The Discharge Checklist: 10 Things to Have Ready Before They Come Home
The call comes on a Tuesday. Or a Friday at 4:45 p.m. "We're thinking discharge tomorrow." And suddenly you're supposed to transform your house into a safe recovery environment overnight while managing your job, your family, and a pharmacist who keeps putting you on hold.
Nobody hands you a manual for this. Nobody explains that "discharge planning" is technically the hospital's job — but in practice, you're the one making sure it actually works.
This checklist is what I wish someone had handed me. Not a vague "get the house ready" suggestion. Concrete items, in the order you need to tackle them, with the Medicare and insurance pieces already sorted out.
1. Get the Discharge Summary — Before They Leave
This sounds obvious. You'd be amazed how many caregivers drive their parent home and realize, three days later, that they're not sure which medications are new, which were discontinued, and what the follow-up timeline actually is.
Ask the discharge nurse for a printed discharge summary before anyone walks out the door. It should include:
- Current medication list (what's new, what changed, what stopped)
- Activity restrictions and lifting limits
- Wound care instructions, if applicable
- Follow-up appointments and who to call with questions
- Signs that warrant an ER return
If they try to send it to the primary care doctor and "you'll get a copy," push back. You need it in your hands that day.
2. Confirm DME Is Actually Ordered — and Actually Coming
This is the one that blindsides families most often. The hospital says, "We've ordered a hospital bed." You assume it's handled. You get home, and there's no bed, because the supplier needs a signed doctor's order, a completed Certificate of Medical Necessity (CMN), and authorization from Medicare — none of which has happened yet.
What to do:
- Ask the discharge planner: "Has the DME order been placed with a specific supplier?"
- Get the supplier's name and phone number before leaving.
- Confirm delivery is scheduled and confirmed — not "in process."
- For Medicare Part B DME coverage, the supplier must be Medicare-enrolled and the equipment must be deemed medically necessary.
If there's any doubt, use DMEHelper's directory to find Medicare-enrolled suppliers in your area who can move quickly on short notice.
3. Do a Walk-Through of the Home With Fresh Eyes
Go through every room they'll need to use. You're looking for:
Tripping hazards: Rugs that slide, cords across walkways, thresholds between rooms.
Clearance: If they're coming home with a walker or wheelchair, doorways need to be at least 32 inches wide. Measure before assuming.
Bathroom safety: Can they safely get on and off the toilet? Is there a grab bar near the shower? A shower chair or transfer bench may be needed even for people who "don't want one."
Bedroom access: Is the bedroom on the main floor? If not, are stairs realistic with their current mobility? Sometimes a hospital bed in the living room is the right call, even if it feels strange.
Do this walk-through the day before they come home, not the morning of.
4. Fill Prescriptions the Day Before (Not After)
Discharge prescriptions are a logistics problem most families don't anticipate. The hospital gives you scripts at 2 p.m. The pharmacy is backed up. The new blood thinner the doctor prescribed requires prior authorization. Now it's 6 p.m. and you're standing in a CVS with someone who just had hip replacement surgery.
If possible, call the pharmacy before discharge and ask them to run the scripts in advance. Some hospitals have discharge pharmacies on-site. Use them.
For ongoing medication management after discharge, ask whether a home health nurse visit is covered under Medicare Part A — they can handle medication reconciliation in the home during the recovery period.
5. Set Up the Equipment Before They Arrive
If you've confirmed the DME is coming, arrange for delivery before discharge day if at all possible. Having a hospital bed arrive while your parent is sitting in the living room waiting is stressful for everyone.
Equipment that may be ordered at discharge:
- Hospital beds (semi-electric or full-electric)
- Walkers or rollators
- Wheelchairs (standard manual or transport chair)
- Shower chairs, grab bars, raised toilet seats
- CPAP machines (if sleep apnea was identified during the stay)
- Oxygen concentrators or portable oxygen
- Wound care supplies or infusion equipment
For each item, ask the discharge planner or DME supplier what Medicare or secondary insurance covers, what requires a copay, and whether you'll need to sign a Certificate of Medical Necessity before delivery.
6. Know Who to Call at 11 p.m.
This one matters more than any piece of equipment. In the first 72 hours after discharge, something unexpected will happen. A wound looks different. They can't swallow a pill. They're more confused than expected.
Before you leave the hospital, write down:
- The primary care doctor's after-hours line
- The hospital's discharge nurse line or care transition number
- The home health agency's 24-hour number, if one is involved
- When exactly to go back to the ER versus managing at home
Do not assume you'll figure this out later. Write it on paper and put it on the refrigerator.
7. Schedule Home Health Early — It May Take 2–3 Days to Start
If the doctor ordered home health services — nursing visits, physical therapy, occupational therapy — Medicare Part A typically covers it for homebound patients after a qualifying hospital stay. But "ordered" does not mean "starting tomorrow."
Home health agencies need to:
- Receive the referral and physician orders
- Complete an intake assessment
- Schedule the first visit
This can take 48–72 hours. If your parent is being discharged Friday, you may not have a nurse until Monday. Plan for that gap. Know what you'll do if there's a wound that needs dressing changes over the weekend.
If home health hasn't been arranged and you think it should be, ask the discharge planner before you leave. This is a legitimate and common request.
8. Prepare the Person, Not Just the House
Your parent may feel scared, embarrassed, or disoriented coming home after a hospital stay. The home looks the same but they feel different in it. Independence they had two weeks ago may be temporarily — or permanently — gone.
A few things that help:
- Walk through what the first day will look like before you arrive. "We'll get you settled in the bedroom, then I'll get lunch, then the PT calls at 3."
- Don't rearrange everything without asking. Their familiar environment is comforting even if it's not optimal.
- Give them control wherever you can. "Do you want the TV on?" matters more than you think.
And if they resist help — the shower chair they don't want, the walker they refuse — don't fight it on Day 1. Let them feel at home first. The conversation will go better in 48 hours.
9. Line Up Your Own Support
Who is covering your Tuesday? What happens to dinner? Have you told your employer you may need flexibility this week?
Caregiver burnout starts in the first week. Not because caregiving is impossible, but because most people try to do it without changing anything else in their life. Something has to give.
Ask for help specifically: "Can you bring dinner Tuesday and Thursday?" is more likely to get a yes than "let me know if you need anything."
If you're a long-distance caregiver coordinating from another city, check out our Caregiver Resources section for guidance on remote care coordination and when to consider professional care management.
10. Document Everything
Keep a simple log for the first two weeks:
- Medications given and when
- Any symptoms, falls, or concerns
- Questions for the doctor at the follow-up appointment
- DME delivery confirmations and supplier contact info
This documentation becomes essential if Medicare questions a claim, if there's a billing dispute with the DME supplier, or if there's a medical complication down the road.
A spiral notebook on the kitchen counter is fine. The point is to have a record.
The Part Nobody Talks About
Discharge day feels like a finish line. The hospital is behind you. They're home.
It isn't a finish line. It's the start of a different phase. The first few weeks at home are statistically when readmissions happen — not because hospitals failed, but because recovery is hard and transitions are complicated.
You are not going to do this perfectly. There will be a day when you don't have the prescription and the delivery is late and they don't want to take a shower and you're exhausted. That's not failure. That's caregiving.
Use the tools available to you: Medicare-covered DME, home health services, the DMEHelper directory to find local suppliers who can deliver on short notice. You don't have to build this infrastructure from scratch.
Frequently Asked Questions
What DME does Medicare cover after a hospital discharge?
Medicare Part B covers medically necessary durable medical equipment including hospital beds, wheelchairs, walkers, CPAP machines, and oxygen equipment when ordered by a doctor and supplied by a Medicare-enrolled DME supplier. Your doctor must certify the medical necessity, typically through a Certificate of Medical Necessity (CMN).
How long does it take to get DME after discharge?
It depends on the supplier and the equipment. Simple items like walkers can sometimes be same-day. Hospital beds typically require 24–48 hours for delivery. Oxygen and CPAP equipment may require prior authorization from Medicare, which can add 2–5 business days. Always confirm before discharge day.
What is a Certificate of Medical Necessity?
A CMN is a form that your doctor signs to confirm that a piece of durable medical equipment is medically necessary for your condition. Medicare requires a CMN for most major DME categories. Without it, the claim can be denied even if the equipment is appropriate. Learn more about CMNs here.
How do I find a Medicare-enrolled DME supplier near me?
Use the DMEHelper directory to search for accredited, Medicare-enrolled DME suppliers by category and location. This ensures the equipment will be eligible for Medicare Part B reimbursement.
What if Medicare denies the DME claim after discharge?
You have the right to appeal. Request an itemized denial notice, gather supporting documentation from the prescribing physician, and file a formal appeal. Our step-by-step Medicare appeal guide walks through the entire process.
Does Medicare cover home health visits after discharge?
Yes. Medicare Part A covers skilled home health services — nursing, physical therapy, occupational therapy, speech-language pathology — for homebound patients following a qualifying hospital or skilled nursing facility stay. The services must be ordered by a doctor and provided by a Medicare-certified home health agency.
Jordan Soblick has 18+ years of experience in Medicare DME operations and compliance, including two patents related to healthcare equipment management. DMEHelper connects patients and caregivers with accredited, Medicare-enrolled DME suppliers — free to search, no listing fees.