The call from HUP rarely comes with the warning you’d want. A resident mentions your loved one is “medically ready” during morning rounds, a case manager follows up by early afternoon, and suddenly you have hours — not days — to get a house ready for someone who needs help getting up the stairs. We coordinate with Penn Medicine discharge planners every week. Here’s the pattern, and how to get ahead of it.
Our transition team works across all three Penn Medicine hospitals in the city — the Hospital of the University of Pennsylvania (HUP) in University City, Penn Presbyterian a few blocks west, and Pennsylvania Hospital in Society Hill. The discharge process runs on the same system-wide playbook at each, which means the pattern is learnable. Families who know it in advance land the transition far better than families who are meeting it for the first time.
How the discharge decision actually gets made
Each unit at HUP runs multidisciplinary rounds in the morning, typically starting between 8 and 10 a.m. The physician team, a case manager, and often a social worker walk through every patient on the floor and flag anyone who’s hit the clinical markers for discharge — stable vitals, no active acute issues, and a documented plan for what comes next.
Being flagged in rounds is not the same as leaving that day. It means the discharge order becomes possible. The order itself — the formal, written go-ahead — usually gets entered sometime before early afternoon, and that’s the point where the clock actually starts for your family.
Your loved one’s case manager is worth identifying early, not on discharge day. Ask their name and how to reach them directly on your second day in the hospital. They’re managing a full caseload across the unit, and families who’ve already introduced themselves tend to get clearer, earlier updates than families the case manager is meeting for the first time mid-crisis.
The timing pattern to expect
Penn Medicine’s stated goal is to give families meaningful notice — often framed internally as a 24- to 48-hour heads-up once a discharge date is anticipated. In practice, the notice you actually get can be shorter, especially if your loved one improves faster than expected or a bed is needed for someone coming through the emergency department. It is common for the “this could be tomorrow” conversation to become “you’re leaving by 4 p.m. today” with very little warning in between.
MyChart, Penn’s patient portal, is usually the first place an estimated discharge date appears — sometimes before anyone calls you. If you haven’t set up portal access for your loved one (with their permission, as a proxy), do it in the first day or two of the stay. It’s the earliest signal you’ll get.
“Families do best when they treat the estimated discharge date in MyChart as real information, not a placeholder. By the time the phone call comes, we want the house already ready — not the packing just starting.”
What to have ready before the call comes
- Ask for the written discharge summary, not just a verbal handoff. It should include a full medication list with dosing times, activity restrictions, wound care instructions if relevant, and every scheduled follow-up appointment. Request it as soon as discharge is mentioned as a possibility, not after the order is entered.
- Confirm how prescriptions will be filled. HUP has an on-site outpatient pharmacy that can fill new prescriptions before you leave the building — ask the case manager to route scripts there rather than to your usual pharmacy if timing is tight. A gap in medication on day one is one of the most preventable, and most common, problems we see.
- Sort out transportation before discharge day, not during it. HUP’s discharge lounge can hold a patient for a limited window while a ride is arranged, but it isn’t built for long waits. If your loved one needs a wheelchair-accessible vehicle or medical transport, book it as soon as a discharge date looks likely — same-day bookings are harder to secure.
- Walk the home before they walk into it. Clear rugs and cords from main pathways, move frequently used items to easy reach, and if durable medical equipment (a hospital bed, walker, raised toilet seat) was ordered through the hospital, confirm the delivery date lines up with discharge — not a day or two after.
- Have home care lined up before you need it, not after. If there’s any chance your loved one will need help at home, start that conversation while they’re still inpatient. Agencies — including ours — can usually move faster with a few days’ notice than with a same-day call, and a caregiver who meets the family before discharge day makes the actual handoff calmer for everyone.
Because Penn Medicine discharges often move faster than families expect, we keep caregiver availability specifically reserved for HUP, Penn Presbyterian, and Pennsylvania Hospital transitions. If your family calls us while your loved one is still inpatient, we can usually have a caregiver introduced before the discharge order is even entered — so day one at home isn’t the first time they’re meeting your family.
If you’re at Pennsylvania Hospital or Penn Presbyterian instead
The mechanics are close to identical — same electronic health record, same case management structure, same rounding rhythm — but the buildings themselves are different enough to matter. Pennsylvania Hospital, at 8th and Spruce in Society Hill, is compact and walkable to Center City, which makes family visits and same-day errands easier during the stay. HUP and Penn Presbyterian, both in University City, involve a Schuylkill River crossing that’s worth accounting for if you’re coordinating from a Center City or Main Line home. None of that changes the discharge process — it just changes your own logistics around it.
The version where you get real lead time
Not every discharge is rushed. For a planned procedure, or a stay where the medical picture stabilizes gradually rather than suddenly, you can get several days of genuine notice. If that’s your situation, use it well: schedule the home safety walkthrough, get durable medical equipment delivered a day early rather than exactly on time, and meet a caregiver in person before discharge rather than over the phone. The families who get lead time and use it fully tend to have the smoothest first week of anyone we work with.
What to do this week if a discharge might be coming
- Identify your loved one’s case manager by name and exchange direct contact information.
- Set up MyChart proxy access so you can see the estimated discharge date as soon as it’s entered.
- Call us, or another home care agency, while your loved one is still inpatient — not after they’re home.
- Walk the home and clear the path, even before a firm date exists.
Either way — a rushed same-day discharge or a well-planned one — the difference between a stressful landing and a smooth one usually comes down to how early the pieces were in motion before the call.
Written by the transition care team at Rittenhouse Home Care, based on our ongoing coordination with Penn Medicine discharge planners. This article reflects our operational experience and is not a substitute for guidance from your loved one’s care team. Discharge processes can change — always confirm current details with your hospital’s case manager.
Expecting a discharge soon? Let’s get ahead of it together.
Our transition care team works directly with Penn Medicine case managers across all three campuses. Call us while your loved one is still inpatient — the earlier we’re introduced, the smoother day one at home tends to be.
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