What is SNF referral review?
SNF referral review is the pre-admission check a skilled nursing facility makes on a hospital discharge or referral packet before it accepts the patient. It covers payer and authorization, skilled need and documentation, medication, and whether the facility can provide the care.
Referral review is the decision step before admission
When a hospital sends a discharge or referral packet, a skilled nursing facility has a short window to decide whether to accept the patient. The review is where unanswered questions in the packet become questions staff verify with the hospital, the payer, the pharmacy, or the family, before the facility commits a bed.
Four areas a referral review covers
Referral decisions turn on the payer and authorization picture, whether the packet supports the level of care, the medication list, and the facility's ability to deliver the care. A complete review touches all four.
Payer and authorization
Payer type, Medicare Advantage authorization gaps, and network status. Administrators and finance weigh the financial side of these, separate from the clinical conversation.
Skilled need and documentation
Diagnoses, acuity, behavioral and cognitive notes, wound and respiratory status, fall and readmission risk, and skilled-need support. Teams also look for missing therapy notes, orders, and medication lists that may need clarification before acceptance, so follow-up does not stall after the patient arrives. They confirm these against the full referral packet.
Medication
High-cost medications, carve-outs, and the medication list in the packet.
Facility capability
Whether the facility can deliver the required level of care: staffing, therapy capacity, isolation, dialysis or respiratory support, specialty services, and equipment. Each is a fit question to confirm with your own staff.
How referral management, referral review, and admissions intelligence differ
These terms are often used loosely. Separating them shows where a tool fits.
| Term | What it means |
|---|---|
| Referral management | The workflow and CRM tool: capturing referrals, tracking sources, logging status, and reporting on the pipeline. It organizes the process but does not, on its own, evaluate whether a specific packet is a good admission. |
| Referral review | The decision step inside that process: a structured read of one packet for payer and authorization, skilled need and documentation, medication, and facility capability. This is where staff form the judgment on whether to accept. |
| Admissions intelligence | Decision support that helps staff review a packet faster and more consistently by listing possible risk items with links back to their source pages. It informs the review, and the reviewer still decides. |
Where AdmitScore fits in referral review
AdmitScore™ is an admissions-intelligence tool for skilled nursing facilities. It reads each packet and lists the payer, Medicare Advantage authorization, documentation, and high-cost medication questions staff should verify. Each item shows the quote and page it came from. AdmitScore does not assess financial questions; your administrator and finance lead do. It does not approve admissions, guarantee payer approval, prevent denials, or guarantee reimbursement. Facility staff verify every output and make the final decision.
Our estimate for hands-on reading time is about 45 minutes a packet by hand and about 15 with a review that links each item to its source page (how we estimate this).
Also see: hospital-to-SNF referral triage, SNF admissions software, how SNF teams evaluate referrals, denial-risk review, the documentation checklist, Compare approaches, and Security.
More on referral review
Who does SNF referral review?
Admissions or intake coordinators usually run intake and coordinate the review. The director of nursing (DON), or a clinical liaison, reviews each packet for clinical fit, and the administrator or finance lead weighs the payer and financial questions.
How long should referral review take?
Referral review often happens under time pressure because hospitals expect a quick response. Many teams aim to give an initial answer within hours, but the right pace is whatever lets staff verify clinical fit, payer status, and documentation first.
Questions about how your team reviews referrals?