What is discharge-planning-checklist?

A checklist for deciding whether a hospital patient is ready to leave. It checks clinical tasks, medicines, follow-up care, education, equipment, and home support using FHIR, a standard format for exchanging healthcare data.

Use it to review pending tests, reconcile medicines, check appointments, create discharge-plan tasks, and assess LACE readmission risk.

It helps staff find unfinished discharge tasks before the patient leaves and highlights factors linked to readmission, or returning to hospital after discharge.

discharge-planning-checklist — Skill by langcare/langcare-mcp-fhir

Install

Getting it into your agent

One page per mod, every tool's command on it. A separate URL per tool would split the same page into five that compete with each other.

Any agent

npx skills add langcare/langcare-mcp-fhir --skill discharge-planning-checklist

Clone the repo

git clone --depth 1 https://github.com/langcare/langcare-mcp-fhir

Made for: Claude Code, Codex.

Wrote this? Show the measurements

A badge with what this costs and how it scanned, read live from this page, so it follows the numbers instead of freezing them. Markdown for a README, HTML for a documentation site or a project page.

README.md

[![agentmods](https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/discharge-planning-checklist/github.svg)](https://agentmods.dev/skills/langcare/langcare-mcp-fhir/discharge-planning-checklist)

Your own site

<a href="https://agentmods.dev/skills/langcare/langcare-mcp-fhir/discharge-planning-checklist"><img src="https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/discharge-planning-checklist/github.svg" alt="Measured on agentmods" height="20"></a>

Or the 80×15 button, for a site that already has a row of RSS and ATOM ones. Only the verdict fits; the numbers stay here.

Your own site · 80×15

<a href="https://agentmods.dev/skills/langcare/langcare-mcp-fhir/discharge-planning-checklist"><img src="https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/discharge-planning-checklist.svg" alt="Reviewed on agentmods" width="80" height="20"></a>

Per session 102 Skills are progressive disclosure: only the name and description are preloaded; the body loads when the skill is used.

When invoked 3,508 The whole file, excluding the scripts and references it only reads on demand.

Security scan A 0 findings. A grade says what 26 rules found in the file — not that it is safe.

Origin original No closer match found in the catalogue.

Token cost

What it costs to keep this loaded

Counted locally with the o200k_base tokenizer, which is exact for GPT models; Claude uses its own tokenizer and its counts differ. Treat this as one consistent yardstick across the catalogue rather than a bill. Prices are per million input tokens.

Model	Per session	Once invoked
Fable 5.1	$0.00102	$0.03508
Opus 5.5	$0.00041	$0.01403
Sonnet 5.5	$0.00020	$0.00702
Haiku 4.5	$0.00010	$0.00351

Measured 2mo ago against content hash 1d44a56895e8, method: parsed. Prices are Anthropic first-party input rates as of 2026-10-07, from the pricing page.

Security

Grade A, and why

discharge-planning-checklist scanned grade A with 0 findings against 26 rules in 11 categories — prompt injection, anti-refusal, data exfiltration, privilege escalation, supply chain, agent snooping, system-prompt leakage, SSRF and excessive agency — measured 2mo ago.

A static scan of the body, not an audit. Every finding is printed with the line that produced it so you can judge whether it matters here. A mod is markdown that instructs an agent; that is exactly why what it instructs is worth reading.

Nothing flagged

None of the 26 patterns this scan looks for appear in this file: no shell pipes, no recursive deletes, no credential paths, no hidden text, no instruction-override or anti-refusal phrasing, no agent-config snooping. That is not a guarantee, it is the absence of the things that are checkable.

skills/core/care-coordination/discharge-planning-checklist/SKILL.md · 327 lines

How it starts

The opening of the file, as written. The whole thing — 327 lines — stays where its author put it; the contents beside it link to each section on GitHub.

Discharge Planning Checklist

Overview

Assess discharge readiness by querying FHIR resources for pending orders, incomplete care plan tasks, unscheduled follow-ups, and unreconciled medications. Generate a structured checklist with pass/fail status for each CMS Condition of Participation discharge requirement. Calculate LACE readmission risk index. Create or update a discharge CarePlan resource with outstanding tasks.

FHIR Resources Used

Resource	Purpose	Key Fields
ServiceRequest	Pending labs, imaging, consults	status, intent, code, authoredOn
CarePlan	Discharge plan with tasks	status, intent, activity, category
Appointment	Scheduled follow-ups	status, serviceType, start, participant
MedicationRequest	Active prescriptions for reconciliation	status, medicationCodeableConcept, dosageInstruction
MedicationStatement	Patient-reported medications	status, medicationCodeableConcept
Encounter	Current admission details	status, class, period, reasonCode
Condition	Active problems for discharge summary	clinicalStatus, code, onsetDateTime
Procedure	Completed procedures during stay	status, code, performedDateTime
Observation	Pending lab results	status, code, valueQuantity
DocumentReference	Patient education materials	type, status, content
DeviceRequest	DME orders	status, codeCodeableConcept, intent

Instructions

Step 1: Retrieve Current Encounter

Tool: fhir_search
resourceType: "Encounter"
queryParams: "patient=[patient-id]&status=in-progress&class=http://terminology.hl7.org/CodeSystem/v3-ActCode|IMP"

Extract: admission date from period.start, reason for admission from reasonCode, attending provider from participant. If no in-progress inpatient encounter found, search for status=finished with most recent date.

Step 2: Check Pending ServiceRequests

Tool: fhir_search
resourceType: "ServiceRequest"
queryParams: "patient=[patient-id]&status=active,draft&encounter=[encounter-id]"

Read the full file on GitHub · 327 lines

Files

What ships with it

2 files beside SKILL.md in the same directory: the scripts, references and assets a skill reads on demand. Not counted in the per-session cost; read them before you install if any of them is executable.

Changes

What this file has done since we first saw it

Hashed on every crawl. A supply-chain change to an agent config is a question of when, not whether, so the history is kept rather than the latest state alone.

2mo ago First seen · 327 lines · 102 tokens per session scan A 1d44a56895e8

Subscribe to this mod's changes

discharge-planning-checklist is a skill published in the GitHub repository langcare/langcare-mcp-fhir (71 stars, last pushed 6mo ago), licensed MIT. It adds 102 tokens to every session and 3,508 once invoked, about $0.0004 per session on Opus 5.5. A static security scan graded it A with 0 findings. No closer match exists in the catalogue, so it is treated as the original; first seen 2026-08-30.

Scientific

discharge-planning-checklist next to 6 skills from other repositories
Mod	Type	Stars	Last push	Licence	Scan	Tokens	Works with
discharge-planning-checklistlangcare/langcare-mcp-fhir	Skill	71	6mo ago	MIT	A	102	Claude Code, Codex
instrument-data-to-allotropeanthropics/knowledge-work-plugins	Skill	35k	2d ago	Apache-2.0	A	123	Claude Code
exploratory-data-analysisK-Dense-AI/scientific-agent-skills	Skill	56k	4d ago	MIT	A	83	Claude Code
matlabK-Dense-AI/scientific-agent-skills	Skill	56k	4d ago	MIT	A	44	Claude Code
phylogeneticsK-Dense-AI/scientific-agent-skills	Skill	56k	4d ago	MIT	A	71	Claude Code, Codex
research-engineerdavila7/claude-code-templates	Skill	33k	yesterday	MIT	A	43	Claude Code, Codex
mapping-to-snomedmaziyarpanahi/openmed	Skill	5.8k	yesterday	Apache-2.0	A	205	Claude Code