Hospital Discharge Planning

Our case managers will coordinate and assist the hospital discharge planner. Many times the social worker or discharge planner in the hospital doesn't have knowledge in the community to all the identified treatment or equipment options. We will assist the discharger planner as needed. Many times the social worker will rely on the external case manager to help outline all of the resources. Our job would be to identify potential challenges so we can help eliminate complications prior to discharge. We will monitor the transition with the patient and family.