Thank you for your interest in Victoria Home, one of
the premiere state-certified, not-for-profit skilled
nursing facilities in the Hudson Valley.
ADMISSION POLICIES GENERAL INFORMATION
Please read the Admission Policies information below
before downloading the application form.
The admission policies
and procedures of Victoria Home, Inc. are established
in accordance with Federal and State codes, rules and
Information regarding admission policies, the application
process and the Homes services will be provided
to anyone on request. Area referral agencies and hospitals
will be provided with copies for their routine use in
the discharge planning process.
Home does not discriminate on the basis of Race,
Color, Creed, Sex, Sexual Preference, Age, National
Origin, Marital Status, Disability or Source of
Payment in the admission, care and retention of
All written information regarding services of the facility
will include the anti-discrimination policy statement.
Candidates and/or their designated representatives will
be informed verbally at the time of application and
interview of the anti-discrimination policy; and the
Home will periodically publish this anti-discrimination
policy in the Westchester/Rockland Newspaper.
All admission inquiries are handled by the Victoria
Home Admission Coordinator(s). The Admission Coordinator
will explain all the services of Victoria Home and the
requirements for admission. If the inquirer decides
to make a formal application to the Home, the Admission
Coordinator will provide the applicant with an admission
The Home applies the following restrictions on the admission
and retention of residents:
Residents under the age of 16 years old.
Residents who are prenatal, intrapartum or post
Residents suffering from communicable disease.
Residents who display a psychiatric disorder
and/or are in need of active psychiatric
treatment beyond the scope of services at Victoria
Home will not be admitted or retained.
Residents who require the following treatment,
therapies or nursing supervision:
Applicants with Ducubitus Level 4 or 5 in PRI
section II, Question 16. The Facility reserves
the right to give priority to the following candidates
Candidates who are referred from agencies or hospitals
with whom the Home maintains a Transfer Agreement.
Candidates who have previously been residents
at the Facility.
Private paying candidates if the current Medicaid
census exceeds 50%.
All PRIs received, regardless of disposition,
will be kept in a central file in the Social Workers
office for a period of 18 months. The PRI cover sheet
will indicate the date of referral, the referral name,
source of referral, race, color, national origin, sex
and disposition of referral.
If an applicant who submits a PRI decides to proceed
with the application process, the PRI will be kept in
an active application file in the Social Workers
office while further documentation is being gathered.
The PRI will be returned to the central file when a
final disposition is reached.
The application may be removed from the active file
if the request for placement is withdrawn or, if after
a period of thirty (30) days, there is no activity by
the candidate or his/her representative or agency towards
completing the application process.