Home Readiness Checklist Hospital Discharge Oklahoma

The hospital says your parent is coming home in 48 hours. The house has a narrow bathroom doorway, a throw rug at the top of the stairs, and no grab bars anywhere. Falls are the leading cause of hospital readmission for older adults after discharge — and most of them happen in the first two weeks.

Before Discharge Day: The Home Walk-Through

Walk through every room your parent will use in the first week home. You are looking for two things: obstacles that create fall risk, and gaps in the equipment they need for safe daily living.

Bathroom. This is where most post-discharge falls occur.

• Install grab bars beside the toilet and inside the shower or tub. Suction-cup bars are not reliable — screw-mounted bars rated for at least 250 pounds are the standard.
• Place a non-slip bath mat in the tub and a non-slip rug on the floor outside it.
• If your parent uses a wheelchair or walker, measure the bathroom doorway. Standard interior doors are 28–30 inches wide; most wheelchairs need 32 inches. A swing-clear hinge adds about 2 inches without replacing the frame.
• A raised toilet seat with armrests reduces the effort needed to sit and stand. A shower bench or transfer seat eliminates the need to step over a tub wall.

Bedroom. Your parent will spend most of their recovery time here.

• The bed height should allow them to sit on the edge with their feet flat on the floor and knees at a 90-degree angle. A bed that is too low or too high makes transfers dangerous.
• Move the bed away from the wall to allow a caregiver to assist from either side.
• Place a nightlight between the bed and bathroom. Falls at night happen because people walk in the dark.
• Remove all throw rugs from the bedroom and hallway path to the bathroom.

Kitchen and living areas.

• Clear pathways wide enough for a walker or wheelchair — at least 36 inches.
• Move frequently used items (medications, water, phone, remote) to a bedside table or waist-height surface. Reaching overhead or bending to floor level after surgery or a hospital stay is a fall risk.
• Secure or remove all loose electrical cords from walkways.

Durable Medical Equipment Coordination

Essential equipment must arrive at the home before the patient does — not the day after. Common items needed after a hospital discharge:

• Hospital bed — if your parent cannot safely use their existing bed for transfers or needs the head elevated for respiratory issues
• Wheelchair or rollator walker — prescribed by the hospital's physical therapist
• Oxygen concentrator — if the patient is being discharged on supplemental oxygen
• Patient lift — for patients who cannot bear weight and need mechanical assistance for transfers

Medicare Part B covers medically necessary durable medical equipment when prescribed by a physician and supplied by a Medicare-enrolled supplier. If the hospital's discharge team has not already initiated the DME order, ask the case manager to do so as soon as the need is identified and obtain a confirmed delivery date. Essential equipment must be in place before discharge, or the team must arrange another safe option.

For patients who need equipment fast and funds are tight, the Oklahoma Durable Medical Equipment Reuse Program (OKDMERP) at 1-833-431-9706 refurbishes and distributes hospital beds, wheelchairs, patient lifts, and CPAPs at no cost. Equipment is reserved for SoonerCare members for the first 60 days after a device becomes available; after that, any Oklahoma resident can access the program regardless of income.

Home Health Setup

If your parent qualifies for Medicare home health services, the receiving agency must conduct an initial assessment within 48 hours of discharge. Before leaving the hospital:

• Confirm that the physician has signed the home health certification orders
• Verify the receiving agency has confirmed an intake slot — a signed order means nothing if the agency is at capacity
• Get the agency's direct phone number and the name of the assigned case manager
• Clarify which services are ordered: skilled nursing visits, physical therapy, occupational therapy, speech therapy, or a combination

Home health is not a substitute for a caregiver living in the home. Medicare home health covers intermittent skilled visits rather than continuous in-home care. Between visits, someone must be present to assist with meals, medication reminders, toileting, and mobility.

The Community Backup Plan

Under Oklahoma Human Services guidelines, patients transitioning home under an ADvantage Waiver program must have a documented Community Backup Plan (Form 02CB001E). Even if your parent is not on the waiver, building one is smart practice.

The plan identifies:

• Secondary caregivers (family, friends, neighbors) who can step in if the primary caregiver is unavailable
• An emergency procedure if the home health aide does not show up for a scheduled shift
• Transportation arrangements for follow-up medical appointments within 7–14 days of discharge

The First 72 Hours

The highest-risk window for readmission is the first three days after discharge. During this period:

• Reconcile all medications — compare what the hospital prescribed against what your parent was taking before admission. Duplicate prescriptions and dangerous interactions are the most common cause of post-discharge complications.
• Monitor for warning signs: increasing pain, fever, confusion, falls, inability to eat or drink, or worsening of the condition that caused the hospitalization.
• Keep the hospital's discharge summary and medication list in a single folder. If you need to call the physician or go to the emergency room, having everything in one place saves critical time.

Our Oklahoma hospital discharge guide includes a printable home readiness checklist, a medication reconciliation worksheet, and a community backup plan template — everything you need to prepare the home before discharge day.

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