Documents Needed for Admission

Below are documents required for admission to a skilled nursing facility.
Patient admission would be pending facility review of the patient’s clinical needs and financial resource approval.

Documents Needed for Admission

Requirement and Details

Level 1 - Click here for fillable form

State Required Document, click for external link to document

DMA-6 - Click here for fillable form

State Required Document, click for external link to document

Facesheet

Patient information and Financial Information


History and Physical

Must be a current history and physical completed by a physician within the last 30 days


Physician Orders

Orders to include services needed i.e. Therapy (OT,PT, ST), long term care placement

Medication Orders

Listing of all current medications, dosages and times including any specific instructions

*Please alert facility staff if resident has been in the hospital within the last 30 days.

**All documents noted above should be faxed to facility representative at 478.453.8514

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