Care Management

Soon after your admission, the care management team will begin assisting you with discharge planning, including identifying a target date for your discharge. Throughout your stay, team members will speak with you about goals that must be met before you leave the hospital.

The care management team also helps by:

• Contacting other clinical staff and community providers to arrange continuing medical services after the patient has been discharged from the hospital, including acute and subacute rehabilitation, assistance with long-term care (including nursing home care), home care needs such as home infusion/IV therapy and home medical equipment
• Referring patients as necessary to community resources such as case management and housing assistance, support groups, crisis counseling, and mental health programs
• Addressing quality of care concerns such as communication issues and the coordination of family meetings
• Regularly reviewing with your insurance provider information about your admission, length of stay and medical services
• Answering questions about your rights as a patient and the appeal process for insurance claims