Physicians Resource

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

Level 1 – Click here for fillable form


DMA-6 – Click here for fillable form




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 706.554.6163

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