Table 2.

– SNF admission processes by site

	SNF 1	SNF 2	SNF 3
Facility characteristics	- Part of large chain - Short-term care only for Medicare and private pay - In-house medical director and physician assistant manage most patients, supplemented by contracted providers	- Small chain - Predominantly long- term care with small skilled unit - Staffed by contracted attending physicians and advance practice providers	- Only accepts in- network patients - Predominantly short-term care with some long-term beds and hospice unit - Staffed by employed in-house physicians only
Screening process and admission decision	-Liaison conducts screening (nursing, business, respiratory therapy backgrounds) - More complex patients referred to Director of Nursing for review - Red/Yellow/Green system	-Liaison (speech pathologist) conducts screening using standardized form - Liaison decides to admit	- Screening by Multidisciplinary admissions committee - Attending physician visits patient prior to hospital discharge to evaluate if uncertainty
Factors Considered When Screening patients	- Primarily payer and perceived length/cost of stay - Patient complexity and stable discharge plan less important	- Payer and cost of stay - Patient complexity important, may turn away complex patients or those without clear discharge plan	- Rehabilitation goals and motivation of patient most important - Medical stability important, will refuse patients until more stable in hospital
Initial Assessment parameters in SNF	-Medical director sees patients within 24 hours of admission - Nurse checks medication list twice and reviews with physician, pharmacist not initially involved	- Attending physician sees patient within 3 days of admission - Approves medication list read by nurse over telephone initially - Pharmacist then reviews medications	- Physician assesses patient in hospital before transfer - Process for automated transfer of hospital medication records to SNF records - Pharmacist reviews medications on admission