Admission Checklist

We know paperwork is not easy. That’s why we’ve created an easy to use checklist to make sure you’ve got everything you need to get your loved one’s application started. The best place to start is gathering the necessary documentation listed in ‘Things You’ll Need’ followed by downloading the applications paperwork in  ‘Application Stage 1’. Feel free to get in touch if you have any questions.

Things You’ll Need

  • Birth Certificate
  • Social Security Card
  • Picture ID (drivers license, passport, etc.)
  • Medically Indigent Program (MIP) Card and Eligibility Notice (Medicaid or HMO)
  • Power of Attorney (if any)

Application Stage 1

  • Application for Admission                                                                                  Download
  • Pre-Admission Medical Report                                                                       Download
  • Physical Examination (requires chest x-ray within 3 months)        Download
  • Medical History                                                                                                       Download
  • Physician’s Orders                                                                                                Download
  • Resident Knowledge of Diagnosis                                                                Download
  • Do Not Resuscitate (DNR) Request                                                            Download

That’s all you need to do to get the process started!     Once all forms are completed give us a call to set up an appointment to review them together. Any additional forms and information will be provided at that time.