Admissions

Admissions Inquiry Form

The decision to contact a skilled nursing home for yourself or a loved one can be a difficult decision to make. However we have staff dedicated to making this process as easy as possible. If you would like to start this process, please fill out the information below and we will contact you. Contact Morgan Voga at (515) 509-6269.

Date of Inquiry(Required)

Name(Required)

First Last

Email(Required)

Phone(Required)

What would you like to learn more about?(Required)

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Have questions or concerns? Let us know what’s on your mind.

Name

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(515) 509-6269

barbara.courtney@bethanylife.org

(515) 733-5293 (fax)

Thank you for reaching out to Bethany Life!

I will be your contact during this process. Once we have your application our business office and clinical staff will look over everything and reach out if they have any questions. We may need additional forms including a PASRR (Pre-Admission Screening and Resident Review required by DHS), a Medication List and History & Physical forms from your primary care provider. We will assist with obtaining this information. Once financially and clinically approved then orders for admit will be requested from your Primary Care Provider. Admission paperwork and releases must be filled out, copies of POA/Living Will obtained and copies of insurance cards will be requested. Again, we are here to help!

Our team will contact you on a day and time for admissions.

Bethany Life Admissions Packet

"Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand."
– Isaiah 41:10