Quick, accurate nursing home admissions help you secure more referrals while providing better care for incoming residents. When your admissions team has the right tools and processes, you can respond to referrals rapidly while still making sound clinical and financial decisions.

In this article, we'll cover the nursing home admission checklist, including:

• Pre-admission assessments and planning

• Required documentation and compliance guidelines

• How ExaCare streamlines the admissions process

Please note: A skilled nursing facility admission checklist tends to be longer and more detailed than the following nursing home checklist because SNFs have different regulatory requirements. An SNF will also have to verify a recent hospital stay and the need for daily skilled nursing care, especially for Medicare coverage. 

For example, an SNF will also have to:

• Verify skilled nursing qualification criteria: Medicare requires documented need for skilled services, not just assistance with daily activities. Flag specific qualifying services like wound care, IV therapy, or post-surgical rehabilitation in your assessment.
  
  

• Check qualifying hospital stay dates: To plan for payment transitions, verify the Medicare-covered days remaining.
  
  

• Differentiate care pathways: Short-term rehab patients have different documentation, reimbursement, and staffing needs than long-term residents. Flag this distinction early to activate the right admission track.
  
  

• Assess discharge potential: For short-term patients, evaluate whether their goals align with realistic outcomes based on their clinical picture.
  
  

• Check medications prescribed: Many SNFs have prevented serious medication errors by comparing hospital discharge orders with home medication regimens. Lab values need special attention during admission review.

Some places may offer both SNF and nursing-home care options, but that depends on the individual company structure.

6-Step admission checklist for nursing homes

1. Pre-admission assessment and planning

Determining clinical fit before admission prevents costly mismatches between patient needs and your facility's capabilities. Skilled assessments at this stage identify both clinical risks and reimbursement opportunities that might otherwise be missed.

Evaluate patient eligibility and care needs

• Screen beyond diagnoses: Cognitive status assessments reveal needs that medication lists don't show. A patient with moderate dementia but excellent mobility presents different care challenges than one with full cognition but limited physical function.
  
  Checks should include pre-authorization verification, medication reconciliation, and care plan development to prevent compliance issues and claim denials.
  
  

• Identify staffing implications: Note special care requirements that affect your staffing decisions, such as 1:1 monitoring needs, isolation precautions, or specialized therapy requirements.

Coordinate with referring providers

• Request standardized data packages: Create templates for what you need from each hospital partner to prevent delayed or incomplete referrals.
  
  

• Establish clinical handoff protocols: Direct communication between your nursing team and hospital clinicians catches critical details that paperwork misses.
  
  

• Sync medication reconciliation: Medication errors during transitions account for many readmissions. Verify all medication orders, including PRNs and recently discontinued medications.
  
  

• Schedule transition-focused physician updates: Ensure referring physicians provide recent visit notes and clear follow-up plans to maintain continuity of care.
  
  

• Create feedback loops with hospitals: Track and share data about referral quality with your hospital partners to continuously improve the handoff process.

2. Obtain documentation and legal requirements

Proper documentation serves as both your clinical roadmap and regulatory shield. Missing physician orders can trigger Medicare claim denials, while incomplete advance directives can lead to family disputes. A nursing home admission checklist can help solve this.

Patient records and assessments

Critical clinical details often get lost during care transitions. A thorough medication reconciliation catches potential dosing errors for high-risk medications like anticoagulants or insulin.

Does your team know which abnormal results require immediate intervention versus routine follow-up? This knowledge is especially crucial during weekend or after-hours admissions when full clinical support may be limited.

Legal and consent documentation

Who can make decisions for your resident? Decision-making authority disputes arise when documentation isn't clear. Your admission agreements should explain all charges in plain language to prevent billing disputes later.

HIPAA forms need regular updates as care teams change. Many facilities find that advance directives don't reflect current wishes or weren't updated after significant health changes. A brief advance care planning discussion during admission aligns documentation with actual care preferences before a crisis occurs.

3. Insurance and financial coordination

Financial surprises can damage relationships with residents and their families. Addressing payment details upfront prevents uncomfortable conversations later and protects your facility from claim denials.

Verify insurance coverage and benefits

Complete insurance verification before admission whenever possible. Many Medicare Advantage plans require pre-authorization –– be sure to document authorization numbers and covered length of stay to prevent denials.

Does your team check for supplemental policies? These can cover co-insurance amounts and reduce resident financial responsibility when billed correctly. Many facilities miss this opportunity to maximize coverage for their residents.

Coordinate financial discussions with families

Discuss out-of-pocket costs before admission so families can make informed decisions. Clear written agreements prevent misunderstandings when financial situations change.

Proactive facilities connect families with Medicaid application resources early and alert them before coverage changes occur. This approach builds trust and gives families time to prepare, reducing collection issues and improving satisfaction.

4. Facility Preparation and Staff Coordination

When a new resident arrives to find their room unprepared or encounters staff who seem surprised by their care needs, their confidence in your facility plummets. Proper preparation before arrival creates a positive first impression while reducing risk factors during this critical transition period.

Facility readiness and room assignment

• Strategic room placement: Consider not just clinical needs but also social factors. Placing a new resident next to a long-term resident with severe dementia can negatively impact both.
  
  

• Equipment readiness verification: Create an equipment checklist based on the pre-admission assessment. Is the proper bed configuration ready? Are all the supplies stocked?
  
  

• Environmental modifications: Adjust room setup for specific needs identified during assessment. Simple changes like moving furniture to accommodate walkers or adding visual cues for residents with cognitive impairments prevent falls and confusion.
  
  

• Welcome kit preparation: Prepare orientation materials, call button instructions, and meal information before arrival to reduce anxiety for the resident and family.

Briefing the care team

• Pre-arrival huddles: Schedule a brief team meeting to discuss incoming residents' key care needs, especially for complex cases. Creating a standardized nursing home admission checklist helps your facility maintain compliance while ensuring no critical documentation is overlooked.
  
  

• Assignment matching: Pair residents with staff who have experience with their specific conditions. A nurse experienced with complex wound care might be the best primary caregiver for a resident with multiple pressure injuries.
  
  

• Communication planning: Establish how often updates will be shared between shifts during the initial transition period when residents are at highest risk.
  
  
  

• EHR accuracy check: Verify that all medication orders, therapy schedules, and care plans are accurately entered in your electronic system before arrival to prevent medication errors or missed treatments.

5. Patient and family orientation

First impressions matter during admission day. When a new resident arrives stressed and uncertain, how you welcome them sets the tone for their entire stay. A thoughtful orientation process reduces anxiety, builds trust, and sets realistic expectations for the care journey ahead.

Facility tour and introduction to key staff

• Personalized facility tours: Show residents and families the areas most relevant to their care plan. For short-term rehab residents, emphasize therapy spaces and highlight success stories from previous residents with similar conditions.
  
  

• Staff introductions: Connect new residents with their primary caregivers across all shifts when possible. This helps establish rapport and gives families confidence about who's caring for their loved one around the clock.
  
  

• Simplified information packets: Provide concise printed materials with only essential information for the first few days. Too much information at once overwhelms families who are already adjusting to a significant change.
  
  

• Tech orientation: Demonstrate how to use the call button, adjust the bed, and operate the TV or other room equipment. These small details make a big difference in resident comfort and independence.

Patient onboarding and care plan review

Discuss realistic expectations for the stay, particularly for short-term rehab residents. What specific functional improvements are you working toward? What timeline is reasonable?

Next, you can identify how family members want to participate in care. Do they want to assist with meals? Attend therapy sessions? 

Finally, cover resident rights in a conversational way rather than just handing out the required documentation. Emphasize your facility's commitment to dignity, privacy, and self-determination.

6. Common bottlenecks: Avoiding admission delays

Knowing where admissions typically get stuck helps you prevent these costly slowdowns. Here are the most common bottlenecks that delay nursing home admissions.

• Incomplete physician orders: Missing signatures or required certifications that must be chased down before admission can proceed
  
  

• Outdated insurance information: Verification delays when the resident's coverage has changed since their hospital admission
  
  

• Missing prior authorization: Discovering too late that the resident's insurance requires pre-approval for admission
  
  

• Medication reconciliation discrepancies: Conflicting medication orders between hospital discharge and primary care physician records
  
  

• Staffing limitations for high-acuity admissions: Lack of specialized staff for complex care needs like ventilator management or isolation requirements
  
  

• Equipment procurement delays: Specialty beds, bariatric equipment, or specialized wound care supplies not arriving before the resident
  
  

• Transportation coordination issues: Poor scheduling between hospital discharge and your facility's optimal admission times

Effective nursing home marketing strategies attract referrals, but your admission process determines whether those leads convert into residents and successful hospital partnerships.

How ExaCare streamlines the admissions process

The admission bottlenecks we just covered affect your ability to accept new residents quickly while making sound clinical and financial decisions. Here's how many nursing homes are using ExaCare to address these challenges.

Automated referral screening and eligibility checks

• When a hundred-page referral packet arrives, ExaCare helps your team focus on what matters by highlighting key clinical information, diagnoses, and care requirements.
  
  

• Your team can quickly identify missing documents and request them immediately, rather than discovering gaps after the resident arrives.
  
  

• Before making admission decisions, you can see insurance verification results and potential reimbursement challenges, including high-cost medications that might affect your bottom line.
  
  

• The system helps identify patient needs that might require special staffing or equipment, allowing you to prepare appropriately or have important conversations with the referring hospital.

Centralized referral management

• Instead of checking multiple platforms throughout the day, your team reviews referrals from WellSky and EPIC Care Link all in one centralized location.
  
  

• When questions arise about a potential resident, your team can communicate directly with hospital case managers through the platform, creating clear documentation of all pre-admission discussions.
  
  

• Many facilities use the response tracking features to ensure no referrals slip through the cracks, especially during busy periods or staff transitions.
  
  

• When you accept or decline a referral, the system helps document your reasoning, which builds stronger relationships with your hospital partners through transparency.

Support for admissions teams

• With standardized workflows, your admissions process becomes more resilient to staff changes and easier to teach to new team members.
  
  

• Understanding patterns in your referral sources, acceptance rates, and response times helps you identify opportunities to strengthen your admissions process.
  
  

• By working alongside your existing EHR systems like PointClickCare, the platform reduces duplicate data entry and helps maintain data integrity.

Frequently asked questions

What are the essential documents needed for a nursing home admission?

You'll need physician orders, current medical history and a physical exam, medication list, therapy evaluations (if applicable), a face sheet with demographics and insurance information, advance directives, and signed consent forms.

A complete nursing home admission checklist guides your team through the entire process, from initial referral review to resident orientation.

For Medicare/Medicaid residents, include appropriate coverage documentation like hospital stay records. Many facilities also require proof of power of attorney or guardianship when someone other than the resident makes decisions.

What role does Medicare and Medicaid play in nursing home admissions?

For SNFs, Medicare covers skilled nursing care for up to 100 days after a qualifying hospital stay, with full coverage for the first 20 days and co-payments starting day 21. It requires a documented need for skilled services.

Medicaid typically covers long-term care for those meeting both medical and financial eligibility requirements. Each program has specific documentation needs that must be addressed during admission to ensure payment.

What is the average time it takes to process a nursing home admission?

The entire process typically takes 4-24 hours depending on case complexity. Initial referral review should happen within 30 minutes to remain competitive.

Documentation gathering and verification often take 2-3 hours, while admission procedures once the resident arrives usually require about 90 minutes. Facilities with streamlined processes complete the workflow faster, which both hospitals and families appreciate.

What's the best way to ensure smooth communication with referring providers?

Establish direct communication between clinical teams, not just admissions staff. Share specific contacts at each organization rather than using general intake lines. Set clear expectations about required information and timelines.

Consider regular check-ins with major referral sources to address persistent issues, and provide constructive feedback when you receive incomplete information rather than simply declining referrals.

How does ExaCare improve efficiency in the admissions workflow?

ExaCare automatically extracts key clinical and financial information from referral documents, allowing faster, more informed decisions. It centralizes referrals from multiple sources into one platform, eliminating the need to check several portals.

The system helps identify missing documentation early, verifies insurance coverage, and flags potential reimbursement issues before admission. Facilities typically cut referral response time while improving decision accuracy.

Is your nursing home ready to streamline admissions?

An effective admission checklist for nursing home providers balances thorough documentation with operational efficiency to help you secure more referrals while maintaining compliance.

Nursing homes often juggle multiple referral platforms, sift through hundreds of pages of clinical documents, and make high-stakes decisions without complete information. This not only slows your response time but also introduces risk into your clinical and financial assessments.

ExaCare improves your nursing home admission process by using AI to organize documentation, flag important clinical details, and help your team make faster, more informed decisions. Our platform reduces administrative burden while improving the accuracy of your admission assessments.

Here's what we offer:

• AI-powered document analysis that extracts key clinical and financial information from referral packets in minutes
  
  

• Centralized management that brings referrals into one platform
  
  

• Insurance verification tools that help identify coverage issues before admission
  
  

• Medication cost alerts that flag expensive treatments that might impact reimbursement
  
  

• Real-time communication hub to connect with hospital discharge planners and your internal team

Ready to see how ExaCare can help your facility streamline admissions and improve referral acceptance rates? Talk with our team to learn more.

Schedule a demo.