A documentation checklist for SNF referral packets.
Referral packets often have gaps you only find when you try to finish the review. Work through the four groups below before you accept, and ask the hospital for whatever is missing. The groups are the four areas a review covers: payer and authorization, skilled need and documentation, medication, and facility capability.
Four groups of records to check before you accept
This is a checklist for organizing the review, not medical, payer, reimbursement, or legal advice, and it does not guarantee skilled coverage. Facility staff verify every item against the source documents and make final decisions.
Payer and authorization
- Payer, plan, and member identifiers
- Network status
- Initial authorization
- Continued-stay cadence
- Payer-specific documentation requirements
Skilled need and documentation
- Physician orders
- Therapy evaluations
- Nursing notes
- Diagnoses
- Functional status
- Discharge summary details that support SNF level of care
Medication
- MAR
- Stop dates
- Route and dose
- Monitoring needs
- Specialty pharmacy questions
- IV antibiotic details
- Who is responsible for high-cost medication
Facility capability
- Wound orders
- Isolation status
- Behavioral notes
- Bariatric equipment
- Dialysis coordination
- Respiratory needs
- Staffing fit
Using the checklist with AdmitScore
AdmitScore™ reads a referral packet and lists possible missing documentation and clarification questions. Each item shows the quote and page it came from, so staff can check the source records before the admission decision. See what it lists in the sample report.
Also see: why SNF claims get denied and Medicare Advantage authorization.
Questions about checking your own packets?