Fort Bayard Medical Center/Fort Bayard State Veterans Home
Adrian Duran
Admissions/Marketing Director
(575) 537-8636
(575) 537-8865 FAX
email: Adrian Duran
Fort Bayard Medical Center Admission Information
Required Information
Click here to download a printable copy of the "Required Information for Admission"
To ensure that the admission of a referred individual is processed smoothly and efficiently, please see that the following information is obtained from the referring hospital, nursing home or attending physician and provided to Fort Bayard Medical Center BEFORE the arrival or admission of an individual.
- Transfer Form or Discharge Summary
- History and Physical Examination Documentation(within 6 months prior to admission)
- MDS 3.0 Abstract(the most current one)
- Most recent lab work to include HIV, X-Rays, MRI, CT Scan (within 1 year), Mammogram, Dexa and Colonoscopy.
- Progress Notes(nursing, social services and physician)
- Incident Reports (identifying behavioral issues, combativeness, sexual inappropriateness, striking out, accidents, etc…)
- Medical History (operations, allergies, fractures, etc…)
- List of Present Medications (Bring them for review at Admission)
- Consultation Reports
- Emergency Room Reports(if applicable)
- Guardianship papers if referred individual is incompetent or statement of competency, copies of Power of Attorney/Durable Power of Attorney, Conservatorship, etc...
- PASSR approval i.e., level I or Level II or documentation from PASSR office suggesting otherwise.
- Copies of Advance Directives (if applicable, i.e., Burial Plan, Life Insurance, Living Will, etc...)
- Copy of Medicaid/Medicare Card(s)
- All Financial Information/attached documents
- Copies of Social Security/Insurance Cards
- Copy of Photo Id
- PT/OT/Speech Evaluations and Progress Notes
- Vaccination records
- Dietary assessment including most recent height, weight, usual body weight, significant weight change for 1,3 & 6 months (if known), and current diet (including supplements and allergies) or tube feeding orders.
For Veteran Placement the following additional are required:
- Copy of DD-214 Discharge Certificate.
- For Spouses, copy of Marriage Certificate
- Letter of Gold Parent Status
If the Referral has a Psych Diagnoses other than Dementia we will require the following as well:
- If the patient is on any Psych Meds, new consents will be needed to continue at our facility.
- Documentation that the patient has been stable on Psych Meds for at least 30 Days
- Any history of violence will automatically disqualify for Admission.
- PASSR approval i.e., level I or Level II or documentation from PASSR office suggesting otherwise. They must qualify for Nursing Home Placement
- Must have POA/Surrogate in place. NO Treatment Guardians are accepted.
- Psychological/Psychiatric Evaluations(if applicable), history of Psychiatric Hospitalizations(if known) and Diagnoses
- PASSR approval i.e., level I or Level II or documentation from PASSR office suggesting otherwise. They must qualify for Nursing Home Placement
- Must have POA/Surrogate in place. NO Treatment Guardians are accepted.
- Psychological/Psychiatric Evaluations(if applicable), history of Psychiatric Hospitalizations(if known) and Diagnoses
If we do not receive all required information, the admission process will be delayed until received.