PDPM items to check in a referral packet before a SNF admission.
Several details that matter under PDPM are already in the referral packet: NTA-related conditions, therapy and skilled-need support, high-cost medications, diagnosis details, and MDS Section GG functional items. AdmitScore™ lists them for staff to verify against the source documents before acceptance.
PDPM items in a referral packet, and what staff verify
PDPM is not a standalone product here. It is one admissions-level signal for staff to verify against the source documents in the packet.
| PDPM item | Where it appears in the packet | What staff verify |
|---|---|---|
| NTA and medication items | Diagnosis details, the medication list, and hospital documentation. | Possible NTA-related conditions, medication concerns, and the supporting documentation. These are questions for administrator review, not final coding decisions. |
| Therapy and skilled need | Therapy notes and skilled-need documentation. | That the notes and supporting documentation are in the packet. They can affect both authorization readiness and the facility's planning. |
| Section GG functional status | Therapy notes, hospital documentation, and functional details. | Functional documentation, including MDS Section GG items where available. |
| Medication and supply implications | The medication list, supply and equipment needs, and isolation and wound care notes. | That high-cost medications, supplies, isolation, wound care, and equipment needs are reflected in the rest of the packet review. |
AdmitScore does not guarantee payer approval or reimbursement. Facility staff verify every item and make the admission decision. For general background on PDPM payment, see the PDPM margin methodology.
Also see: SNF admissions software, referral packet review software, and the documentation checklist.