David J. Ross Nursing Home Administrator Hillsborough County Nursing Home 400 Mast Road Goffstown, NH 03045 Phone: (603) 627-5540 Fax: (603) 627-5547
Candidates for admission, or their representative(s), may file an application for admission to Hillsborough County Nursing Home. Those candidates with residency in Hillsborough County for at least a one year period will be given first priority based on bed availability. Medical records required for admission from a hospital include: a discharge summary and 276 A, B and C forms, history and physical, referral forms completed by a physician, nurse and social worker, copy of last lab work, x-rays, surgical reports, consult discharge summaries with physical, occupational and speech therapies and a completed PASARR form. All admissions will be required to sign a financial agreement on or before admission, which must be signed by the prospective Patient/Resident or his/her responsible party. Patients, Residents and/or responsible party must agree to apply for Medicaid when the Patient/Resident becomes eligible. Verbal approval from the District Welfare Office for Medical Assistance is required prior to admission if the candidate is admitted initially under the Medicaid Program. Admission is contingent upon our ability to meet the needs of the prospective applicant, receipt of medical documentation, verification of payor source and availability of an appropriate bed. Please call our Admissions Office to schedule a tour or to have an admission packet mailed to you. The Admissions Office phone number is (603) 627-5540 ext. 7304.