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Admission Documentation Requirements​​

The State of Michigan requires the following medical documentation when a person is to be admitted to the Cass County Medical Care Facility. The same documentation is required whether the individual comes from home or from a hospital stay.

Documents Required:

A Medical History and Physical Examination Report

This information must be submitted by the admitting physician. It must be current (prepared less than 60 days from the date of admission).

Admission or Transfer Orders

These must be signed by the individual’s own physician and include current medication orders as well and any other special order for care.

Other documents required when an individual transfers to our medical care facility include:

  • Face Sheet/demographic information: This is a page that has all your loved one’s information such as address, contact numbers, all insurance information, emergency contacts, social security number, birth date, etc.
  • PAS/ARR Level 1-this is Form 3877*
  • PAS/ARR Level 2-this is Form 3878*
  • Photo copies of the front and back of all insurance cards
  • Pharmacy coverage information

If your loved one is coming from a hospital or transferring from another facility, that establishment will handle all the necessary paperwork.

If your loved one is coming from home, however, everything listed here can be handled by your loved one’s Patient Care Provider (PCP). Once all the required information is gathered it can be faxed to the facility, to the attention of Admissions.

The Cass County Medical Care Facility admits, provides nursing care to, and accommodates all residents without regard to race, age, sex, color, creed, religion, national origin, or physical or mental handicap, pursuant to the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973.