Care Managers are advocates for the patients and help them understand their current health status, what they can do about it, and why those treatments are important.
We assist our patients with access to care and appropriate use of available resources. For all patients requiring assistance with discharge planning, transfers to other facilities, assistance at home or needing additional equipment at home, we help ensure an effective progression of care, appropriate level of care and safe transition to home or alternate living. This often involves coordination and communication with the patient and family, physician, insurances, and community resources that provide services the patient may need. Our goal is to ensure both optimal patient and hospital outcomes, including quality of care, efficient resource utilization, and reimbursement for services.
Each patients chart is reviewed daily to assure that the patient is in the appropriate admission “status” and level of care for the patients clinical condition. We work very closely with our Primary Care Physicians to assure that the admission transitions appropriately.
Our Care Management department provides a personalized service for our patients. Often, we know our patients and they know us, familiarity smooths out the communications and allows us to offer that extra understanding of discharge needs that may only arise in a rural setting. We will call post-discharge to verify if there are additional needs that were not identified at the time of discharge and assist with those arrangements or answer those questions. If an answer is not clear, we will contact your physician and obtain an answer for you.
Care Management is available Monday – Friday 7:00 a.m. to 4:00 p.m., and on-call on the weekends.