Is this discharge safe? A hospital discharge checklist

Before the day of discharge

• Ask to meet the case manager or discharge planner. Ask when discharge is planned and what the plan is.
• Ask whether your loved one is an inpatient or under observation. It can affect what Medicare covers for rehab afterward.
• Ask what help they will need at home: walking, bathing, toileting, meals, medications, and wound care.
• Ask whether rehab in a skilled nursing facility, home health care, or outpatient therapy is recommended, and why.
• Ask for a list of new, changed, and stopped medications, and who to call with questions.
• Ask what equipment is needed, such as a walker, shower chair, or hospital bed, and who orders it.
• Ask which follow-up appointments are needed and who makes them.

Is going home safe?

A discharge may not be safe if no one can help with what your loved one cannot do alone, if the home has stairs they cannot manage, or if they are confused and live alone. Say so plainly to the case manager and ask what other options exist. You can ask for a written copy of the discharge plan.

If you disagree with the discharge

People with Medicare should get a notice called the Important Message from Medicare about their rights. It explains how to ask for a fast appeal by contacting the Beneficiary and Family Centered Care Quality Improvement Organization named on the notice. Medicare.gov explains the steps and timing. Ask the case manager for the notice if you have not seen it. Medicare Advantage and other plans have their own steps, so ask the plan as well.

The first days at home

• Fill new prescriptions before or on the way home.
• Set up a safe path from bed to bathroom and remove trip hazards.
• Plan who will stay or check in the first nights.
• Keep the discharge papers and medication list by the phone.
• Know which symptoms mean calling the doctor and which mean calling 911.

Printable checklist

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Common questions

Can the hospital discharge my loved one if we think it is unsafe?

The hospital decides when hospital care is no longer needed, but you can raise safety concerns, ask for a different plan, and, with Medicare, ask for a fast appeal using the Important Message from Medicare notice.

Does Medicare pay for rehab after a hospital stay?

Medicare may cover skilled nursing facility care after a qualifying inpatient hospital stay when skilled care is needed. Time under observation may not count. Medicare.gov explains the rules, and the hospital can tell you your loved one's status.

Who helps plan a hospital discharge?

The hospital case manager or discharge planner. Your local Area Agency on Aging can also tell you about help at home where your loved one lives.

Rules vary by state. Check with your state agency or a licensed professional where your loved one lives.

Want this organized for your family? The Care Options Plan and Monthly Guidance turns it into a personalized checklist with reminders. See plans.

Official resources and further reading

• Medicare.gov: Fast appeals when a hospital or facility stay is ending
• Medicare.gov: Skilled nursing facility care
• Medicare.gov: Home health services
• Family Caregiver Alliance: Hospital discharge planning guide
• Eldercare Locator (1-800-677-1116)

Links go to public resources. Kinhaven is not affiliated with them.