Transitional Care Program: Bridging the patient from hospital to home
Welcome. We’re ready to help you with your recovery. At Community Memorial Hospital, we understand there are times when a patient no longer needs the acute care they receive in the hospital, yet they may not feel strong enough to return home. For those patients, we offer a comforting alternative.
Our Transitional Care Program is designed to provide patients with individualized, in-hospital care and physical rehabilitation to help them reach an optimal level of functioning. This post-acute care is designed for patients who are discharging from acute care but need temporary additional care that cannot be provided at home or in a long-term care facility.
Through a combination of first rate rehabilitative therapies, attentive nursing care and medical supervision, patients gain the strength, functionality, balance, and range of motion they need to care for themselves with confidence.
Who Qualifies for Transitional Care?
You’ll find that Medicare and most insurance companies cover transitional care services. These services are usually covered under the “Skilled Nursing Facility” benefit category. Medicare and state regulations provide the following patient eligibility guidelines:
- A patient must be hospitalized as an “Acute Care Inpatient: (Not an “Observation Patient”) for a minimum of three consecutive midnights within a 30-day period.
- Admissions can come from any hospital, including our hospital, after three consecutive midnights as an inpatient in acute care
- A physician referral is required. You or your family can request that your social worker or discharge planner refers you to the Community Memorial Transitional Care Program.
Contact Information: Case Management at 618-635-2200