Physicians Resource
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
- Level 1 - Click here for fillable form
- DMA-6 - Click here for fillable form
- Facesheet
- History and Physical
- Physician Orders
- Medication Orders
Requirement and Details
- State Required Document, click for external link to document
- State Required Document, click for external link to document
- Patient information and Financial Information
- Must be a current history and physical completed by a physician within the last 30 days
- Orders to include services needed i.e. Therapy (OT,PT, ST), long term care placement
- 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 912.356.0104
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