Making the transition from hospital to home

EDUCATIONAL OVERVIEW · SEPTEMBER 2026

A handoff is more than a document.

A discharge plan works best when the patient, family, and receiving team understand who is responsible for the next step. A reconciled medication list, follow-up plan, and reliable contact turn instructions into coordinated care.

Questions worth asking

• Who will receive and review the discharge information?
• Does the patient understand the medication changes?
• Are follow-up visits and needed services arranged?
• Who should the patient call if symptoms change?

Clinical appropriateness does not by itself establish eligibility for a billing code. Check the applicable CMS service requirements.