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Six plain-language reads that move at a calm reading pace, with original music played by your browser. Facts come from the official sources listed under each read. For help with a specific situation, contact Prime Care Link.

1Your part in the plan

Under federal rules, a hospital's discharge planning has to focus on the patient's goals and preferences.

It includes the patient and their caregivers as active partners.

When care after the hospital is part of the plan, the hospital gives a list of available Medicare-participating providers, and tells you that you are free to choose.

2Before the day

Where will care happen next, and when?

What equipment is needed, and who delivers it before the person arrives?

A complete medication list, reviewed with the staff: which to continue, and at what dose.

The names and numbers of who to call with questions.

3If it feels too soon

Hospital patients with Medicare should receive a notice called An Important Message from Medicare about Your Rights.

A patient who believes the discharge is too soon can ask for a fast appeal, by following the directions on that notice, no later than the planned discharge day.

Our suggestion

A tip from us: write the answers down in one place, and keep it with the person's papers.

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Leaving the hospital

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Read it as text: Leaving the hospital
  1. Your part in the plan
  2. Under federal rules, a hospital's discharge planning has to focus on the patient's goals and preferences.
  3. It includes the patient and their caregivers as active partners.
  4. When care after the hospital is part of the plan, the hospital gives a list of available Medicare-participating providers, and tells you that you are free to choose.
  5. Before the day
  6. Where will care happen next, and when?
  7. What equipment is needed, and who delivers it before the person arrives?
  8. A complete medication list, reviewed with the staff: which to continue, and at what dose.
  9. The names and numbers of who to call with questions.
  10. If it feels too soon
  11. Hospital patients with Medicare should receive a notice called An Important Message from Medicare about Your Rights.
  12. A patient who believes the discharge is too soon can ask for a fast appeal, by following the directions on that notice, no later than the planned discharge day.
  13. Our suggestion
  14. A tip from us: write the answers down in one place, and keep it with the person's papers.

Facts in this read come from Medicare: Your discharge planning checklist · Medicare.gov: Skilled nursing facility care · CMS: Livanta, California's Medicare quality organization, checked October 22, 2026. Our tips are marked as tips. General information, not medical advice.

Six short reads

General information, not medical advice. The music is original, written for this page and played by your browser; nothing is downloaded. It starts when a read plays and fades when you leave; turn it off with the note button.

Guides

Know what to ask before the next care decision

Plain-language guides that prepare you for discharge conversations, care settings, coverage questions and license checks. Every fact links to its official source.

Care Settings, ExplainedWhat each kind of care is and which California agencies license them: skilled nursing, rehabilitation, home health, non-medical home care, hospice and palliative care, assisted living, memory care, board and care, respite, and adult day programs.Discharge Planning ChecklistWhat to settle before leaving the hospital or a facility: where care happens next, timing, equipment, medications, transportation, follow-up, home safety and support on arrival, plus your rights if the discharge feels too soon.Family Caregiver GuideWhere California family caregivers can find help: Caregiver Resource Centers, In-Home Supportive Services, local aging agencies and the Ombudsman, plus a simple way to keep the essentials organized.Coverage & Payment BasicsHow Medicare, Medi-Cal, veterans benefits and long-term care insurance generally work for skilled nursing, rehab, home health, hospice and long-term care, with the 2026 amounts Medicare publishes.Care Terms, ExplainedCommon terms such as SNF, ADLs, custodial care, DME, home health, homebound, hospice, palliative care and observation status, explained without jargon.How to Check a LicenseWhere to look up a California facility, agency, caregiver, nurse or physician, what the state record shows, and where to report a problem.How to Apply for IHSSHow In-Home Supportive Services works in California and how to apply: who qualifies, the application and health care form, the county home visit, choosing a provider, and appeals.What a Care Navigator DoesWhat care coordination and care navigation mean, how a navigator differs from a patient advocate or geriatric care manager, and the questions to ask any service.
For case managers & social workers

Options, family communication and follow-through

How we support discharge teams, from the first call to the handoff.

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