Care Transition
Movement of a patient between healthcare settings, such as from a hospital to home health.
Definition
A Care Transition is the movement of a patient between healthcare settings, such as from a hospital to home health, skilled nursing facility, or primary care.
Why it matters
Effective care transitions reduce medication errors, communication failures, and hospital readmissions.
What Should I Document? 100 OASIS Situations Home Health Nurses Face Every Day
100 real OASIS scenarios, worked end to end — clinical situation, common mistake, better approach, and key takeaway. Built around OASIS-E2 (effective April 1, 2026) to turn what you assess into accurate, defensible documentation.
Listen While You Read
Conversations on lupa & pdgm
Episodes from Inside Home Health that put Care Transition in operational context.
Ep 23Ep 23 · Aug 17, 2026
The Hidden Spreadsheet Error That's Causing the Nursing Shortage | Robert Wingo
Robert Wingo, BSN, RN, NI-BCWatch 
Ep 20Ep 20 · Jul 13, 2026
The Real Cost of Ignoring Nurse Burnout | Jennifer Johnson
Jennifer JohnsonWatch 
Ep 19Ep 19 · Jul 6, 2026
AI Won't Replace Nurses, But Nurses Using AI Will | Timi Abiola
Timi AbiolaWatch