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Admission Application Procedures

In order to apply for admission, you will need to complete the application.  All questions must be answered.  Submit it to the Home, along with the following:

  • The veteran's Military Discharge document, or a copy of the
    DD-214 form.

  • Copies of Medicare and/or any Health Insurance coverage cards.

  • A recent History & Physical for the applicant.  For example, a copy of recent physical exam, hospitalization, current medication list, progress notes. If applying  for the Special Needs Unit (Alzheimer's Unit), and the applicant has had a previous CT Scan of the head and/or an EEG, please also send a copy of these reports

  • A copy of a chest x-ray report taken within the previous 90 days.

  • If married (and filed taxes), a copy of the past year federal income tax forms.

  • Verification of income and assets.  For example, copies of current bank account statements, copies of social security or other pension award letters or checks, etc.

  • Copies of guardianship, power of attorney, conservatorship, or patient advocate forms that exist.  We encourage you to look over and consider the Durable Power of Attorney for Health Care form enclosed.  Completion is not mandatory.

What You Can Expect:

After the completed application is received, the staff at the Home will review it for completeness, eligibility, and for level of care.  The applicant (or other contact) will receive a telephone call from the Admission office indicating the status of the admission.

If you have any questions, please contact  admissions at:

(Marquette area) -- (906)226-3576, ext. 305

(Outside local area but in Michigan)  -- 1-800-433-6760
(By Fax)  --  (906)226-2380
or (By e-mail) Feldhausers@michigan.gov 

Financial questions may be directed to the
Benefits Coordinator at:  (906)226-3576, ext 350
or (By e-mail) StrongR@michigan.gov

 

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 •  Application for D.J. Jacobetti Home for Veterans

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