Skilled Nursing and Long Term Acute Care Facility Admission Process

As part of the discharge plan the Utilization team can assist with the transfer of a member to a Skilled Nursing Facility (SNF)* or Long Term Care Facility (LCT), if the member’s contract provides benefits for such services. The following information will be required, as well as a physician order, if the patient has not been hospitalized prior to admittance:

  • Member demographics, including the subscriber number
  • Names of admitting and attending physicians
  • Admitting diagnosis
  • Clinical information supporting inpatient admission (i.e. InterQual Criteria)
  • Route of admission
  • Telephone number of the Facility Utilization Department where the member will be transferred

A 3-day hospital stay is not required, prior to utilizing SNF benefits.

The provider should notify HealthPlus 24 hours prior to the SNF admission by telephone or fax at:

Phone: (810) 230-2105
Fax: (810) 230-2002 or (989) 797-4022

In the event that the request for SNF or LTC services are not approved, the provider may appeal the decision.

Additional Resources: