Admission

Dear Family Member / Prospective Resident:
In order to facilitate each resident’s admission to Sacred Heart Home, Inc. and to comply with federal and state regulations, it is requested that the following paperwork be completed and returned prior to admission:

 Printable Application for Admission

 Social security and picture identification card (front and back)
 All insurance cards (front and back)
 Last 3 bank statements from all accounts with perspective resident’s name
 Last 5 years bank statements if applying of Medicaid
 Medical Information which includes the following:
1. Current medical diagnosis and treatment
2. Previous medical history, if available
3. EKG/chest x-ray, labs
4. Attending physicians name, address and phone numbers
5. Current Medications
6. Immunization record
7. Current Diet
8. Doctors/Nurses notes
Please supply copy of the resident’s advanced directives such as Durable Power of Attorney for Financial, Health Care and/or Living Will, so that we may know the resident’s wishes concerning financial and medical treatment should she/he become unable to communicate those wishes. We strongly encourage each resident to have Advance Directives in place.
Each application for admission will be considered on an individual basis, taking into consideration the behavior and physical condition, her/his comprehensive treatment needs and the ability of Sacred Heart Home to provide for those needs without jeopardizing the safety of the prospective resident or that of the current residents.
Please feel free to call Sister Donna in Admissions with any further questions you may have concerning the admission process at (301) 277-6500.