  
Referral Information
The Broadway House offers the convenience
of a streamlined referral process, supported by a courteous staff
who can help you negotiate Medicaid processing and authorization.
Admission
Criteria:
- Patient must be approved for a Special
Care Unit by the Medicaid Pre-Admission (PAS) System
- Patient must be at least 18 years
old.
- Pregnant women will not be accepted.
- TB Protocol: Patients are required
to submit three negative sputum’s or one negative chest x-ray
(within 30days of admission).
- Patients testing positive for TB
will be assessed on an individual basis.
- Patients with a history of dementia
or psychiatric issues must provide a recent (within one month)
Psychiatric evaluation.
Fax a copy of the patient’s Medicaid Pre-Admission (PAS) and a Broadway House referral form to the Admissions Department at (973) 268-7890. Any questions should be directed to the Assistant Director of Admissions, Dina Grace, at 973 268-9797 ext 1078. Patient applications will be assessed as appropriate. Final decisions are made by the Admissions Committee, which meets weekly.
The following information must be
provided:
Physician:
- History and physical Exam.
- Admission Process Notes.
- Discharge Summary.
- Allergies
Nursing:
- Admission Notes.
- Most current Nurses Notes (last
2 days).
- Medication and Treatment Records.
- Transfer Sheet (completed transfer)
- Presence of pressure ulcers and
assessment.
- Current Status of VRE/MRSA/Status
of isolation.
Reports:
- All Tests and Lab Reports (CBC,
Chemistry, Blood Cultures, MAI) within one week.
- X-rays, EKG’s, CT Scans.
- Consultations
- CD4 Count (T-Cell) and Viral Load.
- Chest X-Ray (within 14 days) /3
negative sputum’s.
- Immunizations (PPD, Pneumovax, Flu
Shot.)
- Telephone number of the lab to follow-up
with results of pending labs.
Social
Services:
- Current Psychosocial Assessment.
- Current Psych Evaluation (if Indicated).
- DNR status/Copy of Advanced Directive/Living
Will/DNR Consent/Health Care Proxy
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