Resident Admissions

admission sign

Admissions Process at Pleasant Lake Lodge

Helping your loved one transition into our care with ease and confidence.

Step 1: Start with the Resident Referral Form


The first step toward admission is completing our Resident Referral Form. This form helps us understand your loved one’s care needs, background, and whether Pleasant Lake Lodge is the right fit for them.


Once your referral is submitted and reviewed, a member of our team will contact you to discuss next steps — including meeting the prospective resident and arranging a personal tour of the home.

Resident referral form

Step 2: Review & Approval

After meeting the resident and reviewing their needs, we’ll determine if we’re the appropriate setting for their care. If approved for move-in, we’ll begin the formal admission process.
Before admission can take place, the following documents must be completed and submitted:

 

  1. Completed Healthcare Appraisal (HCA)

  2. Current Medication List from a physician — we cannot dispense any medication (including over-the-counter) without a written order

  3. Copies of DPOA, guardianship, and/or conservator/payee paperwork

  4. Copy of photo ID or driver’s license

  5. Any DNR or DNI paperwork (must be current)

  6. Copies of all insurance cards

🔹 The referral form includes an upload option — please upload any available documents such as ID, DPOA/court paperwork, face sheet, and medication list. DPOA or court paperwork is essential to confirm that you have the legal authority to make placement decisions for this individual.

Once all required paperwork is received, we’ll schedule your loved one’s official move-in and complete the remaining admission documents, including:

  • Review and sign of home guidelines, policies and procedures

  • Completion of the Assessment Plan

  • Signing of the Resident Care Agreement, which outlines monthly rates, care expectations, and procedures

  • Referral to our visiting house physician

  • Outings and photo permission slip signed so we can have fun and get proof of it

Most of these forms are finalized on the day of move-in. However, the Healthcare Appraisal, Medication List, DPOA/Court paperwork, and DNR/DNI forms must be submitted before that day.

Step 3: Admission Day

Before Move-In

To ensure a smooth and sanitary transition:

 

    • All clothing must be washed and labeled with the resident’s name.

    • Any snacks or food items must be labeled as well — these will be stored in our locked pantry (no food is kept in resident rooms).

    • All medications must be in properly labeled containers. We cannot accept or dispense any medication that is not labeled correctly by a pharmacy or physician.

    • Toiletries are to be provided by family, or designated representative (if applicable) on a monthly or as needed basis. Those should have their initials on them.
    • You are encouraged to bring photos, keep sakes, shelving (we can hang securely) to make your room as cozy and as familiar as possible.
    • Enough incontinent supplies needed. (If receiving them through J & B Medical – please let us know the account number)
    • All medical equipment labeled with the resident’s full name on it.
Resident Referral Form

When you choose Pleasant Lake Lodge, you’re not just finding a place to live — you’re finding a family who truly cares.