Questions to Ask a Hospital Case Manager About Discharge in New Hampshire

Questions About Hospital Status and Coverage

These questions protect you from the financial traps that catch most families off guard:

"Is my parent classified as inpatient or observation?" This single question can save your family tens of thousands of dollars. If the answer is observation, your parent's time in the hospital does not count toward the three-day inpatient requirement for Medicare SNF coverage. Ask the case manager whether the status can be converted to inpatient based on your parent's clinical condition.

"Has the Important Message from Medicare been delivered?" This form (CMS-10065) outlines your parent's discharge rights and appeal process. If you haven't received it, request it immediately.

"What is the estimated length of stay, and what clinical criteria would extend it?" Knowing the discharge timeline helps you prepare. If the case manager is aiming for a date that seems premature, ask what specific clinical milestones your parent needs to hit before discharge.

Questions About the Discharge Plan

"Which home health agency has confirmed they can staff my parent's case, and what is the start date?" Don't accept "we'll arrange home health" as an answer. You need a specific agency name, a confirmed staffing commitment, and a start date. Home health staffing shortages in New Hampshire are real — a referral without confirmation means your parent may come home to no nursing support.

"What specific durable medical equipment has been ordered, and when will it be delivered?" Hospital bed, wheelchair, walker, oxygen equipment, shower bench — whatever your parent needs should be ordered, with coverage or an alternative confirmed, and scheduled for delivery before discharge day. Equipment that arrives three days after your parent gets home isn't helpful.

"Has medication reconciliation been completed?" Your parent may have been on different medications in the hospital than what they were taking before admission. The case manager should provide a single, comprehensive medication list with every current drug, dosage, frequency, and route of administration. This list should also note which medications were discontinued during the stay and why.

"What post-acute follow-up appointments have been scheduled?" Not "your parent should follow up with their PCP" — you need actual appointment dates with provider names and locations. If the hospital hasn't made the appointments, ask who is responsible for scheduling them before discharge.

Questions About Post-Acute Care Options

"What are the SNF options you're referring to, and which ones accept Medicaid?" If your parent may eventually need long-term care funded by Medicaid, placing them in a facility that accepts Medicaid conversions from the start prevents a disruptive second transfer later.

"Has my parent been evaluated for home and community-based care through the CFI waiver?" The Choices for Independence waiver is New Hampshire's primary Medicaid pathway for home-based care. If your parent qualifies clinically and financially, starting the CFI process during the hospital stay can prevent unnecessary nursing home placement. The entry point is ServiceLink, New Hampshire's Aging and Disability Resource Center network.

"What specific medical tasks will I need to perform at home as the caregiver?" Under New Hampshire's CARE Act (SB 187), if you are the designated caregiver and the patient or decision maker has consented in writing to release information, the hospital must provide live instruction on the after-care tasks described in the discharge plan — wound care, medication administration, equipment operation. If the case manager can't answer this question with specific tasks, the discharge plan isn't ready.

What to Do With the Answers

Write everything down. Record the case manager's name, the date and time of the conversation, and the specific answers they give. If answers change between conversations — and they sometimes do — your notes create a paper trail.

If any critical element of the discharge plan isn't confirmed — no home health agency, no equipment delivery date, no medication list — document the gap in writing and give it to the case manager. That written record protects your parent's rights and strengthens any formal appeal through Acentra Health if the hospital proceeds with an incomplete discharge.

The New Hampshire Hospital Discharge Guide provides a structured question checklist you can bring to every case manager meeting, organized by clinical, financial, and post-acute planning categories.

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