Discharge from home health has to be planned and documented. Dumping a patient at the end of an episode without a handoff can lead to readmissions and poor outcomes.
When and how to discharge
Discharge when goals are met, the patient no longer needs skilled care, or they’re transferred or hospitalized. Complete the discharge OASIS and any discharge summary. Notify the physician and, if appropriate, the next provider or facility. Document the reason and the date.
Handoffs that reduce readmissions
If the patient is going to a SNF or back to the hospital, send a summary: diagnoses, medications, recent changes, and any pending issues. That gives the next team a head start and supports better outcomes,which referral sources notice. See reducing hospitalization and readmission for care and documentation that support better outcomes. We have a discharge checklist you can download: what to complete, who to notify, and what to send. Use the button below to get it.