Discharge Planning & Referring

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Discharge Planning

Patients are assessed at the time of admission for possible discharge planning arrangements and assistance.

Discharge Planning referrals can be initiated through an order on the Physician's Orders form. Upon receipt of the referral, the Case Manager will perform an assessment and communicate the plan in the progress notes.

Referring Physician Communication:

Upon discharge, the referring physician should receive a faxed After Visit Summary sheet which contains the following information:

Diagnosis
Procedures performed
Discharge instructions, i.e, medications and follow-up appointment
Name of Home Health agency
Name of durable medical equipment company

Discharge Planning & Referring

Discharge Planning

Referring Physician Communication:

For Patients and Parents

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