Admission Requirements

• History and Physical exam (no more than 5 days old)
• Physician’s orders for admission to Holy Cross Care and Rehabilitation Center
• Results of a chest x-ray (no more than 90 days old)
• Health insurance cards (Medicare, Medicaid, Blue Cross etc.)
• Social Security card
• Durable Powers of Attorney for Healthcare, Guardianship, Conservator, Health Care Surrogate (Not required)

A resident cannot be admitted from home without all necessary medical forms. To assure a current History and Physical, an appointment with the patient’s attending physician may be required.

Holy Cross Care and Rehabilitation Center does not discriminate on the basis of age, disability, race, color, national origin, ancestry, religion, sex or source of payment.

Admission Forms

These forms require Adobe Acrobat Reader

• Application for Admission
• Application for Long-term Care Services
• Identification Evaluation Criteria Certification by Physician for Long-term Care Services
• Physician Certification for Long-term Care Services
• Patient Advocate Form