Phone-based connection. Clinician-directed care. Let’s connect

Guide / The transition home

Before the ride home,
make room for questions.

A discharge plan can contain a lot to remember. A few clear conversations with the clinical team can make the next steps easier to understand.

An older woman using a walker with an attendant beside her in a bright facility corridor

General service information. Updated September 28, 2026.

Ask your care team to explain the plan.

  • Who should I contact with questions once I am home?
  • Which changes need prompt attention, and what should I do?
  • Which follow-up appointments do I need, and who arranges them?
  • Can you explain the medication instructions and any changes?
  • What help should be in place at home?
  • If scheduled check-ins are part of my plan, when do they start and what do they cover?

Include the people you choose.

If you want a family member or caregiver involved, ask the team how to authorize that involvement. Keep the instructions somewhere you and the people you authorize can find them.

Know what a check-in adds.

A scheduled call gives you an opportunity to share how the routine is going. It complements the care plan. It does not replace a follow-up visit, home health service or emergency instructions.

Follow your discharge instructions. Call 911 in an emergency. Do not wait for a website reply or a scheduled check-in.

Learn about transitional care management

A little more connection.

A better next step
starts with a conversation.

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New here? Talk with our team. For an emergency, call 911.