Accepting Resident Applications
To send in an inquiry to become a resident please download the form below:
After filling out the form please submit it to us by one of the following means:
7835 Elders Drive
State Highway 87
Rushville, NE 69360
REQUIRED FOR ADMISSION
The following list is a guide to assist in the admission process. Please review it prior to admission so that you will have all the required information available. We realize how stressful the admission process can be. This will allow you to be prepared to answer all required questions. Thank you for your assistance.
Current physical and/or hospital records. These should include most recent lab results, current physician orders (including medications, diet orders, therapy orders, etc.), therapy notes and other pertinent information. If a person is being admitted from the hospital, the hospital is usually responsible for providing this information.
Most recent physical. This can be faxed directly from the physician’s office. Again, if the person is being admitted from the hospital, the hospital will most likely send this with the above information.
If the person is on Medicaid, please bring proof of this, as well as the name and number of the caseworker involved.
Upon admission, we will need to know the name, address, and phone number of the attending physician. Please verify with the physician that (s)he will follow with the person’s care. If the regular physician is unable to follow, review the list of house physicians available so that one can be chosen upon admission. If you need assistance, please feel free to contact OSLNH Nursing Staff.
We will need at least two emergency contacts and phone numbers. If possible please provide additional contacts.
Be prepared to answer some personal background questions such as place and date of birth, occupation, dates of military service and branch, names of parents and spouse, etc.
Please bring a copy of your tribal enrollment. This can be a card issued by your tribe, or an enrollment document. We are currently accepting applications from potential residents enrolled in any federally recognized tribe.
We will need a copy of your social security card.
Please attach your form of income to the application. This can be a bank statement, a letter for Social Security, SSI, etc.
If applicable, provide the name and address and phone number of the funeral house in which the person has prepared a burial plan.