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Consent to Treatment Assignment Of Benefits Agreement with
Pharmacy Assignment to Use Medicare Part B Receipt of Health Information Portability and Accountability Act Health Information Practices and Release of Information Consent Medicare Determination Letter Consent for a Resident Trust Account Bed Hold Policy Ancillary Services Price List
During
admission process
Admission Coordinator will briefly describe to you each section of
agreement and what you are putting your signature to. To read
whole agreement to you would take 2 to 3 hours. Always request a copy of
agreement (you should not be charged for a copy).
Nursing homes are required to provide you with information and some of this information vary from state to state and nursing home to nursing home. This is how nursing homes prove to regulatory agencies that they have provided you with information. Here is an example list of those types of acknowledgement forms:
Acknowledgement or Receipt of Nursing Home Policies and Procedures Acknowledgement or Receipt of Resident Rights Acknowledgement or Receipt of Falls Management Program Acknowledgement or Receipt of Skin Management Program Acknowledgement or Receipt of Hydration Management Program Acknowledgement or Receipt of Nutrition Management Program Acknowledgement or Receipt of Self-Administration of Medication Acknowledgement or Receipt of Chemical/Physical Restraints
You will feel that you are signing your life away but you are not. All of these forms are standard for admission into most all nursing home rehabilitation units. Be sure to read them as soon as you can. If you have any questions ask them to explain. If they can’t or won’t explain contact
faculty ombudsman for assistance.

Tammy Gonzales, Life Coach and Advocate to Caregivers, of Revitalife Coaching & Consulting, LLC guides Baby-Boomers and the Sandwich Generation on how to take initiative to manage aging and caregiving before it becomes a crisis. Visit www.caregiverinfonline.com for more information.