Hospital to Home Checklist Colorado: What to Arrange Before Your Parent Leaves

The hospital says your parent is going home. Maybe tomorrow, maybe the day after. Between now and then, you need to verify that everything required for a safe transition is actually in place — because once your parent leaves the hospital, getting these pieces arranged becomes exponentially harder.

This checklist covers the critical items Colorado families must confirm before discharge day.

Before Discharge: Questions for the Discharge Planner

These questions need answers before you agree to a discharge date:

Admission status and coverage:

• Was my parent admitted as an inpatient or under observation status? (This determines SNF eligibility)
• How many qualifying inpatient days has my parent accumulated?
• If under observation, has the physician reviewed whether reclassification is appropriate?

Post-discharge care needs:

• What level of care does my parent need at home — skilled nursing, physical therapy, occupational therapy, speech therapy?
• Has a home health agency referral been submitted? Which agency?
• Has the physician documented the face-to-face encounter required for home health eligibility?
• Is my parent classified as "homebound" for Medicare home health purposes?

Medications:

• Has medication reconciliation been completed? (A formal comparison of pre-hospital and post-hospital medications)
• Are there new medications? What are the dosing changes?
• Do we have a 30-day supply, or do we need to fill prescriptions immediately?
• Does the pharmacy accept my parent's insurance (Medicare Part D or Health First Colorado)?

Equipment and safety:

• What durable medical equipment is needed at home? (Hospital bed, oxygen, walker, wheelchair, commode, shower chair)
• Has the DME order been placed? When will delivery occur — before or after discharge?
• Does any equipment require prior authorization?

Follow-up:

• Is a follow-up appointment scheduled with the primary care physician within 7-14 days?
• Has the discharge summary been sent to the follow-up physician?
• Are specialist follow-ups scheduled?

Colorado CARE Act Requirements

Under Colorado's CARE Act (Caregiver Advise, Record, Enable), the hospital must:

1. Record a designated family caregiver in the medical record upon admission. If this hasn't been done, request it now.
2. Notify the designated caregiver before discharge. You should know the discharge date and time in advance, not learn about it after the fact.
3. Provide instruction on post-discharge care tasks. If your parent needs wound care, medication administration, catheter care, or equipment operation at home, the hospital must train you on these tasks before discharge.

If the hospital hasn't provided caregiver instruction, you have grounds to delay the discharge until training is completed. Document the request in writing.

Home Safety Preparation

Before your parent arrives home, verify:

Fall prevention:

• Remove throw rugs, loose cords, and clutter from walking paths
• Install grab bars in the bathroom (near toilet and in shower/tub)
• Ensure adequate lighting in hallways, stairs, and bathrooms
• Place a non-slip mat in the shower or tub
• If stairs are unavoidable, install handrails on both sides

Bedroom setup:

• Can your parent safely get in and out of bed? A hospital bed with adjustable height and side rails may be needed
• Is the bedroom on the same floor as the bathroom? If not, consider temporary bedroom relocation
• Is a bedside commode needed for nighttime?

Medication management:

• Set up a pill organizer with all medications sorted by day and time
• Post the reconciled medication list on the refrigerator or another visible location
• Program medication reminders (phone alarms, or a timed pill dispenser)
• Store medications where your parent can safely reach them

Emergency preparedness:

• Personal Emergency Response System (medical alert device) if your parent will be alone
• Emergency contact list posted by the phone
• Clear path to exits in case of emergency

Transportation Coordination

If your parent cannot safely travel in a standard vehicle:

Medicare ambulance transport — only covered under strict medical necessity (patient must be bed-confined or require stretcher and continuous monitoring during transit). The physician must sign a written certification.

Medicaid Non-Emergent Medical Transportation (NEMT) — Health First Colorado covers transportation to and from medical appointments through regional NEMT brokers. This must be arranged in advance; same-day requests are difficult.

Wheelchair van or gurney transport — private services available throughout Colorado's Front Range and major metro areas. The hospital social worker can provide a list of contracted medical transport companies.

First 48 Hours at Home

The first two days after discharge are the highest-risk window for complications and readmission:

• Take vital signs (temperature, blood pressure) twice daily if you have the equipment
• Watch for warning signs: fever over 100.4°F, confusion, difficulty breathing, new or worsening pain, wound drainage or redness, inability to keep food or medications down
• Confirm the home health agency's first visit is scheduled within 24-48 hours of discharge
• Verify all prescribed medications are on hand and being taken as directed
• Keep the discharge summary accessible for the home health nurse's first visit

The Colorado Hospital Discharge Transition Blueprint includes a printable version of this checklist plus the complete home safety assessment, DME ordering guide, and medication reconciliation worksheet — everything you need organized in one place for discharge day.

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