Submitting the referral can feel like the finish line because it often takes real work to assemble. It is closer to the opening of a case. The plan or its delegate still needs to confirm receipt, gather enough information to review the request, communicate a decision and coordinate with a setting that can safely accept the member.
Track actions, not reassurance
“It is being worked on” is not a status. Ask what stage the request is in, what remains open and who owns the next action.
1. Intake and confirmation
The receiving team should match the referral to the member, confirm the requested service and determine whether the submission is complete enough to begin review. If the plan routes Community Supports through a partner, the referral may move between organizations before a named coordinator contacts the family.
Keep the confirmation. If no acknowledgment arrives, follow up through the same channel and the plan’s member-services line. A date-stamped record is especially important when the current setting is planning discharge.
2. Information gathering and assessment
The reviewer may seek medical history, a current medication list, functional information, a recent physician assessment, discharge notes or details about the proposed residence. They may speak with the member, representative and current care team.
Answer the question asked, but add the practical context that records may miss. A hospital note might say “ambulatory,” while the family knows the person can walk only a short distance with cueing and becomes unsafe at night.
3. RCFE screening and fit
A residence evaluates whether it can meet the person’s needs within its license, staffing, environment and current resident mix. It should review the same core facts the plan sees, plus preferences that affect daily life.
Availability alone is not fit. A fast placement that cannot safely support transfers, medications, cognition or behavior creates another transition. Families should compare the proposed plan of care with what staff can actually deliver.
4. Decision and service planning
The plan communicates whether it authorizes the requested Community Support and under what terms. If approved, the responsible teams align provider arrangements, service details and the move plan. If denied, reduced or delayed, the member should receive notice explaining the decision and review rights.
Before a move date is firm, confirm the authorization, RCFE acceptance, payment plan, medication orders, equipment, transportation and handoff contacts.
- Written plan decision received
- RCFE admission approved
- Admission agreement and costs reviewed
- Medication and pharmacy handoff confirmed
- Equipment and transportation arranged
- Day-one contact and after-hours plan identified
5. Follow-through after move-in
The transition is not complete when the vehicle leaves. Early follow-up should check whether medications arrived, the service plan matches actual needs, appointments are scheduled and the resident knows whom to ask for help.
Use the first 72 hours guide to structure those checks without overwhelming the resident.
Sources & important note
Zeal reviewed the primary sources below while preparing this article. Policies, benefits and individual circumstances can change; confirm current requirements with the responsible agency, health plan and licensed provider.
- DHCS: Community Supports Policy Guide, Volume 1
- DHCS: Closed Loop Referral FAQ and information-sharing guidance
- CMS: Discharge Planning Checklist for patients and caregivers
Editorially reviewed September 2026.