Fair Haven - Resident Admissions

For additional information or to request an admissions packet, contact Carol, Social Services and Activities Director at 937-492-6900.

You may request a complementary "free" copy of the following:

• "Understanding Medicare" as it relates to nursing facilities
• Living Will
• Durable Power of Attorney for Health Care

Items to complete for admission:

• Complete an admissions packet which includes an Admissions Agreement - legally binding the client and the facility together, stating what each must do relating to the relationship of the facility and the client.
• Sign an Authorization for Care - authorizing the facility and physician of choice to provide care and services to the client.
• Complete a Statement of Facts – designating the responsible parties and individuals to be notified in the event of emergencies.
• Individuals unable to pay privately must make an application for the Medicaid program. Application for the Medicaid program is processed through the Department of Human Services. A level of care assessment by Passport is required for all individuals admitted under the Medicaid program.
• The client's physician prior to their admission must complete a History/Physical form.
• Provide the facility with a copy of power of attorney, guardianship, Living Will,   Durable Power of Attorney for health care, social security numbers, insurance cards and Medicare cards and any other required legal documentation..