Some patients may need continued health care after they are discharged
from the hospital. Our Social Workers and Registered Nurse Care Coordinators
try to identify these patients early in their hospital stay to provide
assistance with discharge planning. The discharge planning staff work
with the patient and their physician to develop a plan for care of the
patient after discharge. They can assist the patient and their family
in identifying options for continued care, and will assist in the arrangement
of equipment, home care services, or referral to community agencies.
When patients are not well enough or unable to return home upon discharge
from the hospital, the Social Workers can provide the patient or family
with information on other options such as a nursing care or assisted living
facility. The Social Workers are available to work with the physician,
patient, and family to determine the type of care the patient needs, and
provide assistance with the placement process.
Any patient or family member may request assistance from our discharge
planning and social services staff by simply notifying the patient's nurse.