Table 1.

Assessment of Factors Associated with Readmission Risk.

Questions*
1.	Do you live alone [23]? (Yes, no)
2.	Self-rated health: In general, would you say your health is: excellent, very good, good, fair, or poor [26,28]?
3.	Right now, on a scale of 0 to 10, with 0 representing no pain, 5 moderate pain, and 10 the worst pain imaginable, how much pain do you have [29]?
4.	Have you had a hospitalization or emergency dept visit in the last year [19,21]? (Yes, no)
5.	Over the last 2 weeks, how often have you felt bothered by any of the following: a) Little interest or pleasure in doing things; b) Feeling down, depressed, or hopeless [30]? (scale: 0 to 3; not at all to nearly every day)
6.	Functional Status: a)Can you get out of bed or chair yourself; b) can you dress and bathe yourself; c) can you make your own meals: d) can you do your own shopping [31,32]? (Yes, no)
7.	Are you taking any of the following medications? Pills that impact your blood clotting (Coumadin, aspirin, Plavix), Insulin/blood sugar pills, or prescription pain meds [33,34]? (Yes, no)
8.	Health literacy: How often do you need to have someone help you when you read instructions, pamphlets, or other written material from you doctor or pharmacy [35,36]? (Never, rarely, sometimes, often, always)

*For discharge planning, the following responses were used to indicate potential for patient risk:

a) For questions 1, 4, 6, 7, a “yes” response for any item.

b) For question 2, a response of “fair” or “poor.”

c) For question 3, a score of 5 or higher.

d) For question 5, a score of 1 or higher for either or both questions.

e) For question 8, a response of “sometimes”, “often” or “always.”