (496) 265 530
TOTALS 440 827
When the Board determines compliance, we would request that
all six sets of plans be initialed and stamped in order that they
be disbursed to:
1. Board of Appeals
2 . Building Inspector
3 . Engineering Department
4 . Town Clerk
5 . Petitioner (two sets)
Please confirm that these plans will be considered for
compliance at the Board of Appeals meeting on September 28 , 1995 .
Thank you for your cooperation in this matter.
Very truly yours,
•
Edw d J. Sweeney, Jr.
EJS':lcs
Enclosure
"ASSISTED LIVING PRICE SCHEDULE
(DAILY RATE)
S'1'u1)20 $120 . 00
ALCOVE $12 6. 0 0
RESPITE $150.00
Security deposit of one months rent required. Respite stay
requires a minimum of two weeks, paid in. advance.
SECOND PERSON CHARGE
If not in need of care $40/day
If in need of care $75/day
Effective 7/1/98
•
EXHIBIT
C
(2 Pages)
HEATHERWOOD
At Kings Way
Dear Prospective Resident,
Thank you for considering Assisted Living at Heatherwood. Important decisions
like this can be difficult to make, but having all the pertinent information can make it
easier. I hope you'll find all the information you need in this letter, it is written to
coordinate with the Assisted Living Consumer Information Checklist. Please feel free to
contact me with any other questions; I am always glad to talk about how special we are at
Heatherwood.
Heatherwood Assisted Living is located at 100 Heatherwood Drive,
Yarmouthport, Massachusetts, 02675 and our phone number is (508) 362-1362. Our
Executive Director is Patricia L. Hooley. R.N. Our management company is O'Connell
Engineering and Financial, Inc. We presently have 14 units consisting of studio and one
bedroom apartments.
The rate structure is based on a daily rate that includes 60 minutes of personal
care. You have the option of purchasing additional services if needed. We do not impose
any application or community fees, but do require a security deposit of one month's rent
(held is escrow), and the first month's rent paid in advance. We adhere to the
Massachusetts Landlord/Tenant laws regarding all transactions. We request a letter from
your physician stating that you are free of communicable diseases along with your
medical history.
A studio apartment rents for $120.00 per day and the one bedroom apartment
rents for $126.00 per day. The additional fee for a second person who requires no care is
$40.00 per day, if care is needed the fee is $75.00 per day. Should these rates be changed,
the residents will be notified in writing at least 30 days in advance. Respite rate is
$150.00 per day. At this time, we do not accommodate Medicaid or low-income
residents and have no program in place to accommodate residents who exhaust their
funds.
Heatherwood is generous in the daily services provided by the staff and included
in the base rate. We provide three meals daily. Our menus are evaluated by a qualified
dietician twice a year. All bathrooms are cleaned daily, and rooms are vacuumed once a
week, and dusted bi-weekly with spring cleaning done annually. We provide laundry
service once a week with a maximum of 5 loads of laundry. Our apartments include an
emergency response system in both the bedroom and bath, a full bathroom, cable t.v.
hookup, refrigerator, bar sink, lockable door, window treatments, as well as gas, electric,
water and air conditioning. Stovetop burners and a microwave are always available in
100 HEATHERWOOD DRIVE AT KINGS WAY 34 ROUTE 6A ra•YARMOUTH PORT, MA 02675
(508) 362-9889 FAX (508) 362-5904
i
STANDARD MONTHLY SERVICES AND AMENITIES
(THESE ARE INCLUDED IN THE BASE FEE)
A. The following routine services and amenities are included in the Resident's Monthly
Residence and Service Fee. An individualized service plan will be developed with you.
1. Opportunities for socializing and access to community resources. An activities
program that included social, cultural, and recreational activities with an em-
phasis on social and physical programs.
2. For all Residents whose service plan so specify, such services, supervision of and
assistance with activities of daily living including, at a minimum, assistance with
bathing, dressing, ambulation and arrange for medical care (i.e. routine physical)
up to 60 minutes a day.
3. Three meals daily. Diets evaluated by a qualified dietician. Therapeutic diets
ordered by a physician at an additional cost.
4. Housekeeping of units and common areas. Daily: bathrooms. Weekly: vacuum.
Bi-Weekly: dusting. Annual: spring cleaning.
5. Self-administered medication management by personnel meeting standards for pro-
fessional qualifications and training set forth in the regulations.
6. Ability to provide timely assistance to Residents and to respond to urgent or emergency
needs by the presence of 24-hour per day awake, on-site staff capability, by the provi-
sion of emergency response devices in all units for the purpose of signaling such an
awake staff person or by similar means (call bells or hand bells).
7. Laundry is done weekly with a maximum of 5 loads. Resident must provide their own
laundry detergent. Additional laundry services available at a cost of $3.00 per load.
Dry cleaning available at an additional cost contracted through the dry cleaners which
picks up and delivers to Heatherwood.
8. Heat, electricity and air conditioning. Cable TV available in common areas. (Cable
in own room — separate charge).
9. Scheduled transportation services to community destinations. Refer to transportation
schedules for times and locations.
10. Lockable entry door.
11. Access to cooking area.
Page 1 EXHIBIT
B
(2 Pages)
12. Water and sewer services and refuse disposal.
13. Reasonable maintenance of both the interior and exterior of the Residence, land-
scaping and pest control.
14. Private bathroom.
15. Assigned surface parking. (Resident is responsible for moving his/her vehicle to allow
for snow removal).
16. Use of Assisted Living Common areas including Dining Room, Activities Room and
Lounge.
17. Staff will deliver mail directly to the Residence.
18. Security services for the building and grounds.
B. Assisted Living Residence will arrange for the provision of additional services (at an additional
cost) including the following:
1. Barber/Beauty services. Rates are available on the salon premises or you may continue
to use your own salon.
2. Local transportation for medical and recreational purposes. (i.e.: podiatrist, optome-
trist, dentist). Refer to the transportation policy and doctor's appointments policy.
3. Assistance with and supervision; i.e., shopping, personal companion, personal care.
4. Activate phone and cable in Resident's personal unit.
5. Therapeutic diets, as ordered by a physician.
C. The sponsor will arrange for, but may not use Assisted Living residence staff for the provision
of the following additional services:
1. Heal related services.
a. Ancillary services for health-related care (i.e. physician, pharmacist, restorative
therapies, podiatry, hospice, home health) and other services supporting the
• Resident.
b. Temporary or emergency skilled nursing care, under arrangements with certified
home health agencies, nursing facilities, or hospice care agencies.
2. Management of Resident's funds.
Page 2
EXECUTIVE OFFICE OF THE PRESIDENT
OFFICE OF MANAGEMENT AND BUDGET
STANDARD
INDUSTRIAL
CLASSIFICATION
MANUAL
1987
EXHIBIT
, p
n 0 -+d
SERVICES 387
Industry
Group Industry
-Con. 805 0. No. NURSING AND PERSONAL CARE FACILITIES—Con.
8051 Skilled Nursing Care Facilities
ians are includ- Establishments primarily engaged in providing inpatient nursing and reha-
bilitative services to patients who require continuous health care, but not hos-
pital services. Care must be ordered by and under the direction of a physician. 1
The staff must include a licensed nurse on duty continuously with a minimum
ERS of one full-time registered nurse on duty during each day shift. Included are
establishments certified to deliver skilled nursing care under the Medicare
and Medicaid programs.
of D.C. and en- Convalescent homes with continuous Mental retardation hospitals
ts operating nursing care Nursing homes,skilled
g as Extended care facilities .
8052 Intermediate Care Facilities
-actors
Establishments primarily engaged in providing inpatient nursing and reha-
bilitative services, but not on a continuous basis. Staffing must include 24-
of O.D. and en- hour per day personnel with a licensed nurse on duty full-time during each
as clinics of op- day shift. At least once a week, consultation from a registered nurse on the
delivery of care is required. Included are facilities certified to deliver interme-
diate care under the Medicaid program.
Intermediate care facilities Nursing homes,intermediate care
of D.P. and en- 8059 Nursing and Personal Care Facilities,Not Elsewhere Classified •
clinics of podia- Establishments primarily engaged in providing some nursing and/or health-
related care to patients who do not require the degree of care and treatment
that a skilled or intermediate care facility is designed to provide. Patients in
issued these facilities, because of their mental or physical condition, require some
nursing care, including the administering of medications and treatments or
ctice of health the supervision of self-administered medications in accordance with a physi-
be licensed or cian's orders. Establishments primarily engaged in providing day-to-day per-
lishments oper- sonal care without supervision of the delivery of health services prescribed by
d, are included a physician are classified in Industry 8361.
Convalescent homes for psychiatric pa- Nursing homes except skilled and in-
ces of tients,with health care termediate care facilities
rapists,offices of Convalescent homes with health care Personal care facilities with health care
es of Domiciliary care with health care Personal care homes with health care
ts,offices of Homes for the mentally retarded with Psychiatric patient's convalescent
ants,offices of health care,except skilled and inter- homes
workers,offices of mediate care facilities Rest homes with health care
iical:offices of
except M.D.:offices of 806 HOSPITALS
,offices of
its,offices of This group includes establishments primarily engaged in providing diagnos-
tic services, extensive medical treatment including surgical services, and other
hospital services, as well as continuous nursing services. These establishments
have an organized medical staff, inpatient beds, and equipment and facilities
?roviding inpa- to provide complete health care. Convalescent homes with extended care facili-
providing ding- ties, sometimes referred to as convalescent hospitals, are classified in Industry
xd in Industry 8051.
ttal nursing or `16''
i'I
i
II
1i .V
SERVICES 395 I' I
1
Industry i
Group Industry
I
833 I 0. No. JOB TRAINING AND VOCATIONAL REHABILITATION SERVICES :
8331 Job Training and Vocational Rehabilitation Services f
ion Establishments primarily engaged in providing manpower training and vo-
cational rehabilitation and habilitation services for the unemployed, the un- i 1 ' :.
deremployed, the handicapped, and to persons who have a job market disad-
rid- vantage because of lack of education,job skill or experience. Included are up- H ii
ssi- grading and job-development services, skill training, world-of-work orientation, r 1and vocational rehabilitation counseling. This industry includes offices of ape- ' ! - !
)up cis 1ists providing rehabilitation and job counseling. Also included are estab- I!
I
lishments primarily engaged in providing work experience for rehabilitees. i Ii
Community service employment train- Sheltered workshops I 9 it
ing programs Skill training centers I f 1! t'
Job counseling Vocational rehabilitation agencies II#
Job training Vocational rehabilitation counseling i
Manpower training Vocational schoo training agencies, except I i I
Rehabilitation counseling and training, { I
vocational Work experience centers ! f
835 CHILD DAY CARE SERVICES . l i;
to- 8351 Child Day Care Services ! i i II
in-
les Establishments primarily engaged in the care of infants or children, or in " I 1 - '
ii
es providing prekindergarten education, where medical care or delinquency cor- , `k `!
to rection is not a major element. These establishments may or may not have a f
od substantial educational programs. These establishments generally care for 1 'i I
prekindergarten or preschool children, but may care for older children when 1 1 '{
they are not in school. Establishments providing babysitting services are clas- 1 I
11' sified in Industry 7299. Head Start centers operating in conjunction with ele- , j
17 mentary schools are classified in Industry 821E ,; I
� 1
on Nursery schools
Child care centers I
'al Day care centers,child Preschool centers
Group day care centers,child + 1
Head Start centers,except in conjunct 11
lion with schools t
836 RESIDENTIAL CARE 1 11
,
8361 Residential Care
Establishments primarily engaged in the provision of residential social and 1
personal care for children, the aged, and special categories of persons with , +. i
some limits on ability for self-care, but where medical care is not a major ele- I I
lid ment. Included are establishments providing 24-hour year-round care for chil- ; I 1
dren. Boarding schools providing elementary and secondary education are II j
classified in Industry 8211. Establishments primarily engaged in providing
ics nursing and health-related personal care are classified in Industry Group 805. 1
Alcoholism rehabilitation centers, resi- Homes for children, with health care t
dential:with health care incidental incidental ( '
Boys' i towns Homes for destitute men and women t
Children's boarding homes Homes for the aged, with health care
Children's homes incidental }}Homes for the deaf or blind, with 4 t
Children's villages f'
•
Drug rehabilitation centers,residential: health care incidental }
with health care incidental Homes for the emotionally disturbed, ; i
Group foster homes with health care incidental
Halfway group homes for persons with Homes for the mentally handicapped, •
social or personal problems with health care incidental 1
Halfway homes for delinquents and of- Homes for the physically handicapped, I
i fenders with health care incidental
I
I i'
7 l�
c,
396 STANDARD INDUSTRIAL CLASSIFICATION
Industry Ma
Group Industry
No. No.
836 RESIDENTIAL CARE—Con.
8361 Residential Care—Con.
Juvenile con eaional homes Rest homes,with health care incidental
Old soldiers'homes Self-help group homes for persons with
Orphanages social or personal problems
Rehabilitation centers,residential:with Training schools for delinquents This maj
health care incidental
gardens. The:
839 SOCIAL SERVICES,NOT ELSEWHERE CLASSIFIED
8399 Social Services, Not Elsewhere Classified IndusGrouptry Indus
No. No.
Establishments primarily engaged in providing social services, not else-
where classified, including establishments primarily engaged in community 841
improvement and social change. Organizations primarily engaged in soliciting 8412
contributions on their own account and administering appropriations and allo-
cating funds among other agencies engaged in social welfare services are also
included, but foundations and philanthropic trusts are classified in Finance,
Industry 6732. Civic, social, and fraternal organizations are classified in Indus-
try 8641; political organizations are classified in Industry 8651; and establish-
ments which raise funds on a contract basis are classified in Industry 7389. 842
Advocacy groups Health and welfare councils
Antipoverty boards Health systems agencies 8422
Community action agencies Regional planning organizations, for
Community chests social services
Community development groups Social change associations
Councils for social agencies,exceptional Social service information exchanges:
children,and poverty e.g.,alcoholism,drug addiction
Fundraising organizations,except on a United fund councils
contract or fee basis