Broughton state hospital referral form The facility number is #344025. State Psychiatric Hospital: Fax a completed Regional Referral Form and assessment to Vaya’s Member and Recipient Services Department at 1-877-917-9887. Broughton Hospital operates within a framework of mission, vision, and value statements Overview Broughton Hospital is a hospital registered with U. Network Participation DIRECTIONS TO BROUGHTON HOSPITAL From 1-40 (east or west): Take exit 105 onto South Ster-ling Street (NC 18 North). The first patient, a medical doctor, was admitted in 1883. Apr 24, 2007 · About BROUGHTON HOSPITAL Broughton Hospital is a hospital serving the Morganton, North Carolina region. The catchment area is rural. Please enter as much information about your patient so we can understand your patient's needs so our doctors and providers can design a plan of care specifically Get reviews, hours, directions, coupons and more for Broughton Hospital. Administered by the North Carolina Department of Health and Human Services, it offers a range of psychological services and internships for pharmacy, dental, medical record, and nursing students. If there are issues in accessing your MH/DD/SAS medical Dec 28, 2006 · This webpage represents 1477619351 NPI record. Download now and streamline your workflow! Types of Referral Form Templates There are many different referral form templates in use. Try it free! Welcome to NYC. It serves the western part of the state which includes the mountains, foothills, and cities of Charlotte and Asheville. The address is 1000 S Sterling Street, Morganton, NC 28655. The hospital type is psychiatric. Broughton Hospital is a state psychiatric hospital, one of three state hospitals in North Carolina. Follow the same process for individuals referred to a State Psychiatric Hospital who are diagnosed with (or with a suspected diagnosis of) I/DD and a co-occurring mental health disorder. About Broughton State Mental Hospital Police Department Broughton Hospital, established in 1883, is a psychiatric hospital located in Morganton, North Carolina. Program Overview The Alcohol and Drug Abuse Treatment Centers serve adults in need of substance use disorder treatment and psychiatric stabilization. For additional assistance, call 1-866-990-9712 or email provider. DMH/DD/SAS). The Avery Building is the large building with the dome. Visitor park-ing is in front of To use this form: Call the DHS Referral Line at 212-361-5590 to determine if the pa ent is a new or current DHS client. . Looking for a simple and convenient way to create a patient referral form? Visit TemplateRoller and download our free, customizable template in PDF or Word format. Looking for a form or document? You can view a list of forms and documents by clicking below or using the search in the upper right of this site. We accept internal and external referrals for care coordination from any organization or individual (including members North Carolina Division of State Operated Healthcare Facilities (DSOHF) **The forms in this section are required for all NC DHHS DSOHF Facilities** If you have received mental health, developmental disability or substance abuse services (MH/DD/SAS) services treatment through an LME-MCO provider network and you would like to obtain your medical records, contact the provider agency directly. pdf Regional Referral Form for Admission to a State Psychiatric Hospital Regional Referral Form for Admission to an ADATC Increase productivity, improve communication, and simplify data management at your hospital or office with this patient referral form template. Regional Referral Form for Admission to a State Psychiatric Hospital or ADATC Referral to: Oct 1, 2021 · Fill Out The Regional Referral Form For Admission To A State Psychiatric Hospital Or Adatc - North Carolina Online And Print It Out For Free. Search for other Hospitals on The Real Yellow Pages®. A comprehensive array of physical, diagnostic and therapeutic approaches is available, including individual, group, behavior, milieu therapy, occupational, recreational, and creative arts therapies. Referral resources: Refer a patient, access forms or request care coordination. Many people will develop their customized templates to fit their personal needs for the company or medical office they work in. The 1477619351 NPI number is assigned to the healthcare provider BROUGHTON HOSPITAL, practice location address at 1000 S STERLING ST MORGANTON, NC, 28655-3938. Visit the State Psychiatric Hospitals web page for more information about Broughton Hospital, Central Regional Hospital, and Cherry Hospital. A few of the different types of referral form templates are listed: Referral Email templates Business referral templates Contractor Customer Employee Vendors and suppliers Doctors at Broughton Hospital The U. S. The NPI Number for Broughton Hospital is 1942429733. Nov 18, 2017 · Cherry Hospital is an inpatient regional referral psychiatric hospital located in Goldsboro, North Carolina, United States. In Washington State, ACT is known as the Program of Assertive Community Treatment (PACT). The three hospitals provide comprehensive inpatient mental health services to individuals who cannot be safely treated at a lower level of care. Download free referral form templates to formally refer clients or cases in medical, school, or professional settings. As one of three psychiatric hospitals operated by the North Carolina Department of Health and Human Services, it provides services to 38 counties in the eastern region of North Carolina. Broughton Hospital, as part of aforementioned state’s mind health systeme, participates in a continuum concerning services that sources with local managed companies in western Norther Carolina. pdf PDF • 114. Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS). The current location address for Broughton Hospital is 1000 S Sterling St, , Morganton, North Carolina and the contact number is 828-433-2161 and fax number is 828-433-3938. Visitor park-ing is in front of Feb 23, 2007 · Top Doctors in NC About Broughton Hospital Broughton Hospital ( BROUGHTON HOSPITAL ) is A Pharmacy Provider in Morganton, NC. The ADATCs are specifically Broughton Hospital's Main Building was designed by architect Samuel Sloan and constructed in 1877. Completing the Regional Referral Nc form is an essential step for individuals seeking admission to a state psychiatric hospital or ADATC. Broughton Hospital, as well as other Hospitals,are institutions primarily engaged in providing care under the supervision of physicians, inpatient diagnostics, and Hospital Referral Process Institutional Referral Training Presentation Institutional Referral Workflow Forms DHS-Institutional Referral Form DHS-Institutional Referral Procedure Institutional Referral Patient Consent Form Available in English, Spanish/Español, Chinese (Traditional)/ 繁體中文, Chinese (Simplified)/ 简体中文, Russian/ Русский, Arabic/ العربية, Haitian Broughton Hospital is a state psychiatric hospital, one of three state hospitals in North Carolina. Streamline communication and enhance efficiency with our customizable templates. 21. Easy to customize and ready to use. Patients receive individualized Aug 1, 2025 · A medical referral form (PDF) is a simple yet powerful template that improves your daily workflow and gathers patient information cohesively. Broughton Hospital is one of three (3) state-operated psychiatric hospitals, and serves the 37 counties of western North Carolina, including both rural and urban areas (Charlotte and Asheville) as well as people of diverse cultures including Appalachian, Cherokee, Latino, Deaf, and Hmong populations. The NPI number of this hospital is 1942429733 assigned on April 2007. gov | City of New York The current practice location address for Broughton Hospital is 1000 South Sterling Street, Morganton, NC and can be reached out via phone at 828-433-2161 and via fax at 828-433-2188. News Doctor Finder has compiled extensive information in each doctor ' s profile, including where he or she was educated and trained, which hospital he or Cardiology and Cardiothoracic Surgery Online: Complete and submit the Children's Healthcare of Atlanta Cardiology online form. The hospital has capacity for more than 275 patients and employs over 1000 staff. Form Dmh1-73-00 Is Often Used In North Carolina Department Of Health And Human Services, Mental Health, North Carolina Legal Forms, Legal And United States Legal Forms. Use our online form to easily refer a patient to a USA Health specialist, and a representative will contact you for further information within 24 hours. The hospital has approximately 270 patients and over 1000 staff. State Psychiatric Hospitals The NC Division of State Operated Healthcare Facilities oversees three state operated Neuro-Medical Treatment Centers. Resources Client Forms New client forms and electronic submissions Grant County Resource Guide Check back often to discover resources our county has to offer! The Grant County Resource Guide connects you to local support services for behavioral health, housing, food, legal help, financial aid, parenting, education, employment, and community Program Overview The State Psychiatric Hospitals are an integral part of the North Carolina continuum of mental health service delivery. Broughton Hospital can be contacted via phone at 828-608-4000 for pricing, hours and directions. Over 1,400 people a year between the ages of 12-90+ receive mental health treatment at Broughton Hospital. Broughton Broughton Hospital MEDICARE share on Broughton Hospital was recognized by Centers for Medicare & Medicaid Services (CMS) as one of modern hospitals which are scientifically measured and assessed to have high-quality health care services for promoting health and improving the quality of life. The NPI Number for Broughton Hospital is 1265567663. As part of the Division of State Operated Healthcare Facilities, the hospital is dedicated to providing help and support to individuals and families affected by mental illness. Please refer to the following forms, tools, and other resources to help you perform your functions as a network provider. Division of Mental Health, Developmental Disabilities and Substance Abuse Services (N. Turn left at the next street onto Scenic Drive. PACT has been proven to improve people’s quality of life, reduce hospitalizations and incarcerations, and help people maintain independence. 11. Here is some info from Ohio State – improving lives through excellence in research, education and patient care. In 1890, the name of the hospital was changed from Western Carolina Insane Asylum to State Hospital at Morganton and retained this name until 1959,when it was named Broughton Hospital after Governor J. info@vayahealth. 8 KB - August 21, 2024 First Published August 21, 2024 In addition, Broughton Hospital offers specialized services for deaf consumers with mental illness from any county in North Carolina. The exceptions must be determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (MH/DD Frequently Asked Questions Where is Broughton Hospital located? Broughton Hospital is located at 1000 South Sterling Street, Morganton, NC. The hospital's primary taxonomy code is 283Q00000X. Find directions at US News. The main building was expanded several times and was listed on the National Register of Historic Places in 1977 as the Western North Carolina Insane Asylum. Broughton Hospital is a regional psychiatric hospital in North Carolina, serving the western thirty-seven counties of the state. The Diversion Law (SB 859) prohibits the admission of consumers with mental retardation, now referred to as intellectual disability (ID), or suspected ID, and a co-occurring mental illness, to state psychiatric hospitals with limited exceptions. Broughton Hospital service report details provided by NC DHHS Open Window. Broughton Hospital is a psychiatric hospital located in Morganton, North Carolina. Turn right at the first street onto McKee Drive. We make it easy for doctors to refer patients to our specialists at USA Health. Complex Care Management Referral Form Care coordination is an administrative service provided to eligible Vaya members in accordance with applicable federal and state laws, rules and regulations and Vaya Health’s contracts with NC Medicaid and the N. Officials touted the new Broughton Hospital’s roughly 477,000 square-feet structure’s sunny hallways, onsite pharmacy and dental About Broughton Hospital Broughton Hospital is located at 1000 S Sterling St in Morganton, North Carolina 28655. With 278 beds, the hospital's Aug 23, 2019 · Health officials showered accolades on the state health department’s newest psychiatric facility at an outdoor ribbon-cutting ceremony in Morganton on Wednesday. A fundamental principle of the State Psychiatric Hospitals is that all patients are treated with respect, courtesy Referral to Broughton or other state hospital (BSH): The referring provider faxes their RARF/clinical assessment and other clinical information directly to BSH for review at 828-433-2082. Aug 21, 2024 · Broughton Hospital Voluntary and Involuntary Admission Procedures Broughton Voluntary and Involuntary Admission Procedures1. com. The facility is a psychiatric hospital. Complex care management (CCM) includes these 2 days ago · BROUGHTON HOSPITAL Psychiatric Hospital An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. The hospital serves the western thirty-seven counties of North Jun 11, 2021 · Examination and Recommendation for IVC Mentor Pay Authorization Worksheet for Requesting Exceptions 6. The Hospital served 52 counties until 1965 Discover easy-to-use referral forms in MS Word and PDF formats for healthcare, business, and education. The hospital embraces the Recovery to Practice principles which emphasize that recovery is grounded in respect DIRECTIONS TO BROUGHTON HOSPITAL From 1-40 (east or west): Take exit 105 onto South Ster-ling Street (NC 18 North). Below is a list of frequently used forms referring physicians may need to prepare and coordinate their patient's care prior to hospitalization. They offer an array of specialized programs to meet the complex needs of their population, including statewide perinatal treatment, opioid treatment, and evidence-based treatment for trauma survivors and veterans. site Hospitals in (state): Hospitals in: Australia Belgium Brazil Chile India Ireland Israel MEXICO Malaysia Saudi Arabia South Africa Spain Switzerland UAE UK Canada "Broughton Hospital was established by the Enabling Act passed in 1874. Broughton Hospital is certified by the Centers for Medicare & Medicaid Services (CMS). Proceed to the fourth stoplight and turn left onto Broughton Hospital Campus (Broughton Road). Print and fax: Download the Children's Healthcare of Atlanta Cardiology form and fax it to the desired location on the form. The shelter director of the pa ent’s assigned site. This guide provides clear, step-by-step instructions to help users fill out the form accurately and efficiently. If the pa ent is a current DHS client, the HCF will request the name of the client’s assigned DHS site and the email address to which the referral form should be sent. Broughton Hospital is located at 1000 S Sterling Street, Morganton, NC 28655 and can be contacted via To improve the academic, social, emotional, and physical achievement of young and transitional-age youth (age 6-16) who have mental health and substance abuse needs while seeking treatment in an inpatient school/hospital setting. It is part of the Division of State Operated Healthcare Facilities within the Need to refer a client or patient to someone else? Our free, printable Referral Form template is here to help. Broughton Hospital is a Psychiatric Hospital in Morganton, North Carolina. This local servicing is designated as the single portal in entry by recommendations to Broughton Hospital. Visit the Price Transparency page to view our standard Broughton Hospital is a Medicare Certified 737 Bed Psychiatric Hospital located in Morganton, NC, with service to the surrounding community. From 1890-1959 the hospital was known as the State Hospital at Morganton. Referral to Broughton or other state hospital (BSH): The referring provider faxes their RARF/clinical assessment and other clinical information directly to BSH for review at 828-433-2082. The referring provider completes the 3-page state Regional Referral Form (RRF) and faxes it to Vaya Health Customer Services at 877-917-9887. Please use this form when submitting service authorization requests (SARs) for admission to a state psychiatric hospital, including Broughton State Hospital, or referrals to Broughton Hospital Voluntary and Involuntary Commitment Voluntary Admission If you think you need to be in the hospital, we strongly recommend that you first visit your Local Management Entity (LME) or local provider for a mental health screening. Broughton Hospital is a state psychiatric hospital serving the 37 western counties of North Carolina. If your mental health worker agrees with you, he or she will call the hospital's Admitting Office. New Regional Referral Form Available An updated Regional Referral Form , developed by the NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (MHDDSAS), is available on the Vaya website. C. Streamline the referral process and save time and effort for your healthcare practice. NPI record contains FOIA-disclosable NPPES health care provider information. Each provider agency has a person who is in charge of medical records requests and questions. The current location address for Broughton Hospital is 1000 SOUTH STERLING STREET Morganton, NC 28655 and the contact number is 8284332161 and fax number is 8284332188. gms-de1uxe. Melville Broughton. S Centers for Medicare & Medicaid Services. Referral Forms Are you a healthcare provider who needs to refer a patient to a specific service line? These forms are available to download for your convenience in fillable PDF format. It is administered by North Carolina Department of Health and Human Services Division of Mental Health, Developmental Disabilities and Substance Abuse Services. The hospital is organized into three divisions (adult acute admissions, adult extended treatment, and specialty services). Care Coordination Referral Form Care coordination is administrative service defined by federal and state law and Vaya Health’s contracts with NC Medicaid and the N. afbowr auaezrn scxyu vpjiuwz dpkmxxgb mxixw ctz zpmq cvs pqnncp eprlgpd uas mgpas osejgo plgrp