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Hospital Discharge Planning  
Hospital discharge planning is a service to assist patients arrange care needed following a hospital stay. Discharge planners help arrange services including home care, nursing home care, rehabilitative care, outpatient treatment and others. Hospital discharge planning is usually handled by the hospital's Social Services Department.

Why is discharge planning important?

Hospital patients frequently require a variety of care and services following their hospital stay. It is often difficult to identify how to obtain needed services. Furthermore, many care programs and services have complicated eligibility rules and some also have waiting lists. Discharge planners help patients and their representatives identify and arrange needed services before discharge from the hospital.

In order to contain costs, most hospitals discharge patients as quickly as possible. Hospital recuperation periods are usually very short so some patients are discharged with greater care needs than in the past.

How do I obtain discharge planning services?

If you think you may need help following your hospital stay, ask your doctor to contact the hospital social services department on your behalf. You can do this when you are admitted to the hospital or even shortly before admission. If a hospital discharge planner does not contact you within a short time, contact the social services department directly for assistance.

What requirements exist for discharge planning services?

Medicare-certified hospitals (most hospitals) are required to provide discharge planning services which meet the following criteria:

  • Hospitals must identify and evaluate persons who may require discharge planning assistance. A patient must be evaluated for discharge planning needs if a request is made by a patient, patient representative or physician.
  • The evaluation must be done on a timely basis and must determine the need for services after the hospital stay and the availability of those services.
  • The results of the evaluation must be discussed with the patient or patient's representative.
  • If requested by the physician, the hospital must help develop and implement a discharge plan for the patient.
  • Discharge planning must be provided or supervised by a social worker, registered nurse or other appropriately qualified person.

What if I cannot get needed help or am being discharged too soon?

If you experience difficulties in obtaining needed help from the hospital discharge planning unit, talk with your doctor or the hospital administrator. Explain your concerns.

If you think you are being discharged from the hospital too soon or without needed help, you may want to file a complaint. There is another ombudsman Fact Sheet that gives information about your right to receive needed care and tells you how to file a complaint.

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