Contents
(Click below to display each section)

VISITING HOURS
BED RETENTION POLICY - BED, ROOM AND UNIT CHANGE POLICY
DISCHARGE/TRANSFER NOTICE – FAIR HEARING
THERAPEUTIC LEAVE POLICY
CLINIC VISITS
PERSONAL POSSESSIONS
CLOTHING AND LAUNDRY
OVERNIGHT ACCOMMODATIONS
AN IMPORTANT ANNOUNCEMENT REGARDING AMBULETTES AND AMBULANCES
RULES ABOUT TOYS AND BALLOONS
RULES ABOUT FOOD
SMOKING POLICY
ADVANCE DIRECTIVES
DO NOT RESUSCITATE
VACCINE ADMINISTRATION POLICY
OPPORTUNITY FOR IMPROVEMENT
PASTORAL CARE SERVICES

VISITING HOURS

For your child’s protection and security, all visitors MUST sign in and out at the reception.

1. Visiting hours are 10:00 a.m. to 8:00 p.m.

2. Visiting is limited to a reasonable number of people for each child. Only visitors approved by the family/legal representative are allowed to visit.

3. Visitors under 12 years of age must be supervised by an adult at all times.

4. Visits should take place in your child’s room. If your child is medically stable and is able to leave the unit, visits may also take place outdoors, weather permitting. Please ask the nurse if your child may leave the unit.

5. Children who are attending school should be visited during non-school hours.

6. If your child is on a restricted diet, please speak with Dietitian prior to bringing food. Foods brought from outside must be labeled with your child’s name, dated and stored in the Nutritional Services Department.

Telephone Inquiries

1. Family members may telephone the Nursing Unit to ask the nurse about your child. Please ask the Nurse what time is best to call. You may also use these phones to speak to your child.

Children’s Unit West (CUW) – 718-281-8720
Children’s Unit North (CUN) – 718-281-8930
Toddler Unit – 718-281-8740
Nursery – 718-281-8730
Traumatic Brain Injury Unit (TBI) – 718-281-8710

You may also contact your child’s doctor or nurse practitioner at these numbers.

2. We encourage you to call prior to 9:00 p.m., while they are awake. Interruptions in your child’s structured daily program such as school therapy and mealtimes are not recommended.

3. Your child’s social worker will be introduced to you on the day of admission. He/She will provide you with his/her phone numbers.

4. The main facility phone number is 718-281-8800.

ST. MARY'S FOLLOWS THE NEW YORK STATE BED RETENTION POLICY GUIDELINES :

When a child has been at St. Mary’s at least 30 days, his/her bed will be held if he/she is transferred to an acute care hospital.
The bed will be held for up to 20 days, he/she will be discharged from St. Mary’s if the child is ready to leave the acute care Hospital, he/she will be readmitted to the first available bed if he/she still requires the services provided by St. Mary’s.
The bed will also be held if the child goes on therapeutic leave (overnight visits in the community) for a total of 8 nights per month plus July 4, Thanksgiving Day, Christmas Day and New Years Eve.

Bed, Room and Unit Changes:

During you child’s stay at St. Mary’s it may be necessary to change his/her bed, room and/or unit. The decision will be based on your child’s developmental, social or medical needs upon request from you or your child in an emergency situation. You will be notified in advance of the change. Please be assured that every effort will be made to ensure that your child’s transition will be as smooth as possible.

DISCHARGE/TRANSFER NOTICE – FAIR HEARING

Discharge or transfer planning is an ongoing process, which begins when your child is admitted. The decision to discharge or transfer is made by the interdisciplinary team, which includes the family/guardian, your child (to the extent possible), and involved staff. The goal is to develop a mutually agreed upon plan which includes the necessary services and supports. The discharge or transfer date is established by the team when:

1) Your child’s health has improved to the point that the services provided by St. Mary’s are no longer needed or;

2) It is necessary for your child’s welfare and your child’s needs cannot be met at St. Mary’s or;

3) The health or safety or others would be endangered and alternatives to discharge or transfer have not succeeded or;

4) The family/guardian requests discharge or transfer and your child’s health and/or safety would not be endangered.

5) Your child is reaching his/her 18th birthday and St. Mary’s is no longer able to meet the medical and psychosocial needs of a young adult.

In addition, a discharge or transfer is permissible when there is a failure by the resident, family, Medicaid or third party insurer, after reasonable and appropriate notice, to pay.

If your child and/or family/legal representative disagree with the discharge or transfer, you have the right to request a Fair Hearing to appeal the decision by contacting the New York State Department of Health, Human Resource Administration, Medical Assistance Program, 330 West 34th Street, NY, NY 10001. You can call 718-557-1399 or call toll-free at 1-877-472-8411.

Before a discharge or transfer – The appeal must be filed within 15 days of receipt of the notice of discharge or transfer. Your child may remain at St. Mary’s pending an appeal determination unless the health or safety of others would be endangered or your child’s urgent medical needs require an immediate transfer or discharge.

Following a discharge or transfer – The appeal must be filed within 30 days following a discharge or transfer. Your child will be readmitted to St. Mary’s upon the appropriate availability of a bed if the hearing officer recommends readmission.

For additional assistance, the family/legal representative may also contact the State Office of Aging, Ombudsman Program, Empire State Plaza, Albany, New York 12223, Telephone Number 1-800-342-9871, or for those residents diagnosed with a mental illness or a developmental disability, may call the Commission on Quality of Care and Advocacy for Persons with Disabilities, 1-800-522-4369, 1 Empire State Plaza, Suite 1001, Albany, New York, 12223-1150.

THERAPEUTIC LEAVE POLICY

In an effort to provide Family Centered Care to patients/residents and families, St. Mary’s has a therapeutic leave policy that allows parents, legal representative and/or significant others to take their child off premise. Prior authorization from your medical insurance is required before a day pass is allowed. These passes are designed to promote ongoing family involvement with the child during his/her in-patient stay at St. Mary’s.

During the first 30 days of admission, a family may request day passes only. In order to do this please:

1. Notify the Social Worker on the Unit that you are interested in a day pass, at least 2 days in advance.

2. Have the necessary training to care for your child at home (i.e. CPR, suctioning, medication administration).

3. If Child Welfare Administration is involved with your family, authorization for the visit must be obtained from them by your social worker.

ON THE DAY OF THE PASS PLEASE:

1. Call the nursing unit before picking up your child to make sure that he/she is medically able to leave.

2. Sign the child out of the unit and pick up the needed medications and equipment.
WHEN RETURNING YOUR CHILD TO THE UNIT PLEASE:

1. Sign the child back the unit by 8:00 p.m.

2. Return medication and equipment.

After you child has been at St. Mary’s for 30 days or more, he/she becomes eligible for overnight passes (therapeutic leaves) if approved by your insurance. This means that your child can go home with you for 48 hours, for a total of 8 nights every month (these are Medicaid regulations).

IN ORDER TO OBTAIN ON OVERNIGHT/WEEKEND PASS PLEASE:

1. Notify the Social Work Department that you are interested in an overnight/weekend pass by noon on Tuesday before the weekend visit. We must know by this time in order to make sure medications and other arrangements are in order. Please let us know what time you will pick up and return your child.

2. Have the necessary training to care for your child.

3. If Child Welfare Administration is involved with your family, authorization for the pass must be obtained by your social worker.

ON THE DAY THE PASS BEGINS PLEASE:

1. Call the nursing unit to make sure that your child is medically able to leave.

2. Pick up your child on time; sign your child out of the unit and pick up medications.

3. Let the nursing unit and the social worker know if you will be late or if there are any other changes in your plans.

WHEN RETURNING YOUR CHILD TO THE UNIT PLEASE:

1. Sign your child back in the unit by 7:30 p.m.

2. Return the medication box.

If your child uses the 8 nights before the end of the month, you will be notified by the social worker and your child will not be able to go home overnight for the remainder of the month.

CLINIC VISITS

While with us at St. Mary’s, your child may still need to receive specialized care from the physicians at the hospital that referred you to us or at another hospital or clinic.

It is very important that you participate in this care by being available to escort your child to these scheduled appointments.
Accompanying your child gives you the opportunity to discuss your child’s treatment with the pediatric primary care provider. It’s your right and responsibility as a parent to keep fully informed about those aspects of your child’s care that extend beyond St. Mary’s Healthcare System for Children. Your child will be much more comfortable during these visits if you are there to provide your loving support
The unit coordinator at St. Mary’s will make every effort to schedule these appointments at times that are convenient for you. However, some hospital clinics meet only for morning or afternoon sessions and only during specific days of the week.
Transportation between St. Mary’s and the clinic is provided for your child. If you will be late or otherwise unable to maintain an appointment, we must be notified in advance.

PERSONAL POSSESSIONS

It is strongly recommended that your child brings only those personal possessions most important for his/her stay at St. Mary’s. Resident’s need enough clothing and accessories to last for about a week. St. Mary’s prefers residents not bring valuable personal possessions into the facility. This includes electronic devices such as stereos, hand held video games and cell phones. Those items are best kept, and enjoyed, at home. Small personal radios are allowed in residents rooms. Television sets and electronic toys such as Nintendo are not allowed in the resident rooms, unless it is part of the individualized care plan. Irons, curling irons and similar devices are only allowed under the direct staff supervision. St. Mary’s cannot be responsible to repair or replace any damaged or lost personal items brought into the facility.

All personal possessions should be pre-labeled at home with the residents full name; otherwise they will be label by St. Mary’s upon admission. All personal possessions will be inventoried on an individual log which is kept in the resident’s chart. It is the parent/residents responsibility to inform nursing of any new personal items brought into the facility - all items must be labeled and entered on the possessions log.

CLOTHING AND LAUNDRY

St. Mary’s encourages family members to take an active part in their child’s life while at St. Mary’s. As part of our family-centered care approach, it is our policy that family is responsible for supplying the appropriate clothing for their child.

CLOTHING:

1. The list below outlines what St. Mary’s recommends for clothing selections and quantities.

Outfits (including pants/shirts/dresses/jeans/sweatpants/shorts) – 7 total
Pajamas or Nightgowns – 7 total
Underwear (bras/cotton briefs/boxers/panties/undershirts) – 10 total
Socks – 10 total
Sweatshirts/Sweaters – 3 total
Jacket/Coat – 1 total
Hat/Gloves/Scarf - 1 total
Robe – 1 total
Footwear (shoes/sneakers/slippers) – 2 total
Belt – 1 total
Anything else that the family or St. Mary’s feels is appropriate depending on the child’s age, medical needs or season.

2. Please give the child’s clothing to a nurse on the unit so that it can be brought down to the Facilities Management Department for proper labeling.

3. Please check the child drawers regularly. There is a chance that eventually the child may grow out of his/her clothes or that they may simply get worn out. If this is noticed it is requested the wardrobe is replenished by the family. The assigned Social Worker will be in contact with the family if a staff member observes this.

4. If the family notices that a piece of clothing has been lost or misplaced it should be brought to the Social Workers attention so that the inquiry/misappropriation process is initiated.

5. The Social Workers/Nurses will remind families on a regular basis that clothing brought home with the child for the weekend, must be returned to St. Mary’s and labeled appropriately.

LAUNDRY:

1. Families at St. Mary’s are given the choice of whether they would prefer their child’s clothing to be washed on site or be laundered at home.

2. Clothing should be colorful, attractive and colorfast. Be careful of clothing with decorative trimmings.

3. Bring clothing that is permanent press/wash and wear. Don’t bring clothing like Rayons, Silks, Wools, Nylons and other fabrics that require dry cleaning or special care.

4. Your care label should say things like:

Machine Wash, Tumble Dry Low
Machine Wash, Warm Water, Tumble Dry Low
Machine Wash, Tumble Dry Medium

5. If families wish to launder their child’s clothing at home it is their responsibility to notify the unit staff. The clothing must be brought home and laundered by the family at least on a weekly basis.

OVERNIGHT ACCOMMODATIONS

St. Mary’s understands that you may, on occasion, have a need to spend the night in one of our overnight rooms. Because space is very limited, it is necessary for us to develop the following guidelines, which we ask you to follow:

1. We have two overnight rooms available on a first come first served basis. Arrangements for the use of these rooms must be in advance through either your primary Social Worker or the Social Work office. The general number for the Social Work office is ext. 8811.

2. While it is policy for only one family member to stay in the lounge, two parents will be allowed to use the room together at the discretion of the Nursing and/or Social Work Department(s). Children are not permitted under any circumstances even when accompanied by an adult.

3. As a health care facility, our first priority is the medical needs of the children. Families who need the overnight room either because their child is extremely ill or that they will be escorting their children to a clinic appointment the next morning will receive first consideration.

4. It may be necessary for us to cancel your overnight stay if another family needs to stay for either one of the above purposes. In addition, we reserve the right to cancel overnights for any other extenuating circumstances. When possible, we will give you as much notice as possible prior to canceling your arrangements. We ask for your understanding and cooperation.

5. Smoking is not permitted in any area of the building. If smoking occurs or if we find evidence of smoking, you will be asked to leave.

6. You are welcome to eat in our cafeterias for $2 a meal. Mealtimes are:

Breakfast: 6:30 a.m. – 7:15 p.m.
Lunch: 12:00 noon – 1:15 p.m.
Dinner: 6:00 p.m. – 7:20 p.m.

If you prefer, you are welcome to join your child during meal times. Vending machines are available on the ground floor if you would like to purchase soda, juice or candy. If your child is on a special diet, please help them maintain that diet. Please do not offer food to any other children.

7. Eating is not permitted in any of the overnight rooms.

8. We will provide clean linen and towels for your use. Please bring your own soap, toothpaste and toothbrush, shampoo, and any other personal items you will need. The evening Nursing Supervisor will supply you with linen and towels after 8:00pm when regular visiting hours are over.

9. You will have the use of the overnight rooms beginning at 8:00 p.m. We ask that you vacate the room by 8:00 a.m. the next morning. Staff will need access to the rooms for cleaning. Rooms must be accessible throughout the business day as they are used for other functions within the facility.

10. Showering is permitted in the 1st floor Lounge only. For those staying bedside or in the 2nd floor Lounge, access is available 8:00am-11:30am; 5:00pm-8:00pm. Please do not use the shower in your child’s room or on the unit.

11. Remember we are here to assist you and your child. If you have any questions or concerns please bring them to a staff members attention. Thank you.

We hope that your overnight stay will be a comfortable experience.

AN IMPORTANT ANNOUNCEMENT REGARDING AMBULETTES AND AMBULANCES

IN THE EVENT THAT WE ARE ARRANGING TRANSPORTATION FOR YOUR CHILD, WE NEED YOUR COOPERATION WITH THE FOLLOWING PROCEDURES:

1. Please arrive on time. If you are not present on hour before your scheduled pick-up time, the trip will be cancelled and clinic appointments will be rescheduled to another day.

2. If you are running late, please call your child’s unit. We will try to make changes, but cannot make guarantees.

3. If you know you cannot keep the appointment, let us know in advance and we will cancel transportation and reschedule the appointment.

Ambulette companies will only transport one child and one adult. Please plan accordingly.

A GREAT DEAL OF TIME, EFFORT AND RESOURCES GO INTO COORDINATING THE TRANSPORTATION AND CLINIC NEEDS OF OUR CHILDREN. THE ABOVE STEPS ARE NECESSARY IN ORDER FOR US TO MAINTAIN POSITIVE RELATIONSHIPS AND TO CONTINUE TO PROVIDE YOU AND YOUR CHILD WITH THESE SERVICES.

RULES ABOUT TOYS AND BALLOONS

To protect all of the children from infection and from potential harm, and to meet Federal regulation, St. Mary’s has developed guidelines regarding toys and balloons:

1. Toys brought to St. Mary’s should be made of plastic, wood or washable cloth and should have a smooth surface.

2. Toys should be large enough so that there is no danger that they can be swallowed.

3. Please do not bring more than four toys at a time; our staff will be able to recommend toys that will aid in your child’s development.

4. When you bring a toy, let the staff from the Department of Child and Adolescent Services know and they will mark it with your child’s name.

5. Balloons of any kind are not allowed in any patient area.

RULES ABOUT FOOD

The following list of foods is unacceptable for toddlers and all children with tracheotomies:

Raisins
Peanuts
Popcorn
Prunes
Olives
Kernel corn
Pretzel nuggets
Grapes (ONLY to be given at the discretion of the Nursing Staff)
Hot dog (ONLY to be given by Nutritional Services or Nursing when cut lengthwise, and cut up into small pieces).

SMOKING POLICY

St. Mary’s is dedicated to providing a healthy and comfortable environment for the children, families, and staff.

Therefore, smoking is strictly prohibited within all public and private areas of our facility, including surrounding buildings.

Smoking is permitted only in the designated area. If you smoke, place your cigarette butts in the receptacles provided; do not throw them on the ground.

Thank you for your cooperation and understanding in this matter. Let’s work together to keep St. Mary’s smoke-free and healthy for all.

ADVANCE DIRECTIVES

It is the policy of St. Mary’s to provide the patient/resident and families with information on advance directives to help make end-of-life decisions, if it should be necessary. Patients/residents and families are provided the opportunity to make their health care wishes known and designate a health care agent to make treatment decisions on their behalf when they are unable to decide for themselves. For the minor patient/resident, the parent/guardian or court appointed agent will be designated as the patient’s/resident’s authorized representative.

The patient’s/resident’s or authorized representative’s wishes in this matter will be reviewed annually or when there is significant change in the patient’s/resident’s condition. Enclosed in this handbook is the New York State Proxy Law booklet. If you have questions regarding end-of-life decisions for your child, please speak to your child’s physician or nurse practitioner.

DO NOT RESUSCITATE (DNR)

The State of New York has passed a law, which allows you to request, under certain circumstances, that we not resuscitate your child if he/she should suffer a cardiac or respiratory arrest. This law is known as the Do Not Resuscitate (DNR) Law. If your child meets the requirements and you request such an order, it must be written in the chart by the Physician.

A brochure describing this law and your rights under the law has been written by the New York State Department of Health and is enclosed in this handbook.

If you have any questions about this law and your rights under the law, please contact your Social Worker or your child’s Physician here at St. Mary’s Hospital for Children and we will be happy to discuss your request.

VACCINE ADMINISTRATION POLICY

This is to inform you that St. Mary’s will administer immunizations as needed to your child while he/she is at our facility. It is important that your child’s immunizations are up to date as we are now seeing and increased incidence of some of the childhood diseases that can be quite serious.

In this handbook is information about DPT, Polio, and Measles, Mumps, Rubella (MMR), Chicken pox, Hepatitis B, HIB (hemophilus influenza) Rotavirus vaccines. Please read this information to be aware of the risks of the childhood illnesses as well as any possible adverse effects the immunization might have on your child.

If you have any questions about these immunizations, please contact the physician/nurse practitioner who is caring for your child and let him know if you are interested or concerned. If you do not contact us, the immunizations will be given according to a schedule developed by the New York State Department of Health, which is attached.

You will be asked to give your consent for all medical care including administering these routine childhood immunizations in the Admission Agreement Provisions that you sign today.

Thank you for your cooperation in helping to get all of our children vaccinated appropriately.

OPPORTUNITY FOR IMPROVEMENT

St. Mary’s, in keeping with the philosophy of Family Centered Care (and in accordance with New York State Department of Health Regulations), welcomes suggestions, concerns and/or complaints from residents and family or legal representatives.

When you have a suggestion, concern or complaint, you should bring it to the attention of the supervisor, manager or director of the department, which has responsibility for the area of the concern. The name of the appropriate person is available from any staff person or from the Social Work department. You may do this in person or in writing. Forms are available from the Social Worker.

The supervisor or manager of Social Work will also be informed of the concern. The concern will be reviewed and you will be given a verbal or written response within ten working days. Resolution of the concern may take longer depending on the nature of the concern or complaint.

You do not have to use your name to make a suggestion, concern and/or complaint. Your suggestion, concern or complaint will be reviewed and appropriate action will be taken. Please keep in mind that if we do not have your name we will not be able to give you a direct response.

PASTORAL CARE SERVICES

Sometimes, more than just good medicine is needed. St. Mary’s Pastoral Care department provides compassionate as well as spiritual support to assist you in coping with your child’s illness.

The Pastoral Care Department serves all St. Mary’s resident’s and their families by:

Providing interfaith pastoral care and/or clergy from your own faith group.
Supporting the spiritual needs of patients and their families as they cope with illness.
Serving your specific spiritual desires for prayer and ritual.
Helping patients and their families to find spiritual comfort.
Addressing the emotional and spiritual concerns of all, even if you do not consider yourself to be religious.

The Chapel of the Holy Child is always open for prayer and meditation. It is located on the main floor next to the reception desk. It is peaceful and we encourage you to use it at anytime. Your loved ones and/or special intentions can be remembered in prayer by writing their names or intentions on the prayer lists by the votive candles in the chapel. These names and intentions are commemorated daily and at our community service on Sundays at 12:30. All are welcome! Holy Day services are conducted, as announced, at various times during the year.

Due to the Generous financial contribution of the Geduld family of New York City, St Mary’s has opened a Prayer and Meditation Room. The purpose of this new “chapel” is to provide a non-denominational approach for those families of different faith traditions whose children are hospitalized at St. Mary’s. It is located on the lower level and it’s designed with comfortable furniture, artwork, appropriate musical selections and with a wonderful view of our Cloister Garden. It provides a contemplative setting to stimulate spiritual and emotional comfort.

There are pamphlets at the main reception desk in the hospital’s lobby that address a wide range of concerns for you and your child. Please feel free to take them and share them with members of your family.

St. Mary’s is a community of caring. You and your child are not alone with your concerns and worries. Let us share them with you. You can reach Michael Maroutsis, Pastoral Care Director at (718) 281-8852.