Admitting a loved one...


... to The Fountainview Center or any other skilled facility is a serious decision and one that is eased by the effective flow of information between the involved parties. Information about the Fountainview Center and the services it provides is crucial for the responsible parties.

Additionally, The Fountainview Center needs information about the prospective resident to determine if the needs of that individual can be properly served by the facility. To help you, we have provided access to the admitting forms and information requirements as detailed below:


The Fountainview Center needs some preliminary information for each potential resident. This Initial Information starts the process.

The Fountainview Center also requires a Medical History as well as information on the ability of each potential resident to perform normal functions. Also required is permission to obtain medical information from current and past providers. I.e. physicians, medical facilities, other skilled facilities, etc. The Information Authorization is needed for all providers.

Other required information forms are DMA 6 and the PASRR Level 1 Form DMA 613. These 2 forms are to be completed by the applicant's physician. Also, please note that they must be dated within 30 days of admission, not application.


This information is required prior to initiating the admission process and is critical in determining how The Fountainview center will provide the care and services required for your loved one. Any question can be directed to the Director of Community Services.


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