Hospital to Home Checklist California

Your parent is being discharged from a California hospital and going home. The discharge planner hands you a stack of papers, a bag of prescriptions, and a follow-up appointment card. You drive home and realize the hospital bed has not been delivered, the home health agency has not called, and you cannot figure out which of the six new medications replaces which of the old ones.

Most hospital readmissions within 30 days trace back to failures in the discharge transition — not to the original medical condition. This checklist covers what needs to happen before your parent leaves the hospital bed, not after.

Before Leaving the Hospital

Medication reconciliation. Sit down with the discharging physician or hospital pharmacist and compare the pre-admission medication list against the new discharge prescriptions. For every medication, confirm: Is this new or a replacement? What was stopped and why? Are there drug interactions between the new medications and the ones being continued? Under California Business and Professions Code Section 4074, the hospital must provide detailed information on all dispensed medications, including dosing instructions and potential side effects.

Durable medical equipment. If your parent needs a hospital bed, wheelchair, walker, commode, oxygen concentrator, or any other equipment at home, confirm that it has been ordered and physically delivered before discharge. A gap between discharge and DME arrival is one of the most common causes of falls and readmissions in the first 48 hours.

Home health agency. If the physician has ordered home health services (skilled nursing visits, physical therapy, wound care), confirm which agency has been assigned, when the first visit is scheduled, and what number to call if your parent's condition changes before that first visit. Confirm whether the initial visit is scheduled within 48 hours of referral or your parent's return home, or on the physician-ordered start-of-care date.

Caregiver training. Under California's CARE Act (SB 675), you have the right to be designated as a family caregiver in the medical record and to receive direct, in-person instruction on all post-discharge care tasks before your parent is physically discharged. This includes wound care procedures, medication administration techniques, and use of medical devices. Do not leave the hospital until you have received this training and feel confident performing the required tasks.

The Home Safety Check

Before your parent arrives home, walk through the residence and address these items:

• Fall hazards: Remove loose rugs, secure electrical cords along walls, clear pathways between the bed and bathroom
• Bathroom access: Install grab bars near the toilet and in the shower or tub if not already present. Place a non-slip mat in the tub or shower
• Bed access: Ensure the bed height allows your parent to sit on the edge with feet flat on the floor. If a hospital bed was ordered, verify it is assembled and operational
• Lighting: Install nightlights along the path from bedroom to bathroom
• Emergency access: Place a phone within reach of the bed and the primary sitting area. Program emergency numbers including the home health agency triage line

Within the First Week

Follow-up appointments. Schedule a primary care physician visit within 7 days of discharge and any specialist follow-ups within 14 days. These visits catch medication problems, wound complications, and declining vital signs before they trigger a readmission. If your parent cannot travel to the physician's office, ask about telehealth or home visit options.

Medication organization. Set up a pill organizer and establish a daily medication schedule. If your parent is managing multiple medications with different timing requirements, consider asking the pharmacist to synchronize refill dates and simplify the dosing schedule where clinically possible.

Emergency plan. Write down what to do if your parent falls, experiences chest pain, develops a fever, or shows signs of confusion that were not present at discharge. Follow the discharge instructions for when to call the care team or emergency services. Post this plan where the caregiver can see it.

The California Hospital Discharge Guide includes a printable 24-hour transition timeline, a medication reconciliation worksheet, and a home safety evaluation form designed to be completed before your parent arrives home from the hospital.

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