Averyn Care
Hospital-to-Home Tracker
Hospital-to-Home Tracker (4 weeks) — Susan
Weekly check-off pages (non-clinical) • Day 0 starts Wed, Jan 7, 2026 • Generated Tue, Jan 6, 2026 17:00 ET
✅ How to use this
Quick start- Each page is one week (7 days). Use a pen to check off scheduled medicines morning/evening.
- For as needed medicines (like an inhaler or Tylenol), check only if used and write time(s).
- Measurements are optional unless the clinical team asked you to track them.
- If anything here conflicts with discharge paperwork, follow the discharge paperwork.
Key contacts:
Averyn navigator: Brianna Cole — 1-844-283-7961 • family.support@averyncare.com
Primary care: Alan Hughes, MD — Parkside Primary Care Group — 1-216-555-1234
Home health scheduling: Willow Pathways Home Health — 1-216-555-7654
Home therapy scheduling: Summit Pathways Therapy — 1-216-555-7655
Pharmacy: City Pharmacy — Main Street — 1-216-555-0987
Emergency: call 911
Averyn navigator: Brianna Cole — 1-844-283-7961 • family.support@averyncare.com
Primary care: Alan Hughes, MD — Parkside Primary Care Group — 1-216-555-1234
Home health scheduling: Willow Pathways Home Health — 1-216-555-7654
Home therapy scheduling: Summit Pathways Therapy — 1-216-555-7655
Pharmacy: City Pharmacy — Main Street — 1-216-555-0987
Emergency: call 911
🗓️ Week 1: Jan 7 – Jan 13, 2026
7 daysLegend: ☐ not yet • ✔ done • For “as needed” medicines, check only if used and write time(s).
| Item | Wed Jan 7 1 | Thu Jan 8 2 | Fri Jan 9 3 | Sat Jan 10 | Sun Jan 11 | Mon Jan 12 | Tue Jan 13 4,5 |
|---|---|---|---|---|---|---|---|
| Medication check-off | |||||||
| Antibiotic (Augmentin) — morning dose (with food) — through Jan 13 | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Lisinopril 10 mg — morning | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Antibiotic (Augmentin) — evening dose (with food) — through Jan 13 | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Atorvastatin 20 mg — evening | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| As-needed medicines (check if used; write time(s)) | |||||||
| Albuterol inhaler — for wheeze/shortness of breath | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ |
| Tylenol (acetaminophen) — for pain/fever | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ |
| Measurements (only if asked to track) | |||||||
| Temperature (°F) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Oxygen saturation (%) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Blood pressure | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ |
| Weight | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Pain (0–10) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Notes / questions (optional) | |||||||
| Notes / questions | |||||||
1 Day 0: first full day at home — confirm you have all medications; set up a pill organizer; note any questions for follow-up.
2 Home health nurse start-of-care visit expected (Willow Pathways Home Health). Time window to confirm.
3 Home physical therapy evaluation expected (Summit Pathways Therapy). Time window to confirm.
4 Primary care follow-up: Parkside Primary Care Group • 10:30 AM.
5 Antibiotic course ends today — last dose (evening).
🗓️ Week 2: Jan 14 – Jan 20, 2026
7 daysLegend: ☐ not yet • ✔ done • For “as needed” medicines, check only if used and write time(s).
| Item | Wed Jan 14 | Thu Jan 15 1 | Fri Jan 16 2 | Sat Jan 17 | Sun Jan 18 | Mon Jan 19 3 | Tue Jan 20 |
|---|---|---|---|---|---|---|---|
| Medication check-off | |||||||
| Lisinopril 10 mg — morning | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Atorvastatin 20 mg — evening | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| As-needed medicines (check if used; write time(s)) | |||||||
| Albuterol inhaler — for wheeze/shortness of breath | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ |
| Tylenol (acetaminophen) — for pain/fever | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ |
| Measurements (only if asked to track) | |||||||
| Temperature (°F) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Oxygen saturation (%) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Blood pressure | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ |
| Weight | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Pain (0–10) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Notes / questions (optional) | |||||||
| Notes / questions | |||||||
1 Home physical therapy visit expected (time to confirm with Summit Pathways Therapy).
2 Home occupational therapy visit (if ordered) expected (time to confirm).
3 Home physical therapy visit expected (time to confirm).
🗓️ Week 3: Jan 21 – Jan 27, 2026
7 daysLegend: ☐ not yet • ✔ done • For “as needed” medicines, check only if used and write time(s).
| Item | Wed Jan 21 | Thu Jan 22 1 | Fri Jan 23 2 | Sat Jan 24 | Sun Jan 25 | Mon Jan 26 3 | Tue Jan 27 |
|---|---|---|---|---|---|---|---|
| Medication check-off | |||||||
| Lisinopril 10 mg — morning | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Atorvastatin 20 mg — evening | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| As-needed medicines (check if used; write time(s)) | |||||||
| Albuterol inhaler — for wheeze/shortness of breath | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ |
| Tylenol (acetaminophen) — for pain/fever | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ |
| Measurements (only if asked to track) | |||||||
| Temperature (°F) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Oxygen saturation (%) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Blood pressure | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ |
| Weight | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Pain (0–10) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Notes / questions (optional) | |||||||
| Notes / questions | |||||||
1 Home physical therapy visit expected (time to confirm).
2 Home occupational therapy visit (if ordered) expected (time to confirm).
3 Home physical therapy visit expected (time to confirm).
🗓️ Week 4: Jan 28 – Feb 3, 2026
7 daysLegend: ☐ not yet • ✔ done • For “as needed” medicines, check only if used and write time(s).
| Item | Wed Jan 28 | Thu Jan 29 1 | Fri Jan 30 | Sat Jan 31 | Sun Feb 1 | Mon Feb 2 2 | Tue Feb 3 3 |
|---|---|---|---|---|---|---|---|
| Medication check-off | |||||||
| Lisinopril 10 mg — morning | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| Atorvastatin 20 mg — evening | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ | ☐ |
| As-needed medicines (check if used; write time(s)) | |||||||
| Albuterol inhaler — for wheeze/shortness of breath | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ |
| Tylenol (acetaminophen) — for pain/fever | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ | ☐ ____ ☐ ____ |
| Measurements (only if asked to track) | |||||||
| Temperature (°F) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Oxygen saturation (%) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Blood pressure | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ | ____/____ |
| Weight | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Pain (0–10) | _____ | _____ | _____ | _____ | _____ | _____ | _____ |
| Notes / questions (optional) | |||||||
| Notes / questions | |||||||
1 Home physical therapy visit expected (time to confirm).
2 Averyn weekly check-in: send photo of this sheet or a quick summary (what’s going well / what’s hard).
3 End of 4-week tracker — if still helpful, print another copy for the next month.
📄 Disclaimer
ScopeThis tracker is for non-clinical organization and communication. It does not provide medical advice and does not replace hospital discharge instructions. For urgent concerns, contact the clinical team or call 911.