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Discharge planning assessment form 2026

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  1. Click ‘Get Form’ to open the discharge planning assessment form in the editor.
  2. Begin by filling in the 'Admitting Diagnosis' section. This is crucial for understanding the patient's medical background.
  3. Next, complete the 'Living Arrangements' section. Indicate whether the patient lives in a house, apartment, or other facility, and provide details such as the number of steps to enter.
  4. In the 'Caregiver After Discharge' section, specify if there will be a caregiver available. Include their name, relationship to the patient, and contact information.
  5. Assess the patient's mental status and prior functional status. This helps in planning appropriate post-discharge care.
  6. Address any financial concerns and transportation issues that may affect discharge plans.
  7. Complete sections on previous home health care services and any patient/family concerns that need attention.
  8. Finally, outline the anticipated discharge plan including necessary home health care services and durable medical equipment required post-discharge.

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If you have just been discharged from hospital and remain unwell, this could be considered a failed discharge. If you remain very unwell you will need to reattend the hospital you were discharged from.
A hospital discharge planning evaluation is an assessment by the hospital to see if you need a discharge plan. Hospitals must complete an evaluation if a patient requests it. 1. If the evaluation shows you need a discharge plan, the hospital must develop one.
The following criteria are to be used in determining discharge: Functional inpatient rehabilitation goals are met in all therapy areas. No significant progress is evidenced toward functional goals. Goals can be addressed in a less intense program (i.e., therapy provided at non-acute inpatient setting).
The Department of Defense (DoD) authorizes six characterizations of service for military service members to receive on discharge: (1) Honorable; (2) Under Honorable Conditions (General); (3) Under Other than Honorable Conditions; (4) Bad Conduct; (5) Dishonorable, and (6) Uncharacterized.
Discharge readiness assessment is the evaluation of strengths and needs in five areas: physiologic stability, competency (cognitive and psychomotor) of the patient and family to carry out self-care management regimens, perceived self-efficacy to carry out self-care management regimens, availability of social support,

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In creating your discharge plan, hospital staff will consider things like: whether you live alone. how mobile you are. whether you need assistance at home. whether you will have physical restrictions, for example not driving or lifting.
Hospitals should provide written instructions covering at least these five topics: What activity you can do at home. Your diet. Follow-up appointment. Discharge medications. What to do if symptoms return or worsen.

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