Continuing Your Care

When it’s time to leave our hospital, we want to make sure you’re set up for success on your health journey. Whether you’re going back to life as usual or continuing your care, here’s an overview of what to expect

Case Management

Case management is a collaborative process with physicians and other departments. Team members will work with a case manager to assess, plan, implement, coordinate, monitor and evaluate options and services required to meet a patient’s healthcare needs.

Discharge Planning

The case manager assesses the patient for discharge needs at the time of admission and throughout the hospital stay. Working with the patient, family and medical team, the discharge plan is outlined and communicated to the next-care providers upon discharge. Discharge planning referrals are made upon receipt of a physician order or verbal request of a patient or family.

Physician Communication

All patients receive an after-visit summary that details the discharge plan. Some items included on the after-visit summary include:

  • Diagnosis
  • Procedures performed
  • Discharge instructions regarding medications and follow-up appointment
  • Name of home health agency
  • Name of durable medical equipment agency
For more information, please call (361) 694-5607.

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