The inquiry sheet
12Questions
to carry in
Bring this page in with you. Planners answer these questions every day, and the ones who ask them leave with a better plan.
Questions to Ask Your Hospital Discharge Planner
Endurance Home Care, the home care agency at 60 Long Ridge Rd in Stamford, CT, compiled these questions to ask a discharge planner so families leave the hospital knowing what was ordered, what Medicare covers, and who arrives first.
Families ask whether it is rude to slow a discharge down with questions. It is not, and the hospital's own incentives say so. The Hospital Readmissions Reduction Program is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination, to engage patients and caregivers in discharge plans, and in turn to reduce avoidable readmissions. Being engaged is the point of the meeting, not an interruption of it.
The planner has answered these questions before, usually several times that week. What changes is whether your household leaves with a plan or with a folder. This sheet is built to be carried in and written on: four groups of questions, in the order a discharge meeting tends to move. The hub page covers transitional care after a hospital stay stay in full.
- Group 01
What was ordered
- Group 02
Hours and limits
- Group 03
Timing
- Group 04
Paying, and what to bring
What was actually ordered
Start with the paperwork, because everything after it depends on what it says. Medicare home health is not something a family opts into: a health care provider must order the care, and a Medicare-certified home health agency must provide it. So the order already names services and it already names an agency, and the planner is holding both. Ask for the agency by name and write it down. Then ask the qualifying question directly, because it decides whether any of it happens at all. Medicare covers home health only for people who need part-time or intermittent skilled services and who are homebound as Medicare defines it. Both conditions, at the same time, or the benefit does not open.
Write the answer down
Which services are ordered, and who signed the order?
Names and signatures, not categories. This is the line every later question refers back to.
Which agency is providing them, and is it Medicare-certified?
Medicare requires a certified agency for the covered visits. Ask for the name and a phone number.
Does my parent meet both Medicare conditions, skilled need and homebound?
Ask for a plain yes or no on each condition separately.
If the answer is no, which of the two conditions is the one that fails?
It changes what you arrange next, and how soon.
The one gate
Part-time or intermittent skilled need, and homebound, both true at once?
The Medicare benefit opens, on its own terms: a set number of covered hours, nothing to pay for them, and a list of things it will not do. Take our discharge checklist to fill out along the wayongside the plan, and keep reading for the hours.
Care at home does not stop being possible. Home care needs no order and no homebound status, and a household arranges it directly. That is transitional care from Endurance, built for the days right after a discharge.
How many hours it really covers
8 hours a day. 28 hours a week.
An order in hand is not a schedule. Ask for the hours before anyone leaves the room. In most cases Medicare defines part-time or intermittent care as skilled nursing care and home health aide services up to 8 hours a day combined, for a maximum of 28 hours a week. Read that as four hours a day and the shape of the benefit stops being abstract. It is real help, and it is not a staffed household.
Two more things are worth hearing said plainly. People eligible for the Medicare home health benefit pay nothing for covered home health services, so the covered visits are not the part to budget for. And the benefit does not pay for homemaker services, such as shopping and cleaning, that are unrelated to the care plan. Groceries, laundry, the ride to the follow-up, somebody in the house on a Sunday afternoon: those sit outside it and get arranged separately, by you.
How many hours a week are covered, and across how many visits?
Hours and visits are different answers. Ask for both.
What will we be billed for the covered visits?
What is not covered at all under this plan?
Housekeeping, errands, and companionship usually live here.
Who helps on the days and hours no visit is scheduled?
The first covered visit has a date on it. The first night home has nobody assigned to it.
Ask for a day and a time, not a range, and ask it while the planner is still in front of you. Then ask the second half of the question, which is the half that gets skipped: who is in the house between the car pulling into the driveway and that first visit. Endurance built the Homebound program around exactly that stretch, targeting the first 72 hours after a discharge as a plan for the first days home. We walk through what happens in the first 72 hours after dischargeer a discharge in more detail, hour by hour.
What day and time does the first visit happen?
Who is in the house on the first night, before that visit?
What changes mean we should call, and which number do we call?
Ask for the number that is answered after hours, and write it on the discharge papers.
Bring the policy, not only the questions.
Long term care insurance is a live payment surface, not a footnote, and the terms differ enough that reading yours matters more than any general answer. Carry the policy, the discharge papers, a list of the household routines somebody now has to cover, and a pen. Endurance sits down with families and reads the policy alongside them, and says plainly what it looks like it will and will not cover.
What should I bring to this meeting, and to the next one?
Connecticut License HCA.0002450 · New Jersey License HP0435100 · Connecticut DPH License 9915786 (Endurance Home Health). Endurance Home Care provides care at home in Connecticut and New Jersey, with companion care only in New York. Skilled nursing, home health aides and physical therapy in Connecticut are provided by Endurance Home Health. Client Support Line (203) 936-6847. Hospital-to-home care serves Connecticut and New Jersey; New York service is companion care only.
Questions families ask
What questions should you ask a hospital discharge planner?
Ask five: What services are ordered, and which agency provides them? Does my parent meet Medicare's home health conditions? How many hours will actually be covered, and what falls outside them? When does the first visit happen, and what covers the gap before it? What symptoms mean we call, and which number? Write the answers on the discharge papers themselves.
Who qualifies for Medicare home health after discharge?
Two conditions, both required: the person must need part-time or intermittent skilled services, and must be homebound as Medicare defines it. A health care provider must order the care, and a Medicare-certified home health agency must provide it. Ask the planner directly whether your parent meets both conditions, and get it in writing.
What if my parent does not qualify for Medicare home health?
Nothing stops care at home. Home care requires no doctor's order and no homebound status; a family arranges it directly with an agency like Endurance. Bathing help, meals, rides, reminders, and supervision are all available this way, and a long term care insurance policy may help pay for it.
Twelve answers, written down, beat a folder of paperwork.
Home care across Fairfield County and New Haven County, Connecticut, from an agency licensed by the state. Tell us what the planner said, and we will tell you what it leaves you to cover.
Call (203) 936-6847