Discharge Planning

Leaving the hospital

As important as it is to know what to expect when a patient enters Self Regional Medical Center, it is just as essential to know what happens when he or she is ready to leave. This is a guide to the discharge planning process for caregivers. A caregiver is a person who helps someone who is ill, disabled or elderly, and can be a relative or friend.

Discharge planning

Discharge planning is a process, not a single event. Medicare defines discharge planning as “a process used to decide what a patient needs for a smooth move from one level of care to another.”  As a result of that process, the discharge plan may be to send the patient to his or her own home or someone else’s, a rehabilitation facility, nursing home or some other place outside the hospital. Discharge from the hospital does not mean that the patient is fully recovered. It means that a physician has determined that the patient’s condition is stable and he or she does not need hospital-level care. Discharge planning is a short-term plan to get a patient out of the hospital. It is not a blueprint for the future. If you think the patient you are caring for is in need of discharge planning, let the nurse know.

Making the transition

Only a physician can authorize a hospital discharge. If the patient is unable to return home alone or if he or she needs assistance at home, the discharge planner will assist you. It could be as simple as a home health referral to a more complex need of nursing home placement.

Levels of care available

Home health
Once a physician has determined that the patient needs home health and writes a physician’s order, the discharge planner will provide to the patient or family choices for home health. Once a choice is made, the referral will be given to the selected agency. Home health can provide physical therapy, occupational therapy, speech therapy, skilled nursing services, and other services. Most insurance companies pay for home health.

Assisted living
There are several assisted livings facilities in our community. Assisted living facilities provide 24-hour care in a home-like setting. The discharge planner can provide you pamphlets from the local facilities and/or contact the facility to schedule a meeting. Facility charges are the responsibility of the patient or the patient’s family or caregivers.

Skilled nursing facility care
This is a level of care that requires the daily involvement of skilled nursing or rehabilitation.  Medicare Part A pays for this care for up to 100 days in a nursing facility. Days 1-20 are covered at 100 percent. After that, the patient is responsible for approximately $124 per day for days 21-100. Then, the patient will either be responsible for the full charges or must apply for Medicaid coverage. If at anytime during these 100 days you no longer need skilled care, but you still cannot return home, your Medicare Part A will stop paying and you will be billed for the remainder of your stay unless you have Medicaid. Medicare requires that discharge planners identify placement facilities within 50 miles of the hospital, so a placement may not be made at the closest facility or at the one preferred by the patient or family.

Contact us

For information on Self Regional’s discharge planning, please call 864-725-6036.


Information provided by The Family Caregiver Alliance.