800-464-9797

EXECUTIVE OFFICE
120 WEST JOHN STREET HICKSVILLE, NEW YORK 11801 516-932-7799
516-932-1415 (FAX)

DATAHR HOME HEALTH CARE
120 KISCO AVENUE
MT. KISCO, NEW YORK 10549
914-242-1903
914-242-7010 (FAX)

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How to Make the Referral

AS EASY AS A-B-C

1. Obtain and provide the following information:

• Demographic:
  • Patient's name and address with apartment number, zip code, cross streets, and phone number.
  • Emergency contact, with home and work telephone numbers.
  • Patient's Date of Birth.
  • Patient's social security number.
  • Insurance information, with carrier's phone number and contact person to validate, and the name of the person who owns the policy. Include all authorization information from managed care carriers.
  • Physician (name, address, license and UPIN numbers) who will sign the initial orders, and name and telephone number of any other physician who will provide care in the community.
• Medications the patient is currently taking and any known allergies.
• Diagnoses and prognosis (the anticipated outcome of treatment).
• Specific goals for home care (what you want us to do for the patient; the skilled needs).

We will provide all assessments and obtain all CHHA services as needed.

We will do the paperwork for you.

2. Call our Intake Nurses Martha Stuber or Lorraine Rosen at:

1-800-464-9797, Extension 222

or

1-516-932-7799

3. If you require on site assessment of patient in preparation for discharge, we will provide if for you.