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Guide

Preparing the care handover.

In short: a good handover starts early. For the request, clinical details without name and address are enough at first. The complete documents follow once a provider has confirmed.

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Framework

Discharge management is part of hospital treatment (Section 39(1a) SGB V). The details are set out in a framework agreement at federal level.

For nursing, the expert standard on discharge management in nursing (Expertenstandard Entlassungsmanagement in der Pflege) of the DNQP describes professional requirements. The rules and standards of your hospital remain decisive.

Checklist for the request

A provider needs these details to decide whether it can take over – without name, address or date of birth:

  • Type of care: home care (outpatient), short-term care, day/night care, permanent residential care, assisted living / outpatient shared flat or out-of-hospital intensive care
  • Postcode and town where care is needed
  • Planned discharge and desired start
  • Care level or status of the application
  • Services needed with frequency: personal care, treatment care, domestic help
  • Mobility and aids
  • Special requirements, for example wound care, oxygen or dementia
  • Type of payer
  • Contact person in the social service with a shared mailbox

Checklist for the handover

After confirmation, the provider usually needs for the first day:

  • Nursing transfer form
  • Medication plan and medication for the first days
  • Prescriptions, for example for home nursing care or aids
  • Discharge letter or provisional medical letter
  • Wound documentation, if needed
  • Contact of the relatives or the legal representative
  • Date and type of transport

Workflow in the hospital

1. Identify the need early

Clarify early whether care will be needed after discharge.

2. Clarify consent and wishes

Talk with the patient and the relatives about wishes and consent.

3. Make the request

Contact suitable providers with the clinical details.

4. Prepare the handover

After confirmation, put together the documents and agree on the date.

Requesting with minimal data

On Pflege Patienten you post care needs in pseudonymised form – without name, address or date of birth. You pass these details on to the provider directly after the selection, not via the portal. You obtain the consent of the patient to the referral.

What this guide does not cover

This guide is not a procedural instruction. The framework agreement, the standards of your hospital and the requirements of your data protection officer are decisive.

Read more: For hospitals and social services · Privacy and security

Status

Pflege Patienten editorial team · Published 11 Oct 2026.

Editorial status: 11 October 2026. The linked sources were checked automatically. No independent professional or legal review of this article has taken place so far.

Further information: Federal Ministry of Health (German)

Requesting follow-up care

How social services work with Pflege Patienten is shown on the page for hospitals.