Hospital Discharge Checklist for Tennessee Families

When a parent is discharged from a Tennessee hospital, the transition happens fast. The social worker gives you a stack of papers, a pharmacy bag, and a list of follow-up appointments. You drive home, close the front door, and realize you have no idea if the oxygen concentrator is arriving today or Thursday. This checklist keeps the critical items from falling through the cracks.

Before Discharge Day

Verify hospital status. Confirm whether the stay is classified as inpatient or observation. This determines Medicare SNF rehab coverage and changes the entire financial picture. Ask the billing department directly — don't assume.

Designate a caregiver. Make sure the hospital has recorded your name as the family caregiver in the medical chart. This triggers the hospital's obligation to include you in discharge planning and demonstrate medical tasks.

Request the Important Message from Medicare. This form (CMS-10065) outlines appeal rights. The hospital must provide it within two days of admission. If you haven't received it, ask.

Attend the care conference. Participate in the discharge planning meeting with the physician, social worker, and therapists. Get answers on medications, follow-up appointments, home health, DME, and warning signs.

Request physical demonstrations. If you'll be performing wound care, medication injections, catheter care, or transfer assistance at home, the nursing staff should show you how — not just hand you instructions.

Medications

Get the reconciled medication list. Compare discharge medications against what your parent was taking before admission. Ask the pharmacist to flag new medications, discontinued ones, and dosage changes.

Pick up prescriptions before leaving. Many Tennessee hospitals have discharge pharmacies on-site. Don't leave without the medications in hand — a gap in critical medications during the first 24 hours is a leading cause of readmission.

Clarify timing and interactions. For each medication: what time of day, with or without food, potential interactions with other prescriptions, and side effects to watch for.

Home Health and DME

Confirm the home health agency. Get the agency name, phone number, and the date of the first scheduled visit. "A referral has been sent" is not the same as "the agency confirmed a visit on Thursday."

Verify DME delivery date. If your parent needs a walker, hospital bed, oxygen equipment, shower bench, or raised toilet seat, confirm the delivery date and ensure it's on or before the discharge date. Medicare Part B covers 80% of approved DME when ordered by a physician through a Medicare-enrolled supplier.

Assess the home environment. Before your parent arrives, check: clear pathways for a walker or wheelchair, grab bars in the bathroom, throw rugs removed, adequate lighting at night, and a bed that's accessible (ground floor if they can't do stairs).

Follow-Up Care

Schedule follow-up appointments. Get specific dates, times, and locations — not "follow up with your PCP within two weeks." Schedule them before leaving the hospital if possible.

Arrange transportation. If your parent is on TennCare, non-emergency medical transportation is available through the MCO — schedule at least 72 hours in advance. For urgent transport needs, the MCO broker has 3–4 hours to provide a ride.

Know the warning signs. Get a written list of specific symptoms that should trigger a call to the doctor versus a return to the ER. Fever thresholds, wound changes, pain escalation, confusion — make these concrete, not vague.

Financial and Legal

Do not sign as financial guarantor. If your parent is transitioning to a SNF, cross out any "responsible party" or "guarantor" language in admission paperwork. Sign only as your parent's authorized representative, never in your own capacity.

Start the TennCare CHOICES application early. If long-term care may be needed, don't wait until Medicare runs out. Begin the application during the hospital stay or rehab stay to minimize the pending period.

Request itemized billing. Before leaving, ask for an itemized statement. Observation status billing in particular can contain errors that significantly affect your parent's out-of-pocket costs.

The Tennessee hospital discharge transition toolkit expands each item on this checklist into actionable steps with Tennessee-specific contacts, forms, and deadlines — including the complete medication reconciliation worksheet and home safety assessment form.

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