Leaving the Hospital in 48 Hours: A Family Checklist

Quick answer: If your parent is being discharged in about two days and can’t go home safely, use the first 12 hours to get the plan and the doctor’s paperwork moving, the next 12 to line up options and tours, and the last 24 to confirm a home, transport and medications. If you think the discharge is too soon, Medicare gives you the right to a fast appeal.

Our longer guide, The Hospital Says Mom Can’t Go Home. Now What?, explains your options, costs and what Medicare covers. This page is the short, printable version for when the clock is already running. Work through it in order. Cross things off as you go.

The short version

• Hours 0 to 12: get the plan, the care level, and the doctor’s report started.
• Hours 12 to 24: gather documents, set the budget, and find homes with an opening.
• Hours 24 to 48: tour, choose, and lock in move-day details.
• At any point: if the discharge feels unsafe, ask about your Medicare fast-appeal rights.

Hours 0 to 12: Get the facts

• Get the name and direct number of the discharge planner or case manager
• Ask: “What is the planned discharge date and time?”
• Ask: “What level of care do you recommend after discharge?” (home with help, rehab, care home, memory care)
• Ask: “Is my parent admitted as an inpatient, or under observation?” This affects Medicare rehab coverage (Medicare.gov)
• Ask the team to start the Medical Assessment form (LIC 602A), which any licensed medical professional can complete and a California care home (RCFE) needs before admission
• Ask whether a recent TB test is on file, or can be done before discharge
• Request a copy of the discharge summary and current medication list as soon as they’re ready

Say this to the discharge planner: “We want a safe plan. Can you tell us what you need from us today, and by when?”

Hours 12 to 24: Get organized

• Decide who in the family is the main contact, so the hospital and homes call one person
• Gather: photo ID, Medicare and insurance cards, Medi-Cal card if any
• Gather: power of attorney, advance directive, POLST if your parent has them
• Set a realistic monthly budget. Licensed care homes in California typically cost $4,000 to $15,000 a month
• Find any long-term care insurance policy and call the insurer
• Call a placement service, or start calling homes, to find places that have an opening and can meet your parent’s care needs

A simple way to decide the next stop:

• If your parent needs daily skilled nursing or therapy, then ask about short-term rehab in a skilled nursing facility first.
• If they need daily hands-on help but not a nurse, then plan for a licensed care home.
• If they have dementia and may wander, then ask for memory care options.
• If they can go home with help, then line up in-home help and home health before discharge day.

Hours 24 to 48: Choose and confirm

• Tour your top choices in person or by video
• For each home, ask: “Can you meet my parent’s care needs today?” and “What is the all-in monthly price at that care level?”
• Confirm the home has received what it needs: the doctor’s report, medication list and discharge summary
• Confirm the move-in date and time with both the hospital and the home
• Arrange transport. Ask the hospital whether your parent needs a wheelchair van or other help
• Make sure prescriptions are sent to the right pharmacy, or ask how the home handles medications
• Pack: comfortable clothes labeled with your parent’s name, glasses, hearing aids, dentures, chargers, a few familiar photos
• Bring walkers, wheelchairs or other equipment, or ask the hospital who arranges them

What if the discharge feels too soon?

Know your rights: If your parent has Medicare and is a hospital inpatient, they should get a notice called “An Important Message from Medicare about Your Rights” within 2 days of admission and before discharge. It explains how to ask for a fast appeal from an independent reviewer (a BFCC-QIO). To keep coverage while you wait, follow the notice’s directions no later than the scheduled discharge day (Medicare.gov).

If you didn’t get the notice, ask for it. If your parent is in a Medicare Advantage plan, different rules can apply, so ask the plan too.

Quick money facts for the next 48 hours

• Medicare doesn’t pay for assisted living or board and care (Medicare.gov).
• Medicare rehab in a skilled nursing facility, after a qualifying inpatient stay of at least 3 days: $0 per day for days 1 to 20, $217 per day for days 21 to 100 in 2026, and nothing after day 100 (Medicare.gov).
• Medi-Cal’s Assisted Living Waiver exists in Sacramento County but not Placer County, and has a waitlist, so it won’t solve a 48-hour discharge (DHCS).

Move-day checklist

• Discharge papers and medication list in hand
• Transport confirmed, with a pickup time
• Someone from the family there for move-in, if possible
• Home has the doctor’s report and medication orders
• Clothes, glasses, hearing aids, dentures and chargers packed
• Discharge planner’s number saved, in case of questions

How Nonna Placements works: Nonna Placements is free to families. Licensed homes pay us a placement fee when someone moves in. You can choose any home. This article is general information, not medical, legal, or financial advice.

Need help right now?

If discharge is in the next day or two, call us. Nonna Placements helps families across California, find licensed care homes that have an opening and can meet their parent’s needs. We can set up same-day tours and work with the discharge planner for you. It’s free to your family.

Call or text (916) 261-2644 or email roberto@nonnaplacements.com.

Related reading: The Hospital Says Mom Can’t Go Home. Now What? · Board and Care or Assisted Living? · How Will We Pay for Mom’s Care?

Sources

• Medicare.gov, Fast appeals: https://www.medicare.gov/providers-services/claims-appeals-complaints/appeals/fast-appeals
• Medicare.gov, Skilled nursing facility care: https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care
• Medicare.gov, Long-term care: https://www.medicare.gov/coverage/long-term-care
• California DHCS, Assisted Living Waiver: https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/

About the author

Roberto Hategan is the CEO & Founder of Nonna Placements, a senior placement service serving families across California. Contact: roberto@nonnaplacements.com

Photo credits: Tima Miroshnichenko, Wheeleo Walker, and Markus Winkler, via Pexels, Pexels License.