What To Do Before You Are Discharged From A Hospital

Before being discharged from a hospital

• Do not wait until the day of discharge to start planning.  
• Meet with the hospital discharge planner as soon as you can and get a discharge plan. The plan should include everything you'll need to know for life after the hospital.
  • Every hospital has a discharge planner. The person may be a social worker or a nurse or an administrator.
  • A hospital discharge planner's job is to advise and consult with you about what is necessary for you to be discharged. Some of the services a discharge planner can provide are:
    • Help assure that you have a safe environment to return to when you're released from the hospital.
    • Help get you a post-hospital care plan.
    • Help make follow-up appointments with your doctor, including transportation to and from the doctor if necessary.
    • Help you understand the medications the doctor wants you to take, and how to obtain them. A planner can also help you learn about potential drug side effects and what to do if they occur.
    • Help you learn what continuing symptoms to expect - and which ones should trigger a call to your doctor.
    • Make sure you have a discharge release from the business office. (If you leave a hospital without the discharge release, it is likely the insurer won't pay for any part of your stay).
  • For information about what should be included in a discharge plan, click here.
  • If upon discharge, you will not require further professional medical services, and you have family or friends staying with you, a discharge meeting with your doctor may be sufficient.  Ask your doctor. If you do not need a discharge planner, be sure your doctor explains what your treatment plan will be at home, what symptoms are okay and which should trigger a call to the doctor. Also set the next appointment with the doctor.   
  •  If you are elderly, live alone, are transferring to another medical facility, or require additional treatment/services such as physical therapy, hospice, or home nursing care, you should meet with the hospital discharge planner.  
• Also get a copy of a discharge summary. It recaps what happened in the hospital. Take it to your next doctor's appointment. 
  • To learn what should be included in a discharge summary, click here. 
  • It is advisable to keep a copy of your discharge summary with your copy of your medical records.
• If you will need assistive or medical devices: 
  • If you are going to require the use of a wheel chair, walking aid, or other medical device, ask for a demonstration/lesson while in the hospital.  Make certain that you feel comfortable using the device before going home.
  • Keep in mind that many of these items can be rented if they are only going to be used for a short period of time. 
  • If money is a problem, the discharge planner should be able to help you find free sources for these devices. 
  • Most hospitals have a physical therapist on staff that will come to your room if you need therapy in hospital or at home. If you think you need a physical therapist and your doctor hasn't ordered one, ask your nurse to speak with a doctor to arrange for one.
  • Find out if your caregivers need any special training to care for you after your discharge. 
• It is also advisable to request a copy of results of all tests performed while in the hospital. Ask how to get a copy of your medical records. These records will be useful in maintaining a history of your medical treatment. You are legally entitled to a copy of tests and your medical records. You may be charged a fee for the copy. To learn more about medical records, click here. 
• If the hospital asks you to pay the bill before leaving: Some hospitals ask for payment or co-payment in advance before discharge. This is to reduce their bad-debt expenses. They also use "time-of service" collection, which means when the medical treatment is performed the patient is expected to pay.  
  • If you don't have insurance: Negotiate with the hospital regarding the cost of the medical procedure and your stay in the hospital. Demand that you be given you the price that they give to insurers, their "best" price. To discover Medicare reimbursement rates for a procedure in your area go to www.cms.hhs.gov/apps/pfslookup/step1.asp / . To learn how to negotiate with a hospital, click here.
  • If you are insured and the hospital demands you pay your co-pay on the spot, call your insurance company for advice to see if this is their agreement with the hospital. You may not have a co-pay if medical procedures and treatments were performed in hospital. 
• If you want to stay in the hospital, but the doctor thinks it is time for you to leave:
  • The length of your stay in the hospital depends on your doctor and insurance company. They determine when your condition is medically stable so that you can be discharged. If they want you to leave the hospital earlier than you think reasonable, you don't have to go quietly. 
  • Do not leave the hospital if you feel disoriented, faint or unsteady; have pain that is not controlled by drugs you take by mouth; you cannot go to the bathroom alone, have trouble urinating or moving your bowels, or you cannot keep food or drink down. 
  • To learn how to stay in a hospital if the doctor thinks it is time for your to leave, but you don't feel ready, click here. 
• On the other hand, press firmly if you want to leave earlier than your doctor thinks advisable. Do not leave without medical consent. If you do, you may be stuck with the bill for your entire stay even if you have insurance.

Assume any belongings you bring home from a hospital are contaminated and should be washed before being used again. As you are aware, there are potentially deadly germs in our hospitals.

• When you leave the hospital, assume any belongings you bring home are contaminated. 
• Do not mix clothes you bring home with any other clothes. Wash them with bleach. Regular laundry detergents do not kill some of the most potent germs.
• Wipe down with a cleaner containing bleach any photographs, art work or other items which were brought to the hospital to make your stay more comfortable.

NOTE: If there are follow-up problems, the best way to ensure that you are covered by insurance is to return to the same hospital.  For example, postoperative care is part of surgery and follow-up will likely be part of it.  Surgery may begin when you enter the operating room but it does not end when you leave.   

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