We are thrilled that you are considering Congregational Home
for your needs! Here is how the admission process works.

PLEASE NOTE: If you will be admitting for a SHORT-TERM rehab stay from a HOSPITAL setting and you will be covered by INSURANCE, there is NO NEED to submit a Financial Statement or Application for Admission.

1^st Prior to admission, submit a Financial Statement and Application for Admission for any of the following:

A.  If you will be admitting for Long-Term Residency
       (Admitting for Skilled Nursing Home, Assisted Living or Independent Living)

B.  If you will be admitting from a Non-Hospital setting
       (Admitting from Home or other Rehab, Skilled Nursing Home, Assisted Living or Independent Living Facility)

C.  If you will be Private Pay at any point during your stay

PLEASE NOTE:  If you will be admitting from a HOSPITAL setting, there is NO NEED for you to do anything below.  The hospital will take care of all these requirements for you; they will send us the medical records we need to first assess & then admit.

2^nd Medical Records & Assessments

If you will be admitting from a NON-HOSPITAL setting, i.e. from Home or other Rehab, Skilled Nursing Home, Assisted Living or Independent Living Facility, the following needs to take place:

A.  Order Existing Medical Records: We order specific medical records from your physician(s) and/or the healthcare facility you are currently in so we may do a medical needs assessment

B.  In-Person Assessment: For ASSISTED LIVING admissions only, we set up an in-person assessment with you and our nurse and/or social worker to confirm needs & expectations

C.  Set Admission Date: Together we set an admission date

D.  Update Medical Records: Once we’ve set an admission date, you get specific medical records updated by having your community physician or current healthcare facility physician complete, sign & date the appropriate Congregational Home form or packet (See Below) within a specific number of days prior to your admission here; this is required by government regulations. You will need to make an appointment with your physician to do this. The completed, signed & dated form / packet must be faxed or emailed to our Admissions Department at least one business day prior to your admission here so that we may review it & make sure we have everything we need.

INDEPENDENT LIVING ADMISSION:

Free From Communicable Disease Statement This form must be completed, signed & dated by your physician or nurse practitioner within 30 days prior to your admission here.  (Your physician or NP may require a chest X-Ray for this)

ASSISTED LIVING ADMISSION:

Admission Medical Summary (AMS) for ALF This packet must be completed, signed & dated by your physician or nurse practitioner within 30 days prior to your admission here.  This packet requires the following information:

• History & Physical

• List of Current Medications & Treatments

• Original, Hardcopy Prescriptions for Controlled Substances Level 2 – 5

• Free From Communicable Disease Statement
  (Your physician or NP may require a chest X-Ray for this)

• If Applicable: Order to Eval & Treat for Therapy (PT / OT / ST)

• If Applicable: Order for Hospice

SKILLED NURSING HOME or SHORT-TERM REHAB ADMISSION:

Admission Medical Summary (AMS) for SNF This packet must be completed, signed & dated by your PHYSICIAN within 5 days prior to your admission here (A physician must sign; a  nurse practitioner can’t sign this packet).  This packet requires the following information:

• History & Physical

• List of Current Medications & Treatments

• Original, Hardcopy Prescriptions for Controlled Substances Level 2 – 5

• Free From Communicable Disease Statement
  (Your physician may require a chest X-Ray for this)

• Order to Admit to Skilled Nursing Facility

• If Applicable: Order to Eval & Treat for Therapy (PT / OT / ST)

• If Applicable: Order for Hospice

• If Applicable: Healthcare Power of Attorney

• If Applicable: Activation Form for Healthcare Power of Attorney
  (Activation Form is a Mental Incapacitation Form Signed by 2 Doctors)