admission paperwork for nursing home

Nursing Home Admission Checklist

Learn the ins and outs of this comprehensive tool and guide for effective and well-informed transitioning into a nursing home setting.

By Harriet Murray on Jul 15, 2024.

Fact Checked by Ericka Pingol.

What is a Nursing Home Admission Checklist?

A Nursing Home Admissions Checklist is a comprehensive tool used by individuals, families, and healthcare professionals to ensure a smooth and well-informed transition when admitting a loved one or a patient to a nursing home facility. This checklist serves as a guide, detailing essential factors and considerations that need attention before, during, and after admission. 

Nursing home admission checklists typically cover a wide range of crucial aspects, including medical, social, financial, and emotional considerations. For instance, it may include items such as medical history documentation, medication management, personal care needs assessment, insurance coverage verification, legal paperwork review, and discussions about the resident's preferences and expectations.

The checklist offers several valuable benefits in the nursing home admission process. Firstly, it is a comprehensive framework that helps individuals and families organize and gather necessary documents and information. It ensures xdno critical details are overlooked, facilitating a smoother and more efficient admission process. Instigating the use of this checklist promotes informed decision-making. 

By outlining various aspects to consider, such as medical needs, facility amenities, staff-to-resident ratios, and available services. The checklist assists in evaluating different nursing home options, which in turn aids families and caregivers in choosing a facility that best aligns with the resident's needs and preferences.

The checklist fosters communication and collaboration among healthcare professionals, families, and the nursing home staff. It encourages discussions about the resident's care plan, expectations, and any specific requirements, ensuring that everyone involved is on the same page regarding the resident's care and well-being. 

This checklist also serves as a reference tool beyond the admission phase. It remains a valuable resource for ongoing care planning, helping families and staff stay organized and attentive to the resident's evolving needs throughout their stay in the nursing home.

Nursing Home Admission Checklist Template

Nursing home admission checklist example.

How does it work?

The admissions process for a nursing home can be lengthy and requires thorough detail to ensure all aspects of care are discussed and can be met by both the facility and the individual. Below are the steps involved to create a viable Nursing Home Admissions Checklist:

Step one: Gather your resources

Admissions checklists for nursing homes are a valuable resource and essential to keep on hand. Make sure that you have a copy of the free printable PDF when the need arises by either clicking the “Download Template” or “Use Template” button or by searching “Nursing home Admissions Checklist” on Carepatron’s template library’s search bar on the website or app.

Step two: Gather information

Begin by collecting information about the resident/patient. This includes their medical history, current medications, care needs, preferences, and any legal or financial documents relevant to their care.

Step three: Identify key categories

Outline the different categories or sections that need consideration in the checklist. This often includes medical information, personal care needs, legal and financial aspects, facility amenities, and resident preferences.

Step four: Consult resources

Utilize resources such as nursing home admission guidelines, healthcare facility checklists, and regulatory requirements to ensure the checklist encompasses all essential areas.

Step five: Medical assessment

Include items related to the resident's medical needs. This involves details about medical conditions, allergies, required medications, and any treatments or therapies the resident requires.

Step six: Personal care needs

Document the resident's daily living requirements, such as bathing, dressing, mobility assistance, dietary needs, and any specific care instructions.

Step seven: Legal and financial documentation

Include a section for legal paperwork, insurance coverage verification, financial considerations, and advance directives, ensuring all necessary legal documents are in place.

Step eight: Facility assessment

Evaluate the nursing home facility against specific criteria. Consider factors like staff-to-resident ratio, available services (rehabilitation, social activities), safety measures, cleanliness, and overall quality of care

Step nine: Resident preferences

Incorporate questions or items that inquire about the resident's preferences regarding activities, meal choices, social interactions, religious considerations, and any specific requests they might have.

Step ten: Review and revision

After creating a draft, review the checklist to ensure it covers all necessary aspects. Seek input from healthcare professionals, family members, and the nursing home staff to refine and enhance the checklist.

Step eleven: Finalize and distribute

Once the checklist is comprehensive and inclusive, finalize the document. Share copies with involved parties, including family members, healthcare providers, and the nursing home staff, to ensure everyone is informed and prepared.

When would you use this template?

Nursing home admission checklists are used at various stages of the admissions process:

Pre-admission planning

Families and healthcare professionals use these checklists when considering different nursing home options during the initial planning phase. They help evaluate facilities, assess their services, and compare them based on the resident's specific needs.

Admission procedures

When the decision is made to admit a loved one or patient to a nursing home, the checklist guides the gathering of essential documents, medical information, legal paperwork, and personal preferences needed for admission.

Facility tours and evaluations

During visits to potential nursing homes, the checklist is a reference tool to assess the facility's amenities, staff-to-resident ratio, safety measures, and overall suitability for the resident's needs.

Communication and coordination

Healthcare professionals, families, and nursing home staff use the checklist to communicate effectively. It ensures that everyone involved is aware of the resident's medical history, care needs, preferences, and any specific requirements.

Ongoing care pllanning

Even after admission, the checklist remains valuable for ongoing care planning. It serves as a reference to ensure the resident's evolving needs, preferences, and care plans are continuously reviewed and updated.

Regulatory compliance

Nursing homes may use standardized admission checklists to ensure compliance with regulatory requirements and to maintain documentation of the admission process for legal and regulatory purposes.

What do the results mean?

The results of a nursing home admissions checklist offer a comprehensive overview and assessment of various critical factors related to the admission process. They represent a thorough evaluation of the nursing home facility, the resident's needs, and the alignment between the two. These results hold significant implications for the well-being and quality of care provided to the residents entering the facility.

The checklist results signify the suitability of the nursing home facility for accommodating the resident's specific needs. They encompass an evaluation of the facility's amenities, staff capabilities, safety measures, available services, and overall environment. 

Positive results indicate that the facility meets or exceeds the necessary standards to provide adequate care and support tailored to the resident's requirements. These results also serve as a snapshot of the facility's adherence to regulatory and quality standards. 

A thorough checklist assessment ensures that the facility complies with legal and regulatory requirements, ensuring that the resident's rights are protected and that the facility operates within established safety, care, and services guidelines.

Additionally, the results of the checklist provide insights into the resident's individual needs and preferences. They document specific care requirements, medical history, dietary needs, mobility assistance, personal care preferences, and other crucial aspects. This information is vital for the nursing home staff to create a personalized care plan that addresses the resident's unique needs, ensuring a comfortable and supportive environment.

The results of this particular checklist facilitate informed decision-making for families and healthcare professionals. They help in choosing the most suitable nursing home that aligns with the resident's needs, preferences, and overall well-being. Positive checklist results can reassure families, indicating that the chosen facility can provide the necessary level of care and support.

These results serve as a starting point for ongoing care planning within the facility. They form the basis for developing a comprehensive care plan that adapts to the resident's evolving needs, ensuring that the care provided remains tailored and effective throughout their stay.

Research & evidence

In recent times, as global life expectancy continues to rise, the proportion of elderly individuals is rapidly increasing (World Health Organization, 2022). Typically, when seniors face health conditions that limit their daily activities, they initially receive care at home. However, when these limitations significantly disrupt their caregivers’ lives, many elderly individuals are often relocated to nursing homes (Butcher et al., 2001). 

While some may prefer spending their final days in their familiar home environments, placing loved ones in nursing homes can alleviate the burden on family caregivers, although it often comes with feelings of guilt (Ryan & Scullion, 2000). An admissions checklist can help alleviate this guilt by ensuring needs can be met by a facility and also assist in helping a caregiver who may be apprehensive about looking into institutional care to see that the loved ones' issues can be managed more confidently out of the home, for example, daily cares with a hoist and larger staff ratios may increase the quality of life. 

Despite not being inherently negative, geriatric researchers and caregivers are extensively studying factors associated with nursing home admissions. Studies are exploring the risks related to various aspects, such as gender, whereby women are more inclined to enter nursing homes (Gaugler et al., 2005), and higher caregiver workload often leads to care recipients being admitted (Chenier, 1997). 

In terms of financial status, lower caregiver incomes correlate with higher admission rates (Yaffe, 2002). The likelihood of admission for patients with cognitive decline increases as ability decreases, and distressing side effects such as weight loss can also trigger the need for admission (Harboun et al., 2008). By utilizing a Nursing Home Admissions Checklist, personal preference and assurance around care delivery can be gained, and empowerment can be placed within the family and patients' hands. 

Butcher, H. K., Holkup, P. A., Park, M., & Maas, M. (2001). Thematic analysis of the experience of making a decision to place a family member with Alzheimer’s disease in a special care unit. Research in Nursing & Health, 24(6), 470–480. https://doi.org/10.1002/nur.10005 

Chenier, M. C. (1997). Review and analysis of caregiver burden and nursing home placement. Geriatric Nursing, 18(3), 121–126. https://doi.org/10.1016/s0197-4572(97)90029-x 

Gaugler, J. E., Kane, R. L., Kane, R. A., & Newcomer, R. (2005). Early Community-Based Service Utilization and Its Effects on Institutionalization in Dementia Caregiving. The Gerontologist, 45(2), 177–185. https://doi.org/10.1093/geront/45.2.177 

Harboun, M., Dorenlot, P., Cohen, N., Steinhagen-Thiessen, E., & Ankri, J. (2008). Impact of hip fracture, heart failure and weight loss on the risk of institutionalization of community-dwelling patients with dementia. International Journal of Geriatric Psychiatry, 23(12), 1245–1252. https://doi.org/10.1002/gps.2058

Ryan, A. A., & Scullion, H. F. (2000). Nursing home placement: an exploration of the experiences of family carers. Journal of Advanced Nursing, 32(5), 1187–1195. https://doi.org/10.1046/j.1365-2648.2000.01589.x 

World Health Organization. (2022, October 1). Ageing and Health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health 

Yaffe, K. (2002). Patient and Caregiver Characteristics and Nursing Home Placement in Patients With Dementia. JAMA, 287(16), 2090. https://doi.org/10.1001/jama.287.16.2090

Commonly asked questions

To create a comprehensive Nursing Home Admission Checklist, simply utilize the checklist provided by Crepatron and identify priorities for you and your loved ones from the list that resonate with the kind of care you are seeking. 

This multi-use tool may come in handy while looking for a nursing home or deciding whether a patient needs to seek nursing home-level care. 

These checklists are used in many ways, whether for nursing home hunting, assessment of care needs, or to act as a discussion point of care priorities between loved ones and the patient. 

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Nursing Home Requirements for Seniors

How Does a Nursing Home Admissions Process Work?

After you have vetted and toured long-term skilled care communities and nursing homes for your parent, you may be wondering: What’s next? How does the admission process work? What paperwork do I need?

The actual admission process can feel overwhelming, as there is often a lot of paperwork that will need to be gathered, filled out, and signed before your parent can move into a nursing home. However, take a deep breath and rely on the admissions specialist at the community you choose to help you through the process.

You can also use this article as a guide to help you prepare. Here’s what you can expect.

Admission Paperwork for Long-Term Skilled Nursing Care

• 1. A physician’s order for admission. This is a medical confirmation that your parent needs a long-term, skilled level of care . Typically, the order for your parent to be admitted into long-term skilled nursing care will come from your parent’s primary physician or the attending doctor if they have been in the hospital.
• 2. A state-required form certifying your parent meets nursing home criteria. Each state has its own required form. The hospital or your primary care physician will fill out and sign this form.
• 3. Physician’s orders for treatment, occupational therapies, and any needed rehabilitation.
• 4. A detailed list of all prescriptions, medications, and dosages.
• 5. Medical history and physical results so attending physicians and nurses have the most up-to-date information on your parent. Your parent’s primary care physician should be able to supply this.
• 6. Contact information for health care providers, family members, and other emergency contacts.
• 7. Basic information about your parent’s daily routine and activities.
• 8. Negative tuberculosis (TB) test or chest X-ray. TB is an airborne communicable disease, and skilled nursing care facilities need to make sure their residents do not have or carry this disease
• 9. Personal information and consent for treatment forms. Many skilled care facilities will have a staff member assist you in filling out several forms that ask for your parent’s Social Security number, personal information, and signature.
• 10. Financial paperwork and insurance documentation. You will need to disclose financial information to ensure you can pay for the care. (Note: Before the admission process, you and your family should consult with an attorney to help make decisions concerning the management of income, assets, and property, especially if one parent will be admitted while the other parent remains living at home.)
• 11. Medical power of attorney paperwork that shows a family member has the power to make arrangements for a move into a nursing home or long-term care community.
• 12. Any advance directives your parent may have.

Financial Questions You May Be Asked about Your Parent

• To help ensure your parent or family can pay for the care, you will be asked to fill out financial paperwork and answer several questions, such as:
• 1. Is your parent enrolled in Medicare (Part A or B) or Medicaid, or do they plan to apply?
• 2. Does he/she have supplemental insurance?
• 3. Does your parent receive veteran benefits, railroad retirement, SSI funds, or a private or government pension?
• 4. What are your parent’s assets, including cash, checking and savings accounts, stocks, bonds, CDs, trust funds, and real estate holdings?
• 5. Does your parent have any paid-up life insurance policies, paid-up burial insurance, or long-term care insurance?
• 6. What is your patient’s current living situation (do they own a home or pay rent)?
• 7. What monthly bills/payment do they have?

Be Prepared Before the Move to a Nursing Home

• Moving a parent to a nursing home or skilled care community is never easy. However, it pays to be proactive. The more research and planning you do now, the more positive the move and experience will be. Also, you and your entire family will be more prepared in case an emergency occurs and you need to make quick decisions.

Let Us Help Answer Your Questions

At Benedictine Living Community – At The Shrine, our team of senior living experts are more than happy to help answer your questions about long-term skilled nursing care and the admissions process. Feel free to contact us if you’d like to talk with one of our counselors or to schedule a tour.

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Nursing Home Pre-Admission Review

Besides being a state and federal requirement for anyone thinking about entering a Medicaid-certified nursing facility, Pre-Admission Reviews are an important part of the long-term care planning process. They help people understand all their options for long-term care, options that may include home and community-based services and assisted living. At Council on Aging, our Pre-Admission Review Team (Pre-Ad) conducts more than 11,000 reviews each year.

Click here  for an information sheet for residents and families.

Resources for Hospital and Nursing Facility Staff

COA’s Pre-Ad team works with professionals from hospitals and nursing facilities to provide screening and review of required PASRR processes and Levels of Care (LOC) as stipulated in Federal Law and the Ohio Administrative Code.

This page provides information on PASRR and LOC processes, step-by-step processes for common scenarios, links to required forms, and updates to rules about nursing facility placement.

• 9401 Submission  
• Hospital Processes
• Nursing Facilities
• Pre-Admission Screening (PAS)
• Nursing Facility to Nursing Facility Transfers
• Nursing Facility Transfers Involving a Hospital Stay
• Healthcare Electronic Notification System (HENS) 
• Hospital Discharge Exemptions
• Level of Care (LOC)
• Out of State Processes
• Resident Review (RR)

Ohio Department of Medicaid Contacts for Nursing Facilities

The following contact information has been provided by the Ohio Department of Medicaid for the purposes noted:

• For questions regarding 9401 submissions, nursing facility admissions and discharges, please contact:  [email protected]
• For questions regarding the PASRR and LOC processes, please contact:  [email protected]
• For questions regarding nursing facility rules and policies, please contact:  [email protected]

Contacting our Pre-Admission Review Team

PASSR and LOC requests: All PASSR documentation must be completed in HENS. Paper/fax requests are no longer accepted as of December 30, 2019.

By E-mail:   [email protected]

By Phone:   (513) 345-8622 8:00 a.m.-4:30 p.m., Monday-Friday

• For Hospitals and Hospice:  (513) 810-3350
• For NFs and Other Agencies:  (513) 810-3360

How do I contact someone on the weekend or a holiday?

Effective July 1, 2023, the Ohio Department of Aging and Ohio Area Agencies on Aging will no longer offer Extended coverage. Please submit all PASSR requests via HENS.

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A Guide to Nursing Home Requirements for Seniors

It’s natural for your health care needs to increase with advancing age, and eventually, you might need to find a nursing home that can deliver the care you need. Unfortunately, it can be confusing and difficult to research nursing home care on your own and to find a place that’s right for you. This guide is meant to help with your search.

If you’re one of the  1.3 million seniors who need the care that 24-hour nursing provides, or if you’re the family member of an older adult who needs help finding good nursing home care, this article can help you know what to look for, assess costs and pick a facility that’s a good fit for your situation.

• What Qualifies a Person for a Nursing Home? 

There is no universally agreed-upon set of criteria for who should be admitted to a nursing home and who should not be, but a standard of sorts has developed around the Medicaid standard for when nursing home services will be covered for beneficiaries. Each state sets its own standards and details vary, but in general, a person may be admitted to a nursing home if they have:

• Limited physical ability: People with disabilities are potentially eligible for admission to a nursing home. The disabilities may be a serious impairment, or they may be instrumental. A person whose disabilities interfere with activities of daily living, such as bathing, dressing or meal preparation, may require admission for basic safety and health reasons. 
• Health or medical needs:  People with special medical needs or chronic health conditions may need skilled nursing care from the inpatient environment of a nursing home. The health issue can be almost anything that your doctor and your state consider disabling or potentially hazardous without skilled nursing care. 
• Cognitive impairment: Seniors with cognitive impairments sometimes need the 24-hour supervision and mental health therapy available in a nursing home. This may be due to Alzheimer’s disease, Huntington’s chorea or advanced Parkinson’s disease dementia. 
• Behavioral issues:  Disturbed or irregular behavior can drive the decision to seek nursing home placement. A senior who gets confused and wanders, seeks escape from indoor environments or gets violent without an obvious cause might only have their needs met with the personal care and expertise a nursing home offers.
• What Documents Are Needed for Nursing Home Admissions?

When you’re admitted to a nursing home, the facility needs to see certain documents . Some of these are needed in every state, some relate to payment authorization or medical decision-making and others are optional or may be produced after you’ve been admitted. To make the process go smoothly, it helps to have these documents in hand before admission:

• Doctor’s orders for admission: A nursing home requires a doctor’s recommendation. This can be as simple as a one-page form, or might even be done electronically or over the phone. The documentation is similar to a doctor’s order to admit you to the hospital.
• Doctor’s prescriptions: Your prescriptions travel with you wherever you’re being treated. Your doctor has to make sure that the medications you need are authorized for disbursal by the nursing home staff. This can also usually be done electronically.
• Detailed medical history: Your medical history is a private set of documents that describes the medical conditions you have, the treatments you’ve received, physician’s notes and several other sensitive bits of information. It almost always travels with you from one facility to another in a special envelope that has to be handed over to your caregiver upon transfer.
• Test results: The nursing staff needs to have a copy of any of your recent test results. These are likely to be in your medical history packet, but it’s good to make sure they’ve been properly transferred.
• A state-approved admission form: Every state requires a nursing home admission form to be filled out at the time of your admission. This form differs in detail from one state to another, but just about every admission includes a completed form that gets filed with the state.
• Facility admission paperwork: Just as the state tracks nursing home admissions, the facilities themselves have various forms to fill out. In many cases, you can fill these out before you arrive at the facility. You could also have a caregiver, loved one or nursing home staff member do it for you.

In addition to these required forms, you might also be asked for a few supplemental documents. These don’t usually have to be presented prior to admission, but the sooner they are on file, the better:

• Durable power of attorney: As a rule, it’s a good idea to designate a third party as your medical decision-maker. It may happen that you need treatment or transfer to another facility and are unable to give your consent. You can name somebody on a legal document to make those decisions for you if needed, and their consent will be as legally binding as yours would have been. 
• Do-not-resuscitate (DNR) orders: Many people, especially those with end-stage conditions, decide to “let nature take its course” with their health and accept a natural death. A properly filed DNR is a record of your wishes not to be resuscitated if your heart stops, and against heroic measures being taken to keep you alive if you are passing away. 
• End-of-life wishes: End-of-life care wishes are your advance statements about how you want to be treated near the end of your life and immediately after in case you’re unable to make decisions at the time. Typical wishes might be that you want hospice care at home, you want continuous, deep sedation, you wish to be cremated and so on. 
• Dietary needs: You’ll be eating meals at the nursing home, and it’s a good idea to let the staff know in advance whether you have any food allergies, sensitivities (medical or cultural) or special dietary needs. For ordinary requests, such as kosher meals, vegetarian menus only or a low-salt diet, it’s usually enough to jot your requests down and submit them, but some people prefer a more formal document.

Nursing Home Financial Assessment

As a normal part of the admission process, the care facility is likely to conduct a financial assessment. This is generally done to determine whether you’re eligible for any state or federal support while you’re in residence. This can be important since nursing homes are not allowed to ask for deposits or other out-of-pocket payments from Medicaid or Medicare beneficiaries. 

The financial assessment is in many ways similar to the application process for a mortgage. Many of the same documents and life circumstances are looked at to determine whether you need help paying for your stay. Commonly asked questions during this assessment include:

• Are you currently enrolled in Medicare Parts A, B or C? Do you plan to apply?
• Do you have supplemental insurance to cover non-Medicare costs? Are you dual-eligible for both Medicare and Medicaid?
• Do you get VA benefits, Social Security, SSI/SSDI, railroad pension benefits or other income?
• What assets do you have, such as CDs or a 401(k)?
• Have you transferred significant assets to anyone else in the last 3-5 years?
• What is your current living situation (i.e. do you own a house, rent, live with somebody, etc.)?
• How much are you paying for your mortgage or monthly rent?
• How to Choose a Nursing Home

Whatever the reason you’re going into a nursing home, and regardless of how long you plan to stay, there are some things you or your loved ones should look for in any place you’re seriously considering admission to. 

• Nursing Home Laws By State

Click on your state on the map below to learn about nursing home laws in your state. 

• The Cost of Nursing Homes

Nursing home care in the United States costs an average of $7,908 a month for a semiprivate room, according to Genworth’s 2021 Cost of Care Survey . This rises to $9,034 for private rooms. This is a national figure, and the true cost of a room varies widely between states, as well as between urban areas within states. Care costs in the District of Columbia, for example, average $10,494 a month for both private and semiprivate rooms, while nursing home care in Louisiana can be as low as $5,759 for semiprivate rooms and $6,060 for private ones.

There’s even more cost variation between types of senior care. For some people, especially seniors who don’t quite need the full spectrum of care a nursing home provides, other types of living arrangements might be more affordable and more appropriate. This table lists common costs for different care levels:

Level of Care

National Median Cost (Monthly)

Nursing Home (semiprivate room)

Nursing Home (private room)

Home Health Care

• How to Pay For Nursing Home Care

Medicare commonly pays for nursing home care , both for established beneficiaries and for adults who have certain chronic conditions, such as end-stage renal disease . Under Original Medicare Part A, the inpatient benefit, the program pays for medically necessary services for a limited time. Medicare-covered services include:

• Lodging in a semiprivate room
• Meals, including special menu requirements
• Nursing care
• Physical, occupational and speech therapy
• Medically necessary social services
• Prescription medication
• Durable and disposable medical supplies
• Medically necessary transportation by ambulance
• Nutritional counseling and diabetes education

These benefits are available for a maximum of 100 days per benefit period, with a sliding scale of cost sharing. Your stay’s share of cost falls into three categories:

Share of Cost

Days 1 - 20

$0 coinsurance

Days 21 - 100

Up to $200 coinsurance per day

No coverage

Seniors who have the minimum necessary work credits are generally eligible for Medicare Part A at no cost. Other parts of Medicare have a monthly premium and may be opted out of for other coverage.

You can learn more about Medicare coverage limits at Medicare.gov .

Medicaid is a low-income health insurance program that helps provide medically necessary services for millions of seniors nationwide. All medically necessary services are included under your Medicaid benefit, with some variation in copayment amounts based on your ability to pay. This includes all doctor-authorized services provided while you’re staying at a nursing home.

Every state sets its own eligibility requirements for who can sign up for Medicaid. You generally need to have a qualifying low income and limited personal assets with some kind of medical need, such as being over age 65.

Click on your state on the map below to learn about your Medicaid eligibility requirements.

Pennsylvania

North carolina, massachusetts, south carolina, connecticut, mississippi, west virginia, new hampshire, rhode island, south dakota, north dakota.

Medicaid Eligibility

*All monthly income except for a $35/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spous.

**Income limit is for applicant only.

*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*All monthly income except for a $130 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.

***Income is limited to $2,742 per month per spouse.

*** Income is limited to $2,742 per month per spouse.

****In addition to the asset limits listed, Pennsylvania allows an extra $6,000 exemption. However, if an applicant has income more than $2,523/mo., the asset limit is $2,400 rather than the total asset limit of $8,000 ($2,000 plus $6,000 disregard).

*****Assets are limited to $2,000 per spouse

*All monthly income except for a $30/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .

*Income must be less than the amount Medicaid pays for nursing home care. Estimated cost is $6,381 – $9,087/mo. Except for a $30/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*Except for a $60/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

***Income is limited to $2,742 per month per spouse. 

*Except for a $40/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*Except for a $100/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*All monthly income except for a $137.10/mo. personal needs allowance and Medicare premiums must go toward nursing home costs. There may also be a monthly needs allowance for a non-applicant spouse, .

** Income limit is for applicant only.

*** Income is limited to $2,742 per month per spouse. 

**** $2,000 per spouse

*Except for a $72.80/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care. 

***$2,000 per spouse

* Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care. **Income limit is for applicant only. ***Income is limited to $2,742 per month per spouse.  ****Assets are limited to $2,000 per spouse

*All monthly income except for a $52 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .

*Except for a $93/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care. 

**The initial asset limit is $3,000 per spouse. After six months, this limit goes to $2,500 per spouse.

*Except for a $45/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*All monthly income except for a $95.97/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .

***Asset limit is $4,000 per couple if sharing a room and $3,000 if in separate rooms.

*Except for a $121/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*Except for a $30/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*All monthly income except for a $30/mo. personal needs allowance and Medicare premiums must go toward nursing home costs. There may also be a monthly needs allowance for a non-applicant spouse, .

****$2,000 per spouse

*All monthly income except for a $38 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse,

*All monthly income except for a $40 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.

*Except for a $74,75/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*Except for a $75/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

***Assets are limited to $2,000 per spouse

*All monthly income except for a $60/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.

***Limit is $1,600 per spouse

**Assets are limited to $2,000 per spouse

*All monthly income except for a $50 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.

****After six months of Medicaid eligibility, the rules for married couples change. They can then can choose to be considered as single applicants, which would change the asset limit to $2,000 each spouse.

*Except for a $35/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*All monthly income except for a $137.10/mo. personal needs allowance and Medicare premiums must go toward nursing home costs. There may also be a monthly needs allowance for a non-applicant spouse.

** Income limit is for applicant only.

*** Income is limited to $2,742 per month per spouse.

* Except for a $44/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

* Income in excess of $62/mo. must go toward nursing home costs. There are exceptions for private health insurance and potentially a spousal income allowance for a non-applicant spouse.

* Except for a $83/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

****Assets are limited to $2,000 per spouse

***Assets are limited to $4,000 per spouse

*All monthly income except for a $40/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse.

***The limit is $2,000 each but may vary on a case-by-case basis.

*All monthly income except for a $50/mo. personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse, .

*Except for a $74/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

****Assets are limited to $2,500 per spouse

*All monthly income except for a $40 personal needs allowance and Medicare premiums must be paid to the facility as a share of cost. There may also be a monthly needs allowance for a non-applicant spouse,

****The asset limit is technically $2,000 for an individual and $3,000 for a couple. However, Maine allows an extra exemption of $8,000 in savings for an individual and $12,000 for a couple. 

*****The $15,000 asset limit is for couples sharing a room in the same facility. For those in separate rooms or different facilities, the asset limit is $10,000 each, for a total of $20,000.

****Assets are limited to $4,000 per spouse.

* Except for a $60/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*Except for a personal needs allowance of $65/mo. for single and $130/mo. for couples who are both recipients, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

*;Except for a $72.66/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient’s monthly income must be put toward the cost of nursing home care.

Veterans Benefits

The VA pays some or all of the cost for many medically necessary nursing home services. Benefits cover some of the most common costs, such as nursing care and therapeutic services. Partial coverage may be provided for some services, though this varies with your service status, disability status and ability to pay. VA benefits may be combined with Medicare and Medicaid for better coverage.

You may be able to access VA inpatient benefits if you are otherwise eligible for VA care at a hospital. If you are a qualifying veteran, your case manager can tell you more about your specific benefits.

Learn more about the VA’s nursing home benefits at VA.gov . 

Private Insurance

Many private health insurance plans have some nursing home benefits. These vary widely by company, plan and even by location. Be sure to ask your plan representative for definitive information about your benefits.

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The Do’s and Don’ts of Signing a Nursing Home Admission Agreement as a Responsible Party

Signing a Nursing Home Admission Agreement as a Responsible Party

When a person is admitted to a nursing home, it is often a family member who manages the details of the move. If you are managing a loved one’s transition into a nursing home, you will likely be asked to sign a nursing home admission agreement as your loved one’s “responsible party.” These agreements can be very thick, complicated, and confusing. To make matters worse, you are often asked to sign them as soon as the person is admitted, at a time when you would rather be focused on making sure your family member is comfortable. You are likely to be facing a great amount of stress. Don’t feel pressured to sign an admission agreement on the spot. Take the time to review the document and make sure you understand what you are signing. You do not want to accidentally accept financial responsibility for your loved one’s care or give up any of your loved one’s rights.

Federal law and CT state law prohibits nursing homes from requiring you to guarantee payment of nursing home bills. This means that they cannot require you to sign as responsible party upon your loved one’s admission. Importantly, the your loved one cannot be refused admission due to your refusal to sign. The simplest way to avoid the risk of signing as a responsible party is by having your loved one sign the nursing home admissions agreement him- or herself. If the person is unable to sign due to a severe cognitive impairment or a physical limitation, you may decide to sign on that person’s behalf. If this is the case, there are other things you can watch out for to avoid liability for the nursing home costs. No matter who signs the agreement, it is important to take the time to make sure that person understands what it means.

Even if you are not made personally responsible for a resident’s nursing home costs, an admission agreement may still require a responsible party to use the resident’s assets to pay the nursing home costs and to help the resident qualify for Medicaid. In Connecticut, nursing homes have successfully sued the responsible party under such a contract. The nursing homes argued that the responsible party breached the contract by failing to qualify the resident for Medicaid in a timely manner, unreasonably delaying the Medicaid application process, or improperly transferring the resident’s assets. Even if you are only signing the admission agreement on behalf of the resident under a Power of Attorney, a court may still find that you are a responsible party. If you are managing the financial affairs of a nursing home resident, you need to familiarize yourself with the requirements for Medicaid. You should consult an attorney with Medicaid experience so that you do not unintentionally jeopardize the resident’s Medicaid eligibility and create liability for yourself.

In addition to understanding the implications of signing as a responsible party, there are other provisions to look for when signing a nursing home admission agreement. Keep an eye out for a binding arbitration provision. This type of provision will state that all disputes regarding the resident’s care will be decided through arbitration. You should know that signing such a provision means you are giving up your right to go to court to resolve a future dispute with the nursing home. The nursing home cannot require you to sign such a provision. However, if you do sign a contract including an arbitration provision, it will generally be enforceable.

If you are helping a loved one’s move to a nursing home, getting informed is one of the best ways you can protect your loved one and yourself. If at all possible, consult an experienced Elder Law Attorney before signing any documents from the nursing home.

by Henry C. Weatherby, Esq,, CLU, ChFC, CEBS Bloomfield, Connecticut

Categories: Nursing Homes

Tags: Binding Arbitration , Caregiving Resources , Elder Law , Medicaid Eligibility , Nursing Home Admissions , Nursing Homes , Responsible Party

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Attorney search, search articles, find attorneys, should you sign a nursing home admission agreement.

Admitting a loved one to a nursing home can be very stressful. In addition to dealing with a sick family member and managing all the details involved with the move, you must decide whether to sign all the papers the nursing home is giving you. Nursing home admission agreements can be complicated and confusing, so what do you do?

It is important not to rush, but rather to read. If possible, have your attorney review the agreement before signing it. Read the agreement carefully because it could contain illegal or misleading provisions. Try not to sign the agreement until after the resident has moved into the facility. Once a resident has moved in, you will have much more leverage. But even if you have to sign the agreement before the resident moves in, you should still request that the nursing home delete any illegal or unfair terms.

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Two items commonly found in these agreements that you need to pay close attention to are a requirement that you be liable for the resident's expenses and a binding arbitration agreement.

Responsible party

A nursing home may try to get you to sign the agreement as the "responsible party." It is very important that you do not agree to this. Nursing homes are prohibited from requiring third parties to guarantee payment of nursing home bills, but many try to get family members to voluntarily agree to pay the bills.

If possible, the resident should sign the agreement him- or herself. If the resident is incapacitated, you may sign the agreement, but be clear you are signing as the resident's agent. Signing the agreement as a responsible party may obligate you to pay the nursing home if the nursing resident is unable to. Look over the agreement for the term "responsible party," "guarantor," "financial agent," or anything similar. Before signing, cross out any terms that indicate you will be responsible for payment and clearly indicate that you are only agreeing to use the resident's income and resources to pay.

Arbitration provision

Many nursing home admission agreements contain a provision stating that all disputes regarding the resident's care will be decided through arbitration. An arbitration provision is not illegal, but by signing it, you are giving up your right to go to court to resolve a dispute with the facility. The nursing home cannot require you to sign an arbitration provision, and you should cross out the arbitration language before signing.

Other provisions

The following are some other provisions to look out for in a nursing home admission agreement.

• Private pay requirement . It is illegal for the nursing home to require a Medicare or Medicaid recipient to pay the private rate for a period of time. The nursing home also cannot require a resident to affirm that he or she is not eligible for Medicare or Medicaid.
• Eviction procedures . It is illegal for the nursing home to authorize eviction for any reason other than the following: the nursing home cannot meet the resident's needs, the resident's heath has improved, the resident's presence is endangering other residents, the resident has not paid, or the nursing home is ceasing operations.
• Waiver of rights . Any provision that waives the nursing home's liability for lost or stolen personal items is illegal. It is also illegal for the nursing home to waive liability for the resident's health.

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8 step guide on how to get a senior admitted into a nursing home.

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Helping a senior get admitted to a nursing home can be an overwhelmingly complex process. When the senior will be relying on Medicare or Medicaid to cover the costs of skilled nursing care , it’s an even more challenging ordeal with strict qualifications.

Before making major financial or legal decisions pertaining to a senior’s long term care and estate, it’s important to discuss your case with an elder law attorney. An experienced attorney can help you protect your personal assets from Medicaid spend-down requirements, and prepare important estate planning documents like an advance healthcare directive and power of attorney.

8 Steps to Getting a Senior Admitted to a Nursing Home

Following is a brief overview of how to get a senior admitted to a nursing home, simplified into 8 easy-to-follow steps. Keep in mind, though, that the actual process may vary slightly depending on the nursing home’s procedures and the state’s Medicaid requirements.  

Step One: Gather the Senior’s Information

The nursing home and physician will need to see the patient’s medical and physical history, including past/current conditions, surgeries, immunizations, allergies, and diagnostic tests. Now is also a good time to start gathering the senior’s financial information, which you’ll need when working with the elder law attorney, nursing home admission director, and Medicaid (if applicable).  

Step Two: Meet With an Elder Law Attorney

The senior will need an advance healthcare directive (also known as a living will) to indicate their healthcare preferences in case they become incapacitated and cannot communicate with their doctor. They will also need a power of attorney to appoint an attorney-in-fact who can manage their financial, legal, and medical affairs should they become incapacitated.

If you’re applying for Medicaid now or expect to in the future, talk to the elder law attorney about protecting the senior’s assets from Medicaid spend-down requirements.

Step Three: Obtain a Doctor’s Order

The senior’s primary provider (family doctor) will need to write an order confirming that the patient requires skilled nursing care. The physician will be handing over care to the nursing home’s doctor, so he or she will also need to issue appropriate orders for medication, treatment, physical therapy, etc.

Step Four: Complete the State-Required Form

Each state has a required form that certifies a patient meets the state’s nursing home criteria. The patient’s doctor or hospital staff will fill out and sign this form.

Step Five: Complete a Tuberculosis (TB) Test

Nursing homes usually require a TB test to confirm that the patient doesn’t have an airborne communicable disease. Some nursing homes require additional tests, so be sure to check with the admissions director to see what (if anything) else is required.

Step Six: Complete the Admissions Paperwork

Most nursing homes let you fill out the admissions paperwork ahead of time so you’re not rushing to get it done the day the patient is admitted. The admissions director will assist you if you have any questions.

Step Seven: Complete the Financial Assessment

To ensure the patient has the financial means to pay for skilled nursing care, the nursing home will require a financial assessment that addresses personal assets, insurance, government benefits, and government assistance programs like Medicaid.  

Step Eight: Complete Medicaid Application (if Applicable)

If the patient plans to use Medicaid benefits to pay for the nursing home, you’ll need to work with the state agency to certify the patient’s income and assets qualify for coverage.  

Unfortunately, there’s often a catch-22 with Medicaid where the state agency won’t approve coverage until the patient is admitted, but the nursing home won’t admit the patient until Medicaid is approved. If you find yourself in this situation, you may need to speak with an elder law attorney to discuss your options.  

FAQs on Getting a Senior Admitted to a Nursing Home

Q: what qualifies a person for a nursing home.

Skilled nursing homes are for seniors who are unable to care for themselves for a sustained period of time, and present a danger to themselves or others without the necessary assistance. To determine this, doctors will evaluate four key areas:

• Behavioral: Is the senior unable to control their mood or actions?
• Cognitive: Does the senior suffer memory issues from Alzheimer’s or dementia?
• Functional: Does the senior need assistance with activities of daily living?
• Medical: Does the Senior require IV drips, catheters, ventilators, or other medical devices?

Q: Can a doctor put someone in a nursing home?

Admittance into a skilled nursing home requires a doctor’s order, much like writing a prescription. In most cases, the patient must see their doctor less than 30 days before entering the nursing home.  

Q: Can social services force someone into a nursing home?

No. Social services may recommend a nursing home after a care assessment, but the social worker cannot force the senior into a nursing home. In rare cases a senior may be detained under the Mental Health Act of 1986, but it’s exceptionally rare.

Q: Who pays for a nursing home if you have no money?

Medicaid is a state-operated government assistance program that pays for long term care for seniors who don’t have any money. In order to qualify for Medicaid, you must “spend down” your personal assets to a state-specified threshold and meet the state’s income requirements.

In Arizona, Medicaid is administered by the Arizona Health Care Cost Containment System ( AHCCCS ).

Q: Can a nursing home take all your assets?

A skilled nursing home cannot “take” a patient’s assets. When debts accrue the facility may send the account to collections and place a lien on personal assets, but they cannot simply take assets to pay the bill.

Q: Can a nursing home kick you out?

Skilled nursing homes can’t evict someone, but they may require a transfer or discharge under certain circumstances. Across the board, facilities cannot force a transfer or discharge for any reason if moving the patient would be more harmful to their health than letting them stay.

Assuming that moving the patient is not detrimental to their health, there are five situations where a discharge or transfer may be permitted:

• The patient requires medical care that’s not available in a nursing home (e.g. hospitalization or transfer to a specialized mental institution)
• The patient’s condition has improved and they no longer require skilled nursing care
• The patient jeopardizes the health and safety of others in the nursing home
• The patient has not paid for care in at least 15 days
• The nursing home plans to cease operations

What to Expect During Your Skilled Nursing Stay

Thank you for considering Abri Health Care Services for your rehabilitative and post-acute care needs. As your transitional care partner, we are committed to providing you with exceptional service throughout your short-term stay. Our skilled medical teams will work with you to develop a personalized treatment plan that best suits your individual needs.

Meet Your Clinical Team

Our therapy and rehabilitation programs have one focus in mind – helping our patients return home as quickly and safely as possible. Working as a team, our professional caregivers and therapists will meet regularly to discuss your recovery plan and goals. Please feel free to utilize them as a resource during your stay with us. This team includes:

• Facility Administrator
• Director of Nursing
• Director of Rehabilitation Services
• Physical Therapist
• Occupational Therapist
• Speech Therapist
• Certified Nursing Assistants

Skilled Nursing Admission Check List

Move-in day at a skilled nursing community can be hectic. To help with your big day, we’ve addressed common questions that many people have before transitioning to a skilled nursing community.

Information and Documents Needed for Admissions

• Proof of Medical Insurance
• Social Security Card
• Medicare or Medicaid Card
• State Driver's License or Photo ID Card
• Copies of any Directives tor your Physician
• Power of Attorney Documentation

Suggested Clothing and Personal Items for Admission

The following items are recommended to make your short-term stay more comfortable.  

• Comfortable clothing for 5 to 7 days
• Hearing aids, eyeglasses, and eyeglass care
• Personal effects
• Reading materials
• If participating in therapy, a pair of non-skid supportive shoes
• We provide standard toiletries for our guests; you are welcome to bring your favorite brands from home
• While the temperature in the facility is closely monitored, we do recommend bringing a jacket or sweater for those who tend to get cold

NOTE : Laundry services are provided FREE OF CHARGE. Please ask your facility representative for additional details. 

What Items Should I Leave at Home?

• Prescription or over the counter medications
• Jewelry and other expensive valuables
• Large sums of money or credit cards
• Rugs or mats
• Extension cords
• Glass or breakable items
• Combustible items such as aerosol cans
• Electric blankets or heating pads
• Any item with a hazardous warning label or disclaimer

Wrapping it Up

We understand that choosing a health care provider can be stressful and intimidating. We would like to thank you again for entrusting us with your care and will strive to provide you with the highest quality service available. 

Before you go, here’s a quick checklist to see if you have everything you need for your big day. Don’t forget to tick these off:

• Have your paperwork in order (Social Security Card, Driver's License, Medical Insurance Card, Medicare/Medicaid Card, Power of Attorney Documents)
• Bring several days of comfortable clothing , including a sweater, gym shorts, toiletries and non-skid shoes
• Bring hearing aids, eyeglasses, and eyeglass care in your overnight bag
• Make sure you have reading materials and personal effects
• Check with your facility prior to admission on what decor is okay to bring into facility (rugs, blankets, mats, plants, etc.)
• Leave valuables, jewelry, credit cards and large sums of money at home

Even if you only will be in a skilled nursing community for a few days, it’s important to make the most of it while you are there. These tips hopefully will help you prepare for that journey!

Other Useful Information

• Prior to your admission, an Abri Health Care Services team member will set up an appointment with you to complete your admissions paperwork and discuss your insurance benefits. This will be your opportunity to ask questions and ensure you understand your benefits and coverage. 
• Visits from family and friends are always welcomed and encouraged. Plenty of rest is needed to facilitate healthy recovery so we ask that visitors be respectful of resting patients during nighttime hours. 
• Medications will be ordered from the pharmacy once signed physician’s orders are received. Medications are typically delivered within 12 hours, however, emergency medications will be available during this time if deemed necessary. 
• Within the first few days of your stay, several members of our team will meet with you to discuss your recovery goals, preferences and to review important information. This team may include the Facility Administrator, Admissions Coordinator, Nurse Managers, Business Office Manager, Director of Therapy Services and your Quality of Life Specialist. 
• Abri Health Care Services provides ongoing engaging activities throughout the day, so be sure to check the activity calendar often to see what’s going on. Your Life Enrichment Director can also help you find great activities to participate in.  

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Nursing Home Admission Checklist

Collect necessary personal information for admission form, collect medical information from primary healthcare provider, determine specific care needs.

• 1 Physical Therapy
• 2 Speech Therapy
• 3 Occupational Therapy
• 4 Wound Care
• 5 Psychological Support

Discuss financial information with family or financial responsible party

• 3 Veterans Benefits
• 4 Private Insurance
• 5 Self-Payment

Schedule pre-admission assessment

Conduct pre-admission assessment.

• 1 Review Medical History
• 2 Discuss Preferences and Expectations
• 3 Address Concerns and Questions
• 4 Assess Mobility and Functional Abilities
• 5 Evaluate Cognitive Abilities

Create care plan based on assessment

• 1 Develop Daily Routine Schedule
• 2 Outline Medication Administration Guidelines
• 3 Specify Dietary Plan
• 4 Address Social and Emotional Support
• 5 Incorporate Preferred Activities

Approval: Physician for the care plan

• Create care plan based on assessment Will be submitted

Prepare resident room and care equipment

• 1 Arrange Furniture
• 2 Set up Medical Equipment
• 3 Organize Personal Belongings
• 4 Ensure Adequate Lighting
• 5 Check Safety Measures

Ensure staffing needs for the resident care

• 1 Registered Nurse
• 2 Licensed Practical Nurse
• 3 Certified Nursing Assistant
• 4 Physical Therapist
• 5 Dietitian

Schedule move-in day with family

Prepare information for the staff about the new resident, conduct admittance paperwork.

• 1 Review Consent Forms
• 2 Verify Legal Documents
• 3 Document Personal Information
• 4 Obtain Emergency Contact Details
• 5 Complete Insurance Information

Review resident rights and responsibilities with the resident and family

Assist with resident move-in.

• 1 Escort to the Resident's Room
• 2 Assist with Unpacking
• 3 Provide Emotional Support
• 4 Answer Questions and Address Concerns
• 5 Introduce to Roommates or Neighbors

Provide introductions and tour for the resident

• 1 Show Common Areas (Dining, Lounge)
• 2 Highlight Recreational Activities
• 3 Introduce Staff Members
• 4 Present Amenities (Gym, Garden)
• 5 Explain Emergency Procedures

Approval: Director of Nursing for admission procedure

• Conduct admittance paperwork Will be submitted

Schedule follow-up meeting with the resident and family

Take control of your workflows today., more templates like this.

How Does Emergency Nursing Home Admittance Work?

Updated 05/20/2022

Published 05/20/2022

Amanda Lambert, MS, CMC, ALCP

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Cake values integrity and transparency. We follow a strict editorial process to provide you with the best content possible. We also may earn commission from purchases made through affiliate links. As an Amazon Associate, we earn from qualifying purchases. Learn more in our affiliate disclosure .

In today’s world, nursing homes don’t always have the best reputation. It’s true that most people would probably prefer to avoid going to a nursing home. Similarly, it’s difficult to navigate this process with loved ones. This leads us to wonder how emergency nursing home admittance works?

Jump ahead to these sections:

What is emergency nursing home admittance, who qualifies for emergency nursing home admittance, emergency nursing home admittance or admission process, what documents will you need for emergency nursing home admittance.

Before beginning this discussion, it is essential to distinguish between a nursing home and a skilled nursing home . A skilled nursing home is a short-term placement for rehabilitation services following a three-night stay in the hospital.

If you have a Medicare Advantage plan, they might waive the three-night stay. If the three-night requirement is met, skilled nursing care is covered by Medicare insurance. In other words, the purpose of skilled nursing is to provide a high level of physical and occupational therapy with a short-term goal of getting the patient back home.

It’s important to keep in mind that a nursing home is considered a long-term care solution for people who may not fit the criteria for skilled nursing. This is when a patient can’t be safely managed in any other setting. Medicare does not pay for emergency nursing home admission. We will talk about what to expect with an emergency nursing home admission, what you need to get admitted, and how to pay for it.

First, what exactly is emergency nursing home admittance? Since this is a topic most people don’t think of until they have to, it’s normal to have questions. The healthcare system can be tricky and confusing, even to those familiar with the process. 

In short, an emergency nursing home admission is any admission that wasn’t planned in advance. Hospital beds throughout the country are scarce. There could be occasions where admission to a nursing home for stabilization before discharge elsewhere makes sense.

A lthough people can stay in the hospital for the amount of time needed to treat their condition, there could come the point where there is no longer a need for hospitalization, yet the patient can’t go home safely.

In other situations, perhaps the patient has tried skilled nursing for rehab but has not made enough progress to continue rehabilitative services or go home. The skilled nursing facility may recommend an emergency nursing home admission when insurance stops paying due to failure to improve. Emergency nursing home admittances aren’t taken lightly, and it’s something you would coordinate with the help of your healthcare team. 

With that in mind, who qualifies for emergency nursing home admittance? Is this something anyone can take advantage of if needed?

State regulations determine qualification for an emergency nursing home admission or any nursing home admission. You can think of a nursing home admission as a last resort in that there are no viable alternatives. 

Emergency admission to a nursing home implies that the stay will be short term but that all depends on whether the patient can recover to the extent a less restrictive placement is possible. Assisted living communities cannot handle complex medical problems, and most have nursing available only on a limited basis. 

With that in mind, this is who qualifies for an emergency nursing home admission:

Someone who has the ability to pay the nursing home

Of course, a nursing home will not admit someone without knowing how the patient will pay for their stay. Either the individual has to already be on Medicaid, can qualify for Medicaid after admission, or pay privately. 

According to Genworth , the median cost of care in 2022 for a semi-private room in a nursing home is $7,908. That cost will be higher in some states and lower in others. Medicaid qualification also varies by state, but generally, an individual can have no more than $2000 in assets. 

Someone with an immediate medical need

Alternatively, not all medical needs can be handled by short-term home health. Home health only provides intermittent medical interventions, not round-the-clock or on-demand care. Some of the medical problems that might necessitate a nursing home stay:

• Intravenous medications
• Catheter care
• Kidney dialysis
• Feeding tubes or ventilators
• Bedbound incontinence

A patient with functional decline

Functional decline describes what happens to someone when they suffer an illness or general debility due to neurological conditions, a stroke, heart attack, uncontrolled diabetes, or any number of other conditions. 

As people age, it is harder to recover due to loss of muscle mass, poor balance, or cognitive impairment. Some examples of functional decline are:

• Challenges getting dressed and undressed.
• Needing assistance to bathe safely
• Assistance with hygiene like brushing teeth or using the bathroom
• Help with transferring in and out of bed or a chair
• Medication management 

An individual with cognitive or behavioral problems

Similarly, people with Alzheimer's disease or other types of dementia may have severe cognitive symptoms like wandering, aggression, paranoia, delusions, and impaired memory. 

Some states will not permit a nursing home admission based solely on a psychiatric diagnosis.  Dementia is usually accompanied by functional and medical problems that require close supervision due to cognitive impairment. 

Someone with a discharge from hospice

Finally, in rare cases, someone may be discharged from hospice because the condition that qualified them is in remission or no longer a threat to their life. Still, that doesn’t mean that the patient doesn’t have extensive needs that can’t be met at home or in assisted living. For example, if someone is homebound, has an indwelling catheter, and requires round-the-clock care, they may qualify for a nursing home admission after hospice discharge.

Now that you know who qualifies for this service, how does the process work? It’s no secret that healthcare, insurance, Medicaid, and everything in between can be tricky. When in doubt, consult with your healthcare team to determine your next steps. 

The emergency nursing home admission process depends on where the patient is when the decision is made to admit him or her to a nursing home. The best way to understand this in practice is by looking at some possible scenarios and how each can affect the process. 

The patient is in the hospital

To begin, the most common process for emergency nursing home admittance is through the hospital. The hospital physician and discharge planner put together all of the paperwork for admission from the hospital.

If you don’t qualify for Medicaid, then there will be a process of determining who is financially responsible for payment. For people who don’t have vast financial resources, it is usually advisable to pick a nursing home that accepts Medicaid if you have to spend down your assets.

The patient is at home

On the other hand, coordinating an emergency nursing home admittance from home can be stressful and confusing. The first step is to locate a nursing home that you think provides the right level of care. 

Finding a good nursing home can be a challenge but check with a physician for recommendations. Keep in mind that the Five-Star Quality Rating System has come under scrutiny due to the discovery that many nursing homes are skirting reporting requirements skewing the results. 

If you have time, visit any nursing home you are considering in person. You can tell a lot by a spontaneous visit. Ask to meet with the director and director of nursing. Staff shortages in nursing homes are at record levels, so assume that any nursing home you choose will have this problem. If you can find a non-profit nursing home in your community, you might have better luck with the quality of care.

Meet with the admissions coordinator of the nursing home you decide on and ask about the admission process. You may be required to guarantee payment if your loved one does not qualify for Medicaid. Some nursing homes will not accept a “Medicaid Pending” patient without a guarantee of payment before Medicaid takes effect. 

Lastly, the nursing home may provide transportation to the facility, but you should ask about it. If you need medical transport to keep your loved one safe, you may have to pay an additional fee. 

The patient is in assisted living

An admission from assisted living could be more manageable since the staff may have experience in expediting an emergency admission. They will have your loved one’s demographic information and medication list. 

An assisted living may also have nursing homes they recommend and can inform you of criteria for returning to the community following the emergency nursing home admission. You may have to pay for your loved one’s apartment during their absence, but most facilities will give you a discount on the room rate.

Every state will dictate documents that you need for an emergency nursing home admission. Hopefully, you will have completed the end-of-life planning checklist , making much of this easier. Generally, these are the documents you can expect to provide.

A physician’s order

It isn’t enough for you or anyone else to think or document the reason for an emergency nursing home admission. A physician must confirm that your loved one needs a nursing home level of care. If your family member hasn’t seen their physician in a while, the physician may require a visit to confirm their medical condition. 

Medical history

The physician needs to provide a complete medical history with diagnoses, medications, and any other relevant information. Also, the doctor needs to include orders for care for the attending physician and staff at the nursing home. Once your loved one enters a nursing home, the nursing home physician takes over their care.

State forms

Each state requires that the patient or power of attorney fill out state forms that certify the patient requires a nursing home level of care. If your loved one is in the hospital, the attending will fill out the appropriate paperwork. The primary care physician fills out these state forms if your loved one is at home.

Vaccine requirements

It used to be that the only vaccines nursing homes were concerned about were tuberculosis, flu, and pneumonia shots. Nursing homes require recent proof of these vaccines; otherwise, they give these shots within three days of admission. 

Now, we have COVID to worry about. Since nursing homes have been disproportionately affected by COVID, they may require a COVID test before admission and proof of vaccination. Always check with the specific facility about vaccine deadlines and requirements. 

Admission paperwork

The admission paperwork for nursing homes can be lengthy. It usually includes:

• Responsible family information
• Signatures for nursing home policies and responsibilities signed by the patient or power of attorney
• Detailed financial information, including bank account, retirement, and other assets if you apply for Medicaid
• Who is legally responsible for paying
• Mortuary information
• Do Not Resuscitate (DRR) orders
• Living will
• End-of-life care wishes

Understanding Emergency Nursing Home Admission

Ultimately, an emergency nursing home admission can be a significant stressor for you and your loved one. Prepare to be an advocate and support your loved one’s efforts to return home. If they can’t come home, monitor signs of loneliness while they are in the nursing home, visit often, and do everything you can to bring comfort and care to a challenging situation.

It’s normal to be intimidated by the nursing home process, but you’re not alone. Use your healthcare team as an advocate for your loved one’s wishes, putting their needs first. Together, you’ll find the right solution for your loved one’s unique situation. 

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Nursing Home Admission Agreements

Posted on Friday, July 15th, 2022 Monday, January 29th, 2024 Author [email protected]

When you are admitted to a nursing home, you will be asked to sign an admission agreement that explains your rights and responsibilities and those of the nursing home. In years past, this involved signing contracts written by nursing homes that often contained deceptive or illegal terms.

California is the first state in the nation to outlaw the use of admission contracts written by nursing homes. By law (SB 1061, 1997), all California nursing homes must use the Standard Admission Agreement developed by the California Department of Public Health. (California Health and Safety Code §1599.61, 22 CCR §72516)

The Standard Admission Agreement’s purpose is to give you peace of mind that you are signing a document that protects your rights and does not expose you or your family to unexpected financial liability. It is important, however, for you to read the document carefully and to make sure you fully understand its terms before you sign it.

The Agreement

The California Department of Public Health has posted the California Standard Admission Agreement for Skilled Nursing Facilities and Intermediate Care Facilities (CDPH 327) on its website in  English ,  Spanish ,  Chinese ,  Korean  and  Vietnamese . The Standard Admission Agreement consists of the basic Agreement and the following attachments:

• Attachment A – Facility Owner and Licensee Identification
• Attachment B-1 – Supplies and Services Included in the Basic Daily Rate for Private Pay and Privately Insured Residents
• Attachment B-2 – Optional Supplies and Services Not Included in the Basic Daily Rate for Private Pay and Privately Insured Residents
• Attachment C-1 – Supplies and Services Included in the Basic Daily Rate for Medi-Cal Residents
• Attachment C-2 – Supplies and Services Not Included in the Medi-Cal Basic Daily Rate That Medi-Cal Will Pay the Dispensing Provider for Separately
• Attachment C-3 – Optional Supplies and Services Not Covered by Medi-Cal That May Be Purchased by Medi-Cal Residents
• Attachment D-1 – Supplies and Services Covered by the Medicare Program for Medicare Residents
• Attachment D-2 – Optional Supplies and Services Not Covered by Medicare That May Be Purchased by Medicare Residents
• Attachment E – Authorization for Disclosure of Medical Information
• Attachment F – Resident Bill of Rights

Before Signing the Agreement

Before signing the Standard Admission Agreement:

• Read it and its attachments carefully;
• List any questions about your rights and responsibilities;
• Make sure that all your questions are answered to your satisfaction before signing;
• Use the Agreement as an opportunity to clarify expectations and to negotiate care needs and costs.
• Consult an attorney or advocate if you have concerns or questions about the Agreement.

Carefully review the actual written Agreement the nursing home is asking you to sign. Do not rely on the standard version of the Agreement on the Department of Public Health website. Although a nursing home cannot legally alter or amend the Agreement unless it receives written permission from the California Department of Health Public Health (22 CCR §72516), it is possible that a nursing home may have altered the Agreement with or without the required permission. Please inform CANHR if a nursing home asks you to sign an Agreement that has been significantly altered from its standard terms.

Signing the Agreement

The person being admitted to the nursing home is the only person required to sign the Standard Admission Agreement. (California Health & Safety Code §1599.65) Section I (Preamble) of the Agreement states: If you are able to do so, you are required to sign this Agreement in order to be admitted to this Facility. If you are not able to sign this Agreement, your representative may sign it for you. Make sure you obtain a copy of the signed Agreement and any other documents presented or signed at admission. Section XII of the Agreement requires the facility to give you a copy of the signed agreement, all attachments, any other documents you sign at admission, and a receipt for any payments you make at admission, upon your request.

Financial Responsibility of Residents’ Representatives Who Sign the Agreement

The resident is responsible for paying any nursing home bills under the Agreement, not his or her family or friends. (Title 42 United States Code §1396r(c)(5), Title 42 Code of Federal Regulations §483.15, California Welfare & Institutions Code §14110.8) Signing the Standard Admission Agreement as a resident’s representative does not make you responsible for using your own money to pay for care provided by the nursing home. Section II (Identification of Parties to this Agreement) of the Agreement states: IF OUR FACILITY PARTICIPATES IN THE MEDI-CAL OR MEDICARE PROGRAM, OUR FACILITY DOES NOT REQUIRE THAT YOU HAVE ANYONE GUARANTEE PAYMENT FOR YOUR CARE BY SIGNING OR COSIGNING THIS ADMISSION AGREEMENT AS A CONDITION OF ADMISSION. Additionally, it states: Signing this Agreement as a Resident’s Representative does not, in and of itself, make the Resident’s Representative liable for the Resident’s debts. However, a Resident’s Representative acting as the Resident’s financial conservator or otherwise responsible for distribution of the Resident’s monies shall provide reimbursements from the Resident’s assets to the Facility in compliance with Section V. of the agreement. The resident’s authorized financial representative is responsible to use the resident’s funds to pay nursing home fees, such as a share-of-cost set by Medi-Cal for a resident on Medi-Cal. (California Welfare & Institutions Code §14110.8)

Signing Other Documents at Admission

You and your representative cannot be required to sign any other document at the time of admission or as a condition of admission or continued stay in a California nursing home. (Title 22 California Code of Regulations §72516) This right is stated in Section I, the Preamble to the Agreement. Do not sign any forms or documents that conflict with the Standard Admission Agreement or attempt to restrict your rights. Avoid signing any documents that seek waiver of liability, binding arbitration or general consent to treatment. The Agreement already includes a general consent to treatment and emergency care in Section III so additional forms are not needed for this purpose at admission. Although you are not required to sign other documents, the nursing home may ask you to do so. It is usually best not to sign other documents at admission. Ask the nursing home to give you copies of any forms to review in advance before making decisions about signing them. If you have any concerns or doubts about a document you are asked to sign, seek advice from a qualified attorney or advocate before doing so.

Binding Arbitration Agreements

Do not sign a binding arbitration agreement at admission. Nursing homes use arbitration agreements to prevent residents from being able to sue for abuse or neglect. By signing a binding arbitration agreement, you give up your constitutional right to go to court if a dispute arises in the facility, even if it involves abuse or neglect. There is no right to appeal a decision made through binding arbitration. Nursing homes cannot require you to sign an arbitration agreement and cannot present an arbitration agreement as part of the Standard Admission Agreement. (California Health & Safety Code §1599.81, Title 22 California Code of Regulations §72516, 42 CFR §483.70(n)). Any arbitration agreement shall be separate from the Standard Admission Agreement and shall contain the following advisory in large, bold type at the top of the agreement: Residents shall not be required to sign this arbitration agreement as a condition of admission to this facility.

Residents and their legal representatives can rescind an arbitration agreement by giving written notice to the facility within 30 days of their signature. (California Code of Civil Procedure §1295, 42 CFR §483.70(n)(3)) If a nursing home asks a resident or resident representative to sign an arbitration agreement, it must explain the agreement in a form, manner and language the resident and representative understand. (42 CFR §483.70(n)(2). To learn more about problems with binding arbitration, read  CANHR’s fact sheet  on this subject.

Advance Directives

At admission, the nursing home should ask you for a copy of your advance directive and, if you don’t have one, may suggest you establish one. Although it is a good idea to have an advance directive, nursing homes cannot require you to have or to make one as a condition of admission or continued stay. This issue is addressed in Section III, Consent to Treatment, in the Standard Admission Agreement. Advance directive is the general term used to describe instructions you give someone about preferences for your future medical treatment. At admission, the nursing home must give you written information about advance directives explaining: (1) your right to direct your own health care decisions; (2) your right to accept or refuse medical treatment; (3) your right under California law to prepare an advance health care directive; and (4) the facility’s policies that govern the use of advance directives. (Title 42 United States Code §§1395cc(f), 1396r(c)(2)(E) & 1396a(w), Title 42 Code of Federal Regulations §§489.102, 483.10(g)(12) & 431.20) There are different types of advance directives. The following types are examples, not a complete list. An Advance Health Care Directive (AHCD), also known as a Power of Attorney for Health Care, allows you to appoint an agent to make health care decisions for you. Your agent only makes decisions for you if you have lost capacity, unless you state otherwise in the document. You can give an agent limited or broad powers in an AHCD, from the right to access medical records to the power to make anatomical gifts. You may also specify healthcare instructions you want to be followed. All adults should have an AHCD. CANHR has published a model Advance Health Care Directive  form  and  instructions . A Physician Order for Life-Sustaining Treatment (POLST) is another form of advance health care planning where you or your legally authorized surrogate can express end-of-life care preferences. The form instructs providers about what to do regarding CPR, comfort care measures, artificial nutrition and hydration, and other important treatments. A POLST must be signed by a physician and is thus an actual medical order that nurses and nursing assistants must follow. The document is meant for people who are terminally ill as a way to control their end-of-life care. In recent years, some nursing homes have told residents and their representatives that a POLST form is required at admission. This is not true. Establishing a POLST is a choice, not a requirement.

Participation in Medi-Cal and Medicare

The admission agreement must clearly state whether the nursing home participates in the Medi-Cal and Medicare programs. (California Health & Safety Code §§1599.66 & 1439.8, California Welfare & Institutions Code §14022.3) This information is found in Section V (Financial Arrangements) of the Standard Admission Agreement. If a nursing home is withdrawing from the Medi-Cal program, it must include this information in Section V (Financial Arrangements) of the Agreement and give the date that it notified the Department of Health Care Services of its intent to withdraw from Medi-Cal. A nursing home that is withdrawing from Medi-Cal is not required to accept Medi-Cal for residents admitted after it notified the State of its intent to withdraw. The Standard Admission Agreement explains that residents admitted on or before the date of the withdrawal notice can use Medi-Cal to pay for their care, even if they become eligible for Medi-Cal after that date. (California Welfare & Institutions Code §14022.4, Title 42 United States Code §1396r(c)(2)(F))

Requirements to Pay Privately

It is illegal for a Medicare or Medi-Cal certified nursing home to require a resident to pay privately for any set period of time. (Title 42 United States Code §§1395i-3(c)(5)(A) & 1396r(c)(5)(A), and Title 42 Code of Federal Regulations §483.15(a)) When a resident qualifies for Medi-Cal or Medicare nursing home coverage, nursing homes certified by these programs must accept their payments. (California Health & Safety Code §1599.69 & 1599.76, California Welfare & Institutions Code §14019.3, and Title 42 Code of Federal Regulations §483.15(a)) Section V of the Agreement on Financial Arrangements includes the following statement: You should be aware that no facility that participates in the Medi-Cal program may require any resident to remain in private pay status for any period of time before converting to Medi-Cal coverage. Nor, as a condition of admission or continued stay in such a facility, may the facility require oral or written assurance from a resident that he or she is not eligible for, or will not apply for, Medicare or Medi-Cal benefits. Some nursing homes require applicants to disclose financial information that is used to project how long they can pay privately before qualifying for Medi-Cal. Applicants with more money are usually given preference. Although this practice is of questionable legality, federal and California authorities are doing nothing to stop it.

Notice About Medi-Cal Eligibility

Prior to admission, Medi-Cal certified nursing homes must notify you about Medi-Cal eligibility standards, using a State mandated notice ( DHCS 7077 ) (California Welfare & Institutions Code §§14006.3 & 14006.4) The legislature required the notice after learning that some nursing homes misinformed applicants and residents about Medi-Cal eligibility. The notice contains important information, including:

• You do not have to use all your resources to qualify;
• Your home is an exempt resource. Its value does not affect your eligibility, and you have the right to transfer the home;
• Medi–Cal has special rules for married couples that protect resources and income for the spouse who is not in the nursing home.

In July 2022, Medi-Cal will begin phasing-out asset limits for seniors and persons living with disabilities, making it easier for them to qualify for Medi-Cal.  Read CANHR’s fact sheet  on the major changes to Medi-Cal asset limits.

A nursing home cannot require or accept a deposit if Medi-Cal or Medicare is helping to pay for your stay. (California Health & Safety Code §1599.70, California Welfare & Institutions Code §14110.9, Title 42 Code of Federal Regulations §489.22 & 483.15(a)) Nursing homes may require a deposit if you are paying privately for your care. Deposits paid by private paying residents must be returned when Medi-Cal or Medicare start paying for their nursing home care. (California Welfare & Institutions Code §14110.8 & Health & Safety Code §1599.70) This issue is addressed in Section V(B) of the Agreement on Security Deposits.

Rate Changes

If a nursing home plans to increase its daily rate or service fees, it must give residents 30 days written notice of the changes. (California Health & Safety Code §1288, 1599.67)

Refunds and Charges Following Discharges

You cannot be charged for any days of care after discharge or death and are entitled to a refund of any advance payments made to the nursing home. (California Health & Safety Code § 1599.71) See Section V of the Agreement on Financial Arrangements. The only exception is if you leave the nursing home voluntarily within three days of admission, in which case you may be charged for up to three days at the basic daily rate if Medicare or Medi-Cal are not paying for your nursing home care. If you are due a refund after your discharge, the nursing home must pay it to you within 14 days of your leaving the facility. See Section V(E) of the Agreement on Payment of Other Refunds to You. If a resident dies, any advance payments must be returned to the heir, legatee or personal representative of the resident within two weeks after discharge or death. (California Health & Safety Code §1599.71(a) and Title 22 California Code of Regulations §72531)

Discharge Notice

The Admission Agreement shall not require a resident to provide advance notice of when he or she is moving out of a facility. (California Health & Safety Code §1599.71.)

Personal Possessions

At admission, the nursing home must establish a personal property inventory and give you or your representative a copy. (California Health & Safety Code §1289.4) Keep the inventory sheet current and save a copy. The nursing home is also required to give you a copy of its policies and procedures regarding protection of your personal property and the state laws that require those policies. (California Health & Safety Code §§1289.3, 1289.4, 1289.5 & 1418.7) See Section VIII of the Agreement on Personal Property and Funds.

Confidentiality

You have a right to confidential treatment of your medical and health information. (California Health & Safety Code §1599.73, Title 22 California Code of Regulations §72527(a)(10) &72543(b), Title 42 United States Code §§1395i-3(c)(1)(A)(iv) & 1396r(c)(1)(A)(iv), and Title 42 Code of Federal Regulations §483.10(h)). You may authorize the nursing home to disclose medical information about you to a family member or other person by completing Attachment E to the Standard Admission Agreement, the “Authorization for Disclosure of Medical Information” form.

Your Rights

The Standard Admission Agreement is intended to inform you about your rights as a nursing home resident. Certain rights are discussed within the Agreement, but Attachment F (Bill of Rights) is a more comprehensive description of your rights. It is a verbatim collection of selected federal and state laws and regulations. Attachment F, however, is 39 pages long due and not an easy way to learn about your rights. Nor is it up-to-date as numerous resident rights have been added or revised since the California Department of Public Health adopted the Standard Admission Agreement in 2011. CANHR’s fact sheet  on resident rights provides a quicker way to learn about your rights.

Admission Agreement Complaints

If your nursing home is not using the Standard Admission Agreement or violates any of your rights, you may file a formal complaint with the California Department of Public Health. For information on filing a complaint, see CANHR’s fact sheet,  How to File a Nursing Home Complaint .

You can also contact your attorney, local ombudsman program or CANHR to discuss your concerns.

BE SURE TO REQUEST AND KEEP A SIGNED COPY OF THE ADMISSION AGREEMENT!

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Court denies nursing home’s effort to withhold privileged safety records, citing dual uses

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Internal investigative documents used to help providers learn from errors and accidents can’t be held back from trial attorneys if they’re also used for other purposes, New Jersey’s top court ruled this week.

The decision reverses a lower court finding from 2023 that had protected such self-critical documentation from discovery under the state’s robust Patient Safety Act. That law is meant to support reflective processes that can help all kinds of healthcare providers improve quality and build in new or better safeguards.

But Monday’s ruling from the New Jersey Supreme Court in two consolidated cases found that a CareOne nursing home and assisted living community had invalidated the protection by sharing self-critical documentation outside of its safety committee.

Independence is a “precondition to applying the PSA’s privilege,” wrote Justice Fabiana Pierre-Louis. “The regulation directs that the ‘patient or resident safety committee shall not constitute a subcommittee of any other committee within a facility or health care system.’”

The ruling leaned on CareOne’s acknowledgement that its review committee was created for the dual purpose of complying with federal and state law. 

“Defendants’ own admissions that they treated their committees related to quality assurance and improvement as patient safety committees to comply with both the requirements of the PSA and their federal obligations shows that they did not follow ‘the only precondition to application of the PSA’s privilege,’” Pierre-Louis wrote.

The court found that the providers’ investigations were not undertaken “exclusively during the process of self-critical analysis” according to state law, and the justices ruled that incident reports and other documents were subject to discovery in both cases.

While privilege statutes are designed to allow healthcare providers and facilities to improve patient safety, Hall Booth Smith attorney Sandra Cianflone previously told McKnight’s Long-Term Care News that compliance with the letter of the law is critical.

“Perhaps a ‘full stop’ is needed to have counsel and risk management teams assess their current processes to ensure complete compliance in the future,” she said after the 2023 CareOne ruling.

Others have warned that allowing more access to previously protected documentation could have a chilling effect on staff willingness to self-report errors or providers ability to conduct robust internal investigations with an aim of improving quality.

For that reason, the New Jersey Hospital Association, the New Jersey Medical Society and 

The American Medical Association had filed briefs supporting CareOne’s arguments.

The documents in question can now be shared with the plaintiffs’ attorneys, potentially sharpening the cases against CareOne.

In Keyworth v. CareOne at Madison Avenue , Madeline Keyworth alleges she was injured in two falls at the skilled nursing facility. In Bender v. Harmony Village at CareOne Paramus , the family of Diane Bender wanted an incident report to substantiate its claims that Bender was attacked by another resident during her stay at the assisted living facility.A spokeswoman for CareOne told McKnight’s Wednesday that the company does comment on litigation “as a matter of policy.”

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Bachelor of Science in Nursing Henry Predolin School

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Embark on a career of passion and take a pivotal role at the forefront of healthcare. Becoming a registered nurse is one of the most rewarding careers and will take you on a journey of bringing hope, celebrating the wins, and having a profound impact on the lives of others every day. You will become a trusted professional, advocating for the health and wellbeing of your patients – and their families. Standing in this space is about the profession of patient care, but you can expect to develop a greater sense of purpose in your own life, too.  

Choosing the right college is a crucial decision that will significantly impact your education, career, and experience as a nursing student. With our excellent reputation and highly respected faculty, the Edgewood College nursing school has a longstanding history of being one of the most respected programs in the state of Wisconsin. Our program is split into two components. Students will take (60) credits of general education, elective, and prerequisite courses. Once complete, students will apply for admission into the Henry Predolin School of Nursing. Admitted students will continue the second half of the program which includes four semesters (60 credits) of professional nursing classes, clinical, and simulation experiences.  

One of the most dynamic and versatile professions, nursing, offers a wide range of career paths. For students with diverse interests and aspirations, becoming a nurse opens the door to an exciting and fulfilling career. Pursuing a Bachelor of Science in Nursing (BSN) degree at a private, liberal arts school in the thriving, capital city of Madison, comes with advantages:  

• Low clinical faculty-to-student ratio.
• Partnerships with reputable healthcare facilities offer diverse clinical opportunities.
• Strong alumni network promotes valuable connections.
• Expand your marketability in a competitive and vibrant healthcare employment market.

Careers in Nursing

Average annual salary for registered nurses with a BSN

Bureau of Labor Statistics, Occupational Outlook, 2023 data

Growth rate for registered nurses in the workforce, from 2022 to 2032

Bureau of Labor Statistics, Occupational Outlook, 2022 data

As healthcare continues to advance, there is a growing emphasis on the value of highly educated nurses in the workforce. With a BSN, you will be prepared to pass the NCLEX exam and enter the workforce having a competitive edge. Many organizations prefer or require nurses to have a BSN for consideration of certain positions, especially leadership roles. Your bachelor’s degree will also prepare you for entry into graduate programs if your career aspirations include advanced positions such as a nurse anesthetist, nurse educator, nurse practitioner, and nurse manager/administrator.

Be Prepared to Pass Your NCLEX

One benchmark metric of a strong program is their NCLEX-RN exam first-time pass rate. Consistently, our pass rate is significantly higher than the national average. With a 99% NLCEX-RN first-time pass rate , the most recent cohort of students (fall 2023) in this program are an excellent reflection of how the best program is directly tied to positive student outcomes.

Nursing by the Numbers

Community Partners for Clinical Placements

Student to Clinical Faculty Ratio

Featured Courses

Nursing 305 Nursing Science: Professional Nursing in a Diverse World

Introductory course that examines concepts of client-centered care, family, community, populations, health promotion, global health, social justice, and diversity.  Students will examine the transitions of care within and across the environments in which care is provided along with developing an understanding of how health is defined across different cultures and populations. Students will reflect on their personal beliefs and how this may impact their nursing care and describe the relationship between personal health and a culture of health. Dominican values will also be examined as a foundation to professional nursing practice. Students will be expected to engage in wellness activities to promote self-care.

Nursing 320 Nursing Science: Pharmacology & Therapeutics

This course focuses on the major classes of drugs, addressing the physiological and pathophysiological rationale for each drug indication, mechanisms of drug action, dosing implications, and adverse drug events. The course will enhance the student’s comprehension of the scientific complexity of therapeutic interventions and will build upon the foundational sciences. Additionally, the course will provide the student with sufficient scientific knowledge and skills to monitor drugs and therapies in a safe and effective manner. Nurse’s role in assisting individuals and families in the pharmacological management of illness and health maintenance is addressed.

Nursing 401 Nursing Science: Perinatal Nursing

Person and Family Centered Care in Maternal and Infant Health engages students in a family-centered approach to health and health alterations in childbearing women, newborns, and families.

Student Organization

Henry predolin student nurses association.

You will gain valuable leadership experience by joining the Henry Predolin Student Nurses Association (SNA), the largest student association in Wisconsin.

The Henry Predolin SNA regularly sends more delegates to the annual statewide conference than any other school. If you’re interested in gaining incredible global health experience, you might want to consider joining our faculty on a trip to underserved areas like Cambodia, El Salvador, and St. Lucia. It’s an enriching experience to learn and grow while making a positive impact on the world.

Accreditation

The baccalaureate degree in nursing program at Edgewood College is accredited by the Commission on Collegiate Nursing Education (CCNE), 655 K Street NW, Suite 750, Washington, DC 20001, 202-887-6791. The program is also approved by the State of Wisconsin Board of Nursing.

Application Process

Eligibility for Admission

Students will apply for full admission to the Traditional Undergraduate in BS Nursing program the semester before they are eligible to begin nursing coursework.

• You have completed all (60) credits of prerequisite coursework or are currently in the semester in which you will complete these credits.
• Maintain at least a 2.75 cumulative GPA in college coursework.
• Maintain at least a 2.75 GPA in prerequisite math and science courses. A minimum grade of “C” is required in all prerequisite math and science courses. NOTE: Required math and science courses must have been taken within (8) years of admission to the first nursing course for credit in the nursing major.
• Complete CPR/BLS for Healthcare Providers Certification.

What Should I Know as an Incoming Freshman Student?

For students entering their first year at Edgewood College without an Associate Degree in Nursing (ADN) or previous bachelor’s degree, you will begin by applying to Edgewood College. Additionally, if you are transferring into Edgewood College and have not yet completed the required coursework, you will start by submitting your undergraduate application.

Applications into the School of Nursing are reviewed for students who have completed, or are in progress to complete, the prerequisite coursework including (60) college credits . Most students* will begin applying to the School of Nursing during their 4 th semester at Edgewood. It is important to understand that admission into Edgewood College does not imply, or guarantee, admission into the Traditional Undergraduate BS in Nursing Program.

• Submit an Undergraduate Application to Edgewood College and select “Freshman Application” as the type of application.
• Submit High School Transcripts with cumulative GPA and class rank (if available) NOTE: If high school transcripts are not available, submit GED.

Complete, or be in progress to complete, (60) college credits including prerequisite coursework

Incoming freshman may be eligible for direct admission into the School of Nursing through our Guaranteed Admission Program . Additional details can be found under the Guaranteed Admissions Program section.

Application Process for Current and Transfer Students

The Traditional Undergraduate BS in Nursing Program is split into (60) credits of core and prerequisite coursework and (60) credits of nursing coursework. Once you enter the final semester of your core courses, you can begin the process to apply for the School of Nursing.

Transfer students: If you have completed your prerequisite coursework at another college and anticipate starting the nursing program for your first semester at Edgewood College, you will begin by applying to the School of Nursing. NOTE: You are not required to submit an undergraduate application to Edgewood College.

This portal is used to simplify and streamline the application process. Edgewood College’s School of Nursing Admission Committee will make all admission decisions. We encourage students to make certain the necessary application qualifications have been met, and to be mindful of the application deadlines.  

• Create an account and login to NursingCAS.
• Complete and submit your application including manual entry of all courses including prerequisites. NOTE: Courses entered should match all courses denoted on your official transcripts.
• Upload official transcripts from all colleges you have attended including Edgewood College.
• Pay the required application fee through NursingCAS portal.
• Upload personal statement with 500 word limit. Choose ONE of the following when writing your personal statement:
• What does professionalism in Nursing mean to you and how will you apply this in your studies and profession? -OR-
• Nurses uphold responsibilities consistent with providing high quality care. In what ways would you utilize this approach in your practice and address related challenges? -OR-
• What moral and ethical principles would you consider in Nursing? Why is this important?

Transfer students: If you are admitted to the nursing program, you will be required to submit your official high school transcripts directly to the Edgewood College Office of Undergraduate Admissions. Admitted students will receive further instructions when this information is required.

Application Deadlines

Once you have determined that you meet the criteria to apply for the nursing program, you will be ready to start the application process. As this is a highly competitive program and admission is capped at (42) students, we recommend submitting your application and required documentation as soon as the application opens. This allows you ample time to complete each requirement and ensure all required documentation has been received so your application meets the priority deadline. After the priority deadline has passed, applications shift to rolling admission.

Applicant Selection Process

The School of Nursing Admissions Committee is comprised of nursing faculty dedicated to screening applicants for admission into this program. Admission to the Traditional Undergraduate BS in Nursing program at Edgewood College is highly competitive and is limited to (42) students in the fall semester and (42) students in the spring semester. The committee will admit the most qualified students based on cumulative GPA, science/math GPA, previous academic records, personal written statement, and credits completed.

Explore Additional Steps to Strengthen Your Nursing School Application

It is common for students to inquire how they can improve the likelihood of securing one of those coveted spots in the nursing program. While the above qualifications take utmost priority in determining program eligibility, the list below offers a guide as to ways decisions are made when we have more highly qualified students than we have open seats.

• Achieve at least a 3.0 GPA or greater (on prerequisite college coursework) to have priority over applicants that meet the minimum GPA of 2.75.
• Complete First Aid certification.
• Complete Certified Nursing Assistant (CNA) requirements and hold a CNA license.
• Degree(s) in other fields.
• Edgewood College Students who have completed (10) or more credits at Edgewood College will have higher priority over those who have less/none.
• Outstanding professional or personal achievements.
• Prior experience working in the healthcare field.
• Proficiency in a second language.
• Strengthen your personal statement.
• Volunteer experience in your community.

Admissions Process

Academic Requirements for Admission

Eligibility for admission to the Traditional Undergraduate BS in Nursing program requires students to complete (60) credits and maintain a cumulative GPA of at least 2.75. These (60) credits must include the following prerequisite courses (or their transfer equivalents) listed below:

Students must also have completed all Edgewood College general education requirements.

** Current Edgewood College students must compete BIO 155 SU, or be in progress of completing, at the time of application .

For transfer students, BIO 155 SU is not a prerequisite for program admission if Anatomy and Physiology I, Anatomy and Physiology II, and Microbiology have been successfully completed and approved for transfer. Transfer students should contact their Academic Advisor to request a special arrangement waiver if they will not need this course.

Students possessing a baccalaureate degree in another field from a regionally-accredited institution, or a 2-year associates of science or arts degree from Madison College or a UW school are considered to have fulfilled all of Edgewood College’s General Education requirements, except COR courses. Post-baccalaureate students, however, must still meet all School of Nursing pre-requirements for supporting courses in the major.

Eligibility for Guaranteed Admission Program

Incoming freshmen with a strong academic background in high school may be eligible for direct admission into the School of Nursing. Students who agree to participate in the Guaranteed Admission Program for the School of Nursing and meet the following criteria will be granted admission into the major:

• Be admitted to Edgewood College as a new college freshman.
• Achieve at least a 3.5 cumulative high school grade point GPA.
• Maintain at least a 3.25 cumulative GPA in college coursework.
• Maintain at least a 3.25 cumulative prerequisite math and science GPA in all college coursework.

I Have Been Admitted – Now What?

Congratulations on being selected for our esteemed School of Nursing! We look forward to supporting your journey to becoming extraordinary healthcare professionals. Please accept admission within (3) weeks of receiving your Offer of Admission Letter.  Nursing students who do not accept admission by the deadline will forfeit their space . Further details will be provided in the School of Nursing Welcome Packet.

Apply for Nursing Scholarships

Visit our scholarships page to view all available Edgewood scholarships.

Go to Edgewood College Scholarships

Nursing Clinical Experiences

The Henry Predolin School of Nursing partners with over 80 community agencies for clinical placements. Locations span across southcentral Wisconsin as well as northern Illinois. Some of these include:

• SSM Health St. Mary’s Hospital – Madison
• The American Family Children’s Hospital
• UnityPoint Health-Meriter Hospitals and Clinics
• UW Hospitals and Clinics
• Veteran’s Administration Hospital

Clinical placements also include multiple public health sites and public/private school sites.

Nursing Faculty Spotlights

Assistant Professor

Suzy Karcher, DNP, APRN-CPNP AC

[email protected]

Senior Lecturer

Katie Selle, MA, RN-BC

[email protected]

View All Faculty

Building Confidence Through the Application of Experiential Learning

The Center for Healthcare Education and Simulation (CHES) is a collaborative partnership between Edgewood College School of Nursing, SSM Health St. Mary’s Hospital, and UnityPoint Health – Meriter Hospital.  This state-of-the-art space has been providing Edgewood College nursing students with innovative education and training through the utilization of patient simulators. Simulation rooms are designed and equipped to replicate a multitude of environments such as a patient room in a hospital or a clinic, or a resident room of a nursing home, or skilled care facility.

Three realistic patient rooms are fully equipped, each viewable from a control room that allows instructors to monitor students and record sessions. Two of these classrooms are equipped with audio-visual equipment that provides live-feed simulation. This reflective learning environment includes opportunities to discuss and debrief. Robot patient simulators include high-fidelity mannequins across the lifespan – infant, child, birthing mother, adult—that can be programmed to replicate patient conditions and physiologic responses. Several low-fidelity mannequins and task trainers are used by students as they practice specific skills and techniques.

Simulation experiences introduce nursing students to clinical scenarios in preparation for real clinical interactions, thus allowing students to safely practice team-based care and improve individual skills. This learning environment places students in the experience and is often mentioned as a favorite aspect of nursing school. This engaging space fosters team-based learning as students learn, train, and work together. This is where students apply their textbook knowledge, learn from their mistakes, practice skills, and improve communication. It’s also when future nurses emerge and begin to build their self-confidence.

This educational tool provides pre-nursing students with a unique and immersive way to study anatomy while enhancing their understanding of the human body. Students interact with a digital cadaver to learn all levels of anatomy from the whole body to microanatomy and includes 3D investigations of normal and pathological case studies. With this unprecedented level of detail, the advanced technology of the anatomage table allows students to visualize every aspect of the human body and makes it an innovative tool used to teach anatomy and pathology. The interactive and dynamic nature of the tool makes learning anatomy more hands-on, creating an engaging learning experience. An investment into the students’ educational experience, the 3D Anatomage Table serves to bridge theoretical knowledge with practical application, ultimately improving the overall educational outcomes and clinical preparedness of graduates of our nursing program.

What are the differences between and ADN and a BSN?

Nurses with a bachelor’s degree in nursing (BSN) and passing NCLEX-RN score are hired as a Registered Nurse (RN). Nurses with an associate’s degree in nursing (ADN) and passing NCLEX-RN score are also hired as RNs. While an ADN requires less education, many organizations require their nurses to hold a bachelor’s degree. Bachelor’s degree programs offer nursing students a more advanced and comprehensive education which will enhance career opportunities, increase earning potential, and position future RNs as leaders in their field.

What if I already have an ADN?

Edgewood College has an innovation option available for students who have achieved their ADN.  We offer an ADN-MSN which allows students with an ADN to complete their BSN in as few as 21 months while integrating 12 credits of MSN coursework into the curriculum. Upon completion of the BSN, students have the option to continue pursuing a master’s degree in nursing with as few as 18 additional credits.

What if I have a baccalaureate degree in another field?

Students in this situation have two options to pursue their Bachelor of Science in Nursing degree (both options require that students have to meet prerequisites):

Option 1: Enroll in the Traditional BSN program

Option 2: Enroll in the Accelerated BSN program (one-year pathway to BSN)

What do I need to know about the CPR/BLS for Healthcare Providers certification?

While not a prerequisite for admission, certification is required for students in the program. We strongly encourage students to be certified at the start of the program to avoid the need to renew in the middle of the program (certification lasts two years).

Does Edgewood College have a partnership for students at UW-Whitewater Rock County?

Yes! This unique collaboration brings the nursing program at Edgewood College to the UW-Whitewater campus, complete with a full faculty, clinical coordination expertise, and an innovative curriculum that integrates classroom instruction with hands-on clinical and simulation experiences. Additional details are available on Partner Schools under the UW-Whitewater Rock County Campus collaboration.

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Immigration Benefits Business Transformation, Increment I; Corrections

A Rule by the Homeland Security Department on 08/09/2024

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• Document Details Published Content - Document Details Agency Department of Homeland Security Agency/Docket Numbers CIS No. 2780-24 DHS Docket No. USCIS-2009-0022 CFR 8 CFR 212 Document Citation 89 FR 65165 Document Number 2024-17400 Document Type Rule Page 65165 (1 page) Publication Date 08/09/2024 RIN 1615-AB83 Published Content - Document Details
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• 8 CFR Part 212
• [CIS No. 2780-24; DHS Docket No. USCIS-2009-0022]
• RIN 1615-AB83

U.S. Citizenship and Immigration Services (USCIS), Department of Homeland Security (DHS).

Final rule; correcting amendments.

On August 29, 2011, the Department of Homeland Security published a final rule titled “Immigration Benefits Business Transformation, Increment I,” which, in part, amended DHS regulations to remove references to form numbers and titles. Two of the amendatory instructions were inadvertently not followed, resulting in errors in the Code of Federal Regulations (CFR). This document describes those errors and corrects the CFR to incorporate the amendments as instructed in the 2011 final rule. This action makes no substantive regulatory changes.

August 9, 2024.

Samantha Deshommes, Chief, Regulatory Coordination Division, Office of Policy and Strategy, U.S. Citizenship and Immigration Services, Department of Homeland Security, 5900 Capital Gateway Drive, Camp Springs, MD 20746; telephone 240-721-3000 (this is not a toll-free number).

The Immigration Benefits Business Transformation, Increment I final rule  [ 1 ] included two amendments to 8 CFR 212.2 that were incorrectly incorporated into the CFR. Specifically, the instruction numbered 64 stated that 8 CFR 212.2 would be amended to revise the term “the Form I-212” or “Form I-212” to read as “the application” wherever it appeared in the listed paragraphs, including paragraph (f) and paragraph (i)(2). [ 2 ] However, the resulting amendments to the CFR were incomplete, as described in the following paragraphs.

In accordance with these instructions, the sentence in former 8 CFR 212.2(f) that read, “The alien must file the Form I-212, where required, with the DHS officer having jurisdiction over the port of entry,”  [ 3 ] should have been revised to read, “The alien must file the application, where required, with the DHS officer having jurisdiction over the port of entry.” However, 8 CFR 212.2(f) was erroneously amended to remove “Form I-212” without incorporating “application.” As a result, the current provision has a blank space and reads, “The alien must file the, where required, with the DHS officer having jurisdiction over the port of entry.”  [ 4 ]

The instructions also sought to amend 8 CFR 212.2(i)(2) by replacing “Form I-212” with “the application” in the two instances in which it appeared in that paragraph. [ 5 ] However, only one instance was amended, resulting in the provision now reading, “If the alien filed Form I-212 in conjunction with an application for adjustment of status under section 245 of the Act, the approval of the application shall be retroactive to the date on which the alien embarked or reembarked at a place outside the United States.”  [ 6 ]

This document corrects these errors in the CFR.

DHS has good cause to bypass any notice-and-comment or delayed effective date procedures that might otherwise apply to this document under the Administrative Procedure Act. DHS has for good cause found that such procedures would be unnecessary, see 5 U.S.C. 553(b)(B) , (d), because this rule merely corrects typographical errors in the CFR.

• Administrative practice and procedure
• Immigration
• Passports and visas
• Reporting and recordkeeping requirements

Accordingly, for the reasons set forth in the preamble, 8 CFR part 212 is amended as follows:

1. The authority citation for part 212 continues to read as follows:

Authority: 6 U.S.C. 111 , 202(4) and 271 ; 8 U.S.C. 1101 and note, 1102, 1103, 1182 and note, 1184, 1185 note (sec. 7209, Pub. L. 108-458 , 118 Stat. 3638), 1187, 1223, 1225, 1226, 1227, 1255, 1359; 8 CFR part 2 . Section 212.1(q) also issued under sec. 702, Pub. L. 110-229 , 122 Stat. 754, 854.

Section 212.1(q) also issued under section 702, Public Law 110-229 , 122 Stat. 754, 854.

2. Amend § 212.2 by revising the last sentence in paragraph (f) and paragraph (i)(2). The revisions read as follows:

(f) * * * The alien must file the application, where required, with the DHS officer having jurisdiction over the port of entry.

(2) If the alien filed the application in conjunction with an application for adjustment of status under section 245 of the Act, the approval of the application shall be retroactive to the date on which the alien embarked or reembarked at a place outside the United States.

Christina E. McDonald,

Associate General Counsel for Regulatory Affairs, U.S. Department of Homeland Security.

1.   See 76 FR 53764 (Aug. 29, 2011); see also 76 FR 73475 (Nov. 29, 2011) (making correcting amendments); 78 FR 22770 (Apr. 17, 2013) (same).

2.   See 76 FR at 53786. “Form I-212” refers to Form I-212, Application for Permission to Reapply for Admission into the United States After Deportation or Removal.

3.   See 8 CFR 212.2(f) (2011).

4.   See 8 CFR 212.2(f) .

5.   See 8 CFR 212.2(i)(2) (2011).

6.   See 8 CFR 212.2(i)(2) .

[ FR Doc. 2024-17400 Filed 8-8-24; 8:45 am]

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Politics latest: New poll makes grim reading for Farage - as PM tells COBRA meeting to 'maintain high alert'

Sir Keir Starmer stressed the need to "maintain high alert" for more disorder as he chaired another emergency COBRA meeting. Meanwhile, new polling suggests support for Nigel Farage has plummeted since the unrest began last week.

Thursday 8 August 2024 20:55, UK

• PM stresses need to 'maintain high alert' for further unrest
• But says swift sentencing of rioters should be 'important lesson'
• Labour councillor arrested on suspicion of encouraging murder
• Farage accused of helping spread conspiracy theories
• London mayor 'astonished' by Tory leadership hopeful's comments
• Listen: How well has the PM handled riots?
• Mhari Aurora: Starmer can't be sure he's out of woods just yet
• Darren McCaffrey: Farage may struggle to have his cake and eat it
• Explained: Robert Jenrick and the Allahu Akbar row | What does 'two-tier policing' mean - and does it exist?
• UK riots latest: Follow updates on arrests and sentences

Our  political correspondent Darren McCaffrey has spotted some interesting polling about Nigel Farage.

According to YouGov, the Reform leader's favourability ratings have fallen since the start of the riots in the UK.

He is viewed unfavourably by every voter group in the UK except Reform backers.

This includes Leave voters - his score with them going from +7 to -4.

The proportion of 2024 Tory voters that have a negative view of him has risen from 52% to 61% - and 47% of the public believe he holds some responsibility for the rioting.

Farage under fire from multiple sides

Darren said: "I think he's trying to strike this balance between trying to lean into some of the causes potentially behind at least the protests, if not the violence, but at the same time trying to condemn them. 

"The question is, can he have his cake and eat it? Can he effectively walk that fine balance?"

Mr Farage questioned the initial police response to the stabbing in Southport, accusing them of withholding information.

The Reform leader has since condemned the violence on the streets - but made allegations of " two-tier policing ", claims which have been denied and criticised by the prime minister and Met Police chief.

Mel Stride, the Tory leadership hopeful, was heavily critical of Mr Farage this morning when speaking to Sky News - and it could be that more Tories come out to attack him.

With yet another COBRA meeting in the bag for the prime minister, the Politics Hub is signing off for the evening.

For continued coverage of the response to the riots, including the latest arrests and court hearings, check out our dedicated blog below:

As things stand, the Politics Hub won't be running tomorrow, so any political news, reaction, and analysis relating to the unrest will be in the above blog - do follow along for the latest updates.

Thanks for joining us today, and have a good evening.

Sir Keir Starmer has told his ministers and police chiefs they need to "maintain high alert" despite last night's anticipated wave of far-right unrest failing to materialise.

Sky News understands that was the PM's main message from tonight's COBRA meeting - his third of the week.

Sir Keir thanked the police and wider criminal justice system, saying the high levels of policing in key areas last night helped deter rioters - as did the swift sentencing of those convicted so far.

The prime minister has condemned a "deeply concerning" rise in antisemitic incidents in the UK this year.

Charity CST, which is dedicated to protecting Jewish communities, reported almost 2,000 cases in the first half of 2024 - a record high.

There were at least 200 every month - something which had only happened five times prior to October 2023.

That marks the point that Hamas launched its brutal attack on Israel, which was followed by the now 10-month bombardment of Gaza.

Sir Keir Starmer thanked the CST for its work and said: "Jewish people, and all those from faith communities, deserve to feel safe on our streets. 

"We will work together to eradicate discrimination of any kind."

While last night didn't see the unrest many had feared, tonight's COBRA meeting comes ahead of what ministers fear could be days of further protests and disorder.

Sir Keir Starmer has vowed he will not "let up" so far as responding to threats from those bent on violence, and has held talks with police chiefs again this evening to discuss what could happen.

Our crime correspondent Martin Brunt has reported there are fears the new football season kicking off this weekend could spell trouble.

It comes after policing minister Dame Diana Johnson told Sky News earlier that intelligence points to more potential protests.

Read more from our political reporter Alix Culbertson  👇

We've been reporting in the Politics Hub today on the arrest of a Labour councillor over comments he made at one of the counter-protests that took place around the country last night.

First came footage from the event, which appeared to show a man calling for "fascist" rioters to have their throats "cut".

Nigel Farage was among those who shared it, and called on police to arrest the man responsible.

He was named online as Dartford Labour councillor Ricky Jones, and the party moved quickly to suspend him.

We then heard from the Met Police, who said they were urgently investigating the video - and later came an arrest on suspicion of encouraging murder.

For the full story and where we've got to as of tonight, our political reporter Faye Brown has you covered 👇

Sir Keir Starmer was in the West Midlands earlier before returning to London for tonight's COBRA meeting.

The PM visited a mosque in Solihull, and has just put out a post on X thanking local leaders he met there - and the police - for "keeping our communities safe".

Our team have spotted cabinet ministers leaving the COBRA meeting in the last few minutes, so hopefully we'll get an update on what was discussed from Downing Street before too long.

We'll bring it to you if and when we do.

By Faye Brown , political reporter

Metropolitan Police chief Sir Mark Rowley has knocked back claims of "two-tier policing" as "complete nonsense".

He said such claims - pedalled online by Nigel Farage and Elon Musk - put officers dealing with the ongoing riots at risk.

The phrase is used to describe the impression that some protests and demonstrations are dealt with more harshly than others.

What are the origins of 'two-tier' policing?

The term has been used to suggest police are more heavy-handed with people on the right of the political spectrum than the left.

Even before the current rioting in the UK, the idea was propagated by the likes of English Defence League founder Tommy Robinson, actor-turned political activist Laurence Fox, and former ex-minister Robert Jenrick.

Reform UK leader Nigel Farage summed up the sentiment when he claimed that "ever since the soft policing of the Black Lives Matter protests, the impression of two-tier policing has become widespread".

'Difference between riot and protest'

However, critics of those who have used the term say there is a clear difference between legal protests and the riots, which has seen mosques and hotels housing asylum seekers attacked, police officers hospitalised, and shops smashed and looted.

One of the strongest rebukes came from Dame Priti Patel, who was home secretary during the Black Lives Matter demonstrations in 2020.

She told Times Radio: "What we saw during the pandemic, we saw protest. We believe in free speech. We saw protests being policed.

"What we're seeing right now is thuggery and disorder and criminality. There is a complete distinction between the two."

What is the law on protests in the UK?

Protest is legal in the UK and the right to freedom of expression is also protected under the European Convention of Human Rights.

However, this only applies to peaceful protest and does not extend to any violence inflicted or damage caused during a protest.

As pointed out by Chris Hobbs, a former Special Branch officer writing for the  Police Oracle website , arrests have been made at pro-Palestinian protests when there has been suspected criminal offences, as has been the case during climate protests and BLM demonstrations.

Prime Minister Sir Keir Starmer is banking on the rapid sentencing of convicted rioters putting people off committing more disorder.

There have been more arrests today - not just over the violence we've seen over the past week, but also inaccurate information about the Southport attack shared online.

False claims about the suspect helped ignite the riots.

People have been sentenced today, too - some to several years in jail.

For the latest on the response of the police and the courts, head to our dedicated live blog:

The unrest of the past week has seen members of the far right target Muslim communities and mosques.

It's reignited calls for the government to adopt an official definition of Islamophobia, with the hope it could help educate sections of the public and clamp down on violence and abuse.

Rishi Sunak's government refused to adopt one, suggesting it could negatively impact freedom of speech, and instead referred to cases of "anti-Muslim hatred".

And it appears the new government won't be quick to adopt one either.

Asked directly on Sky News if it would consider one, communities minister Alex Norris danced around the question.

'Still people out there who want to cause disorder'

"Our focus is on the next few days," he said, adding there'll be "plenty of other things we can look at" when the risk of more unrest has passed.

Mr Norris said while there are "still people out there who want to cause violent disorder", the government's focus is on ensuring police "have the powers they need" and that "swift justice" can be delivered.

We've spotted cabinet ministers and police chiefs arriving for tonight's COBRA meeting in Whitehall.

Met boss Sir Mark Rowley and Justice Secretary Shabana Mahmood are among those we've seen.

The meeting, chaired by Prime Minister Sir Keir Starmer, will discuss what happened last night and what may still be to come - the government has suggested more protests could be in the offing this week.

We'll bring you updates from the meeting whenever we can.

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