The 48-Hour Discharge: A Home-Readiness Checklist for Planners and Social Workers
You have a patient going home Thursday. The PT note says supervision with a rolling walker, no stairs. The daughter says the house is fine.
The house is probably not fine. It was fine three weeks ago, for a person who walked differently.
This is the checklist we use when we prep a home before a hospital or rehab discharge in Las Vegas, Henderson, and Boulder City, written for the people who have to assess readiness from a conference room with two days' notice. Use it, hand it to families, or print it — there's a one-page version here.
The question that actually predicts readiness
Not "is the home safe?" but: can this person get from the bed to the toilet, at 2am, in the dark, with the device they're going home with, without touching a single piece of furniture for balance?
If the answer is no, the discharge plan has a hole in it regardless of what else is arranged.
And if the honest answer is that the home can't be made safe in time, that's not a failure — it's a different plan. A local senior placement advisor can help the family compare assisted living and residential care options quickly, at no cost to them (see our trusted local partners below).
The furniture-touching part matters. People who reach for a countertop or a chair back instead of using the walker — what we call furniture surfing — are at high risk, and it's what people do when the walker doesn't fit where they need to go.
The path: bed to bathroom
This is the first thing to fix and the thing most often missed. For a family-friendly companion handout, the CDC's Check for Safety home fall prevention checklist covers the same ground room by room.
- Clear width along the entire route. A rolling walker needs roughly 30–36 inches of clear path; a wheelchair needs more. Measure the narrowest point, not the average.
- Turning space at the bathroom door and beside the bed — a walker user needs room to pivot, not just to pass.
- Nothing on the floor along that path. Cords, throw rugs, pet bowls, magazine stacks, shoes, oxygen tubing routed across the walkway.
- Thresholds and transitions — door thresholds, tile-to-carpet edges, any height change.
- Lighting the whole route, operable from the bed. Motion-activated night lights are cheap and fix most of this.
- Doors that open wide enough and don't swing into the path.
Sleeping arrangement
- Is the bedroom on the discharge floor? If there are stairs and the order says no stairs, a bed has to come down — or a downstairs room has to become the bedroom.
- Bed height. Feet flat on the floor when seated on the edge, hips slightly above knees. Too-high and too-low beds both cause falls.
- Clear access on the transfer side, with room for a walker beside the bed.
- A stable surface within reach for water, phone, glasses, and medications — a nightstand that won't roll or tip when leaned on.
- Phone or call device reachable from the bed, and from the floor if possible.
Bathroom
- Can the walker get in and turn? Many bathroom doorways cannot accommodate one. If not, this needs solving before discharge, not after.
- Toilet height and whether a raised seat or commode is needed and has actually arrived.
- Grab bars where they'll be reached for — and confirm they're anchored to structure. A towel bar will come out of the wall with someone attached to it.
- Shower or tub entry — threshold height, bench or chair present, non-slip surface.
- Everything needed within reach while seated or standing with support.
Entry and exit
- How does the person get in from the car? Count the steps. Check the handrail on both sides.
- Path from the driveway — width, surface, lighting, gate.
- An exit route in an emergency that works with the mobility device.
Kitchen and daily living
- Daily items between shoulder and waist height. No reaching overhead, no bending to a low cabinet.
- A seated place to prepare food if standing tolerance is limited.
- Walker access to the sink and refrigerator.
- Medications organized and reachable, with expired and discontinued ones removed.
Equipment and services
- DME delivered and set up before arrival — not scheduled for "sometime that week." Medicare covers many items when a doctor orders them; see Medicare's DME coverage rules.
- Someone who knows how to use it present on day one.
- Home health start date confirmed, and the family knows what that service does and doesn't include (what Medicare home health covers).
- A plan for the first 72 hours — who is there, and overnight. If family can't cover every shift, a licensed in-home care agency can fill the gaps.
- Primary care follow-up booked before the patient leaves — ideally within 7–14 days — with the updated medication list in hand.
What the family can do in one evening
Be specific with them, because "make the house safe" produces paralysis:
- Remove every throw rug on the path
- Move cords and reroute oxygen tubing out of walkways
- Clear the floor along the bed-to-bathroom route entirely
- Put night lights in the hall and bathroom
- Move daily-use items to waist height
- Clear the entry path and check the handrail
For more room-by-room ideas to share with families, see the National Institute on Aging's guide, Preventing Falls at Home: Room by Room.
What needs a crew
This is where discharge plans fail, and it's the part a family genuinely cannot do between a work shift and a hospital visit:
- Moving a bed downstairs
- Converting a dining or living room into a bedroom
- Pulling furniture back to widen paths through the whole house
- Clearing an accumulated room enough to be usable at all
- Removing furniture that has to go for the walker to fit
- Hauling away what comes out
That's a one-day job. Two people, about four hours, roughly $240–$300 at our rate, done before the car pulls in.
If the house needs permanent changes — a ramp, a curbless shower, or a different home altogether — that's a job for a Certified Aging-in-Place Specialist (CAPS), not a one-day crew. Not sure which kind of help fits? Read Senior Move Manager, Organizer, Junk Hauler, or Caregiver: Who Do You Actually Need?.
Trusted local partners in Las Vegas & Henderson
We don't do everything, and we'd rather point you to the right people than stretch. These are local professionals we've met and recommend for the parts of a discharge plan outside our work:
- In-home care (first 72 hours and beyond): Home Helpers Home Care — Larry Limon, (702) 802-9865. BrightStar Care of West Central Las Vegas & Henderson — Tammy Tolbert, (702) 982-2273.
- When home isn't the right discharge: Next Home Senior Placements — Lisa Stokuca, (702) 601-9096. Silver State Referral — Matt Davio, (725) 353-9997. Both help families compare assisted living, memory care, and residential care homes at no cost to the family.
- Aging-in-place home changes or a move to a better-suited home: Mitch Schwartz, Keller Williams Realty The Marketplace — Senior-focused agent and Certified Aging-in-Place Specialist (CAPS, SRES), (702) 303-0040.
- Primary care follow-up: Family Health Primary Care, 3430 E Flamingo Rd, Suite 106, Las Vegas, NV 89121.
For discharge planners, social workers, and home health teams
We schedule same-week in Henderson, Las Vegas, and Boulder City. We work directly with out-of-town family so you're not coordinating it. We give a firm price before we start, and we'll tell the family plainly if the job is smaller than they feared.
Medicare doesn't cover this and home health can't do it. That gap is why we exist. (For what does get paid for, see What Nevada Will and Won't Pay For.)
Call (702) 439-2352 or book a free walk-through.