Pre-Discharge Checklist for an Elderly Parent in New Hampshire

The last 24 hours before your parent leaves the hospital set the trajectory for everything that follows. Miss a step now and you're dealing with the consequences at home — without the hospital's team down the hall. This checklist covers the practical items families need to confirm before discharge day.

Medications

• [ ] Get a complete printed medication list from the hospital pharmacist. This should include every drug your parent will take after discharge — name, dose, frequency, and purpose.
• [ ] Compare it to the pre-admission list. Identify what's new, what was stopped, and what changed. Ask the pharmacist or physician to explain every change.
• [ ] Check for prior authorizations. Some new medications require insurance approval before a retail pharmacy will fill them. If your parent is on a Medicare Part D plan, ask the pharmacist whether any discharge prescriptions need prior auth — and if so, whether the hospital can initiate the request.
• [ ] Ask about meds-to-beds. Several New Hampshire hospitals will fill discharge prescriptions through the hospital pharmacy and deliver them to the room before discharge. This prevents the gap between leaving the hospital and getting to a pharmacy.
• [ ] Set up a pill organizer for the first week and have the nurse or pharmacist verify it before you leave.

Home Health and Therapy Services

• [ ] Confirm the home health referral is placed, not just discussed. Ask the case manager which agency was contacted and whether they've confirmed staffing availability. Get the agency's name, phone number, and the date of the first visit.
• [ ] If physical or occupational therapy was ordered, verify the referral was sent. Ask when the first session is scheduled and whether the therapist comes to the home or whether outpatient visits are required.
• [ ] If your parent needs skilled nursing visits (wound care, injections, catheter management), confirm the frequency and duration ordered by the physician.

Durable Medical Equipment

• [ ] Verify delivery dates for any ordered equipment — hospital bed, wheelchair, walker, commode, shower chair, oxygen concentrator. Equipment should arrive before or the same day your parent gets home, not three days later.
• [ ] Check Medicare coverage. The physician must sign a Certificate of Medical Necessity for Medicare to cover DME. Confirm this paperwork is completed before discharge.
• [ ] Know the supplier. Get the DME company's name and phone number. If there's a delivery problem after discharge, you need to be able to reach them directly.

The Discharge Plan Itself

• [ ] Get the discharge summary in writing. This document goes to your parent's primary care physician and any post-acute providers. Don't assume the hospital will send it automatically — ask when it will be transmitted and to whom.
• [ ] Schedule the follow-up appointment with the primary care physician within 7 to 14 days. Do this before leaving the hospital, not from home where it's easy to postpone.
• [ ] Ask about dietary restrictions. If your parent's condition requires a modified diet (low-sodium for heart failure, controlled carbohydrates for diabetes, thickened liquids for swallowing difficulties), get written instructions and ask the nutritionist to walk you through meal preparation.
• [ ] Understand the signs that require a call to the doctor versus the signs that require a trip to the emergency department. Ask the discharging physician to be specific about what to watch for in the first 72 hours.

Home Safety

• [ ] Clear the path. Remove throw rugs, loose cords, and any obstacles between the bedroom, bathroom, and kitchen. If your parent is using a walker or wheelchair for the first time, measure doorways and hallways.
• [ ] Set up the recovery area. If your parent can't climb stairs, arrange a bed and essential supplies on the main floor. Place a phone within arm's reach. Install grab bars in the bathroom if they're not already there.
• [ ] Stock essentials. Have at least a week's worth of groceries, personal care supplies, and any medical supplies (wound dressings, incontinence products, gloves) ready before discharge day.

New Hampshire-Specific Items

• [ ] Confirm your CARE Act rights. Under New Hampshire's Caregiver Advise, Record, Enable Act (SB 187), the hospital must record a designated caregiver in the patient's medical record, notify that caregiver of discharge plans, and provide live instruction on any medical tasks you'll need to perform at home. If this hasn't happened, request it before discharge.
• [ ] If your parent is a Medicare hospital inpatient and you believe the discharge is premature, contact Acentra Health at 1-888-319-8452 before your parent leaves the hospital and before midnight on the discharge date to file a formal appeal. This legally halts the discharge while an independent physician reviews the case.
• [ ] If your parent may need long-term care, contact your local ServiceLink ADRC to start the Choices for Independence waiver application process. Starting during the hospital stay gets the process moving earlier.

The Hospital-to-Home New Hampshire guide provides printable versions of these checklists along with the full discharge appeal process, Medicaid application walkthrough, and post-discharge monitoring tools.

See more New Hampshire guides →