Sometimes it seems as though discharge from the hospital happens all at once, and in a hurry. But discharge planning is a process, not a single event. Medicare defines discharge planning as:

"A process used to decide what a patient needs
for a smooth move from one level of care to another."

As a result of that process, the discharge plan may be to send you to your own home or someone else’s, a rehabilitation facility, a nursing home, or some other place outside the hospital. A discharge plan should be based on a careful review of all the options.

Discharge from a hospital does not mean that you are fully recovered. It simply means that a physician has determined that your condition is stable and that you do not need hospital-level care. Discharge planning is a short-term plan to get you out of the hospital. No one can predict future needs, as your condition may improve or worsen over time. However, it is important for you to think about the long term as much as possible.

Getting Started
Ideally the Discharge Planning process begins on admission to the hospital. If the hospital stay was unplanned, as in the case of an accident or sudden illness, you may not have a clear idea of how long you will be hospitalized or what your condition will be. Still, it is a good idea to start thinking about the options as soon as possible.

Most of the time, an acceptable arrangement can be worked out with you or your relative and the Discharge Planner. However, there may be disagreements. For example, a patient may want to go home as quickly as possible, or the hospital may need the bed. In some cases, a family caregiver may have to balance a relative’s preferences and the hospital’s needs against the hard realities of the situation. Sometimes a patient may have unrealistic expectations about what they can do for themselves.

A physician assessment will be done to determine how much care will be needed immediately after discharge, and for the first weeks of recovery. Your physician will keep you informed of the change in your level of care status. Once your level of care changes and you no longer need acute or skilled care, you should expect to be discharged.

Who Handles the Discharge?
The Discharge Planner is your primary contact and may be a nurse, social worker, or other medical professional. It is important for you to know who this person is and to understand what she or he can do — as well as what is beyond their control. Your Discharge Planner will do everything possible to assist with the process. It may also be useful to talk to others who have been in the same, or a similar, health situation.

What Will Insurance Pay For?
Most people do not have a good idea of what medical insurance will pay for until the need arises. It can be a shock to find that insurance will not pay for many items and services needed at home that are routinely paid for in the hospital.

Unless you or your relative has specific long-term care insurance, many services, especially home care aides or attendants, will not be covered at all or beyond an initial short-term period. The Discharge Planner can assist with insurance, but may not be able to provide all the necessary information regarding your specific policy benefits.

> The Basics of Discharge Planning:
   A checklist to familiarize you with the process.

> Return to Klickitat Valley Hospital

> Children of Aging Parents
> National Alliance for Caregiving
> US Government MEDICARE website