Hospital Discharge Checklist for Elderly Parents in Nebraska

The Day Before Discharge Is When Most Mistakes Happen

Hospital case managers are managing dozens of patients simultaneously. They'll write a discharge plan, but verifying that every piece is actually in place before your parent walks out the door is your responsibility.

This checklist covers the items that most commonly fall through the cracks for Nebraska families — particularly around medication coordination, equipment delivery, and home health scheduling.

Medications

• [ ] Confirm that all discharge prescriptions have been sent to a pharmacy — ideally one with home delivery if your parent lives in a rural county
• [ ] Compare the discharge medication list against what your parent was taking before admission. Ask the pharmacist or nurse about any medications that were added, removed, or changed
• [ ] Verify that your parent or their caregiver understands the dosing schedule, especially for new medications
• [ ] If your parent takes insulin, blood thinners, or controlled substances, confirm that the hospital has coordinated with the outpatient prescriber to avoid supply gaps

Durable Medical Equipment

• [ ] If a walker, wheelchair, hospital bed, or oxygen concentrator was ordered, confirm the delivery date and time — not just that an order was placed
• [ ] Verify that the DME supplier is Medicare-enrolled (required for Part B coverage)
• [ ] Ask whether the hospital has arranged bedside teaching for any new equipment your parent or caregiver needs to operate

Home Health Services

• [ ] Confirm which home health agency accepted the referral — not just which one was contacted
• [ ] Get the agency's name, phone number, and the date of the first visit
• [ ] Verify the planned visit schedule (how many nursing visits, how many therapy sessions per week)
• [ ] If no agency has confirmed availability, raise this with the case manager before agreeing to discharge. Nebraska's rural counties have significant home health staffing shortages, and a referral without confirmation is not a plan

Home Safety

• [ ] If your parent uses a walker or wheelchair, can they navigate the home's entry and hallways?
• [ ] Are grab bars installed in the bathroom? Are throw rugs removed from walking paths?
• [ ] Is someone available to be with your parent for at least the first 24 to 48 hours after discharge?
• [ ] If your parent lives alone, has the case manager discussed whether independent living is safe, or whether assisted living or a family member's home is more appropriate?

Follow-Up Care

• [ ] Are follow-up appointments scheduled with the primary care physician and any relevant specialists?
• [ ] If wound care or dressing changes are needed, does the home health plan include skilled nursing visits for this?
• [ ] Has the case manager provided written discharge instructions your parent or caregiver can reference at home?

Legal and Financial

• [ ] Confirm whether the hospital stay was classified as inpatient or observation — this determines Medicare SNF coverage eligibility
• [ ] If a skilled nursing facility is the next step, has the three-midnight inpatient threshold been met?
• [ ] If long-term care is likely, ask the hospital social worker about starting a Nebraska Medicaid application during the stay — the application takes 45 to 90 days

What to Do If Something Is Missing

If critical items on this list are unconfirmed — no home health agency, no DME delivery date, unsafe home environment — you don't have to accept the discharge. You can file an expedited appeal with Commence Health at 1-888-755-5580. The appeal triggers a billing stay that prevents the hospital from discharging your parent or charging them until the review is complete.

The Complete Discharge System

This checklist covers the basics. The Nebraska Hospital Discharge Guide provides the full framework — including appeal procedures, post-acute placement options, Medicaid eligibility worksheets, and spousal asset protection rules — organized as a step-by-step sequence you can follow from admission through safe transition home.

See more Nebraska guides →