Hospital Readmission Risk Assessment Form

Hospital Readmission Risk Assessment Form

Hospital readmissions are a critical concern for healthcare providers, patients, and families alike. When patients return to the hospital within 30 days of discharge, it often signals gaps in care coordination, medication management, or home support systems. This Hospital Readmission Risk Assessment Form helps healthcare teams identify at-risk patients early and implement targeted interventions to prevent unnecessary readmissions.

Why This Form Matters

Reducing readmission rates isn't just about compliance with healthcare quality metrics—it's about better patient outcomes. This form systematically evaluates key risk factors including recent hospitalization details, medication comprehension, availability of home support, and the patient's ability to recognize early warning signs. By capturing this information in a structured, easy-to-complete format, care teams can make informed decisions about discharge planning, follow-up care, and patient education.

Built for Healthcare Workflows

Created with Paperform, this template gives hospitals, clinics, and home health agencies a professional, HIPAA-aware solution that integrates seamlessly into existing workflows. Use conditional logic to surface relevant follow-up questions based on risk indicators, and connect the form to your EHR, patient management system, or care coordination tools via Paperform's robust integrations.

The clean, accessible design ensures patients or caregivers can complete the assessment without confusion, while healthcare staff receive clear, actionable data that can be reviewed during discharge planning or post-discharge follow-up calls.

Automate Care Coordination with Stepper

Once a patient submits their assessment, use Stepper to automatically route high-risk cases to care coordinators, schedule follow-up appointments, trigger medication education resources, or alert social workers about patients who lack adequate home support. This level of automation ensures no patient falls through the cracks during the critical post-discharge period.

Who This Template Is For

This form is ideal for:

• Hospital discharge planners managing transitions of care
• Primary care physicians conducting post-hospitalization follow-ups
• Home health agencies assessing patient readiness for independent recovery
• Care coordinators identifying patients who need additional support
• Quality improvement teams tracking readmission risk factors across patient populations

Paperform is trusted by over 500,000 healthcare teams worldwide and is SOC 2 Type II compliant, ensuring your patient data is handled with the highest security standards. Start reducing readmissions and improving patient outcomes with this comprehensive assessment template.