Transition of Care testing for

A successful transition of care happens when healthcare providers work closely with patients to ensure a smooth progression from one care setting to another.

Our discharge transition team facilitates the movement from hospital to home health or alternative care settings, with an emphasis on safe and timely passage for every patient.

Case Manager Meeting

A member of our transition team will meet with you within one day of your hospital admission to begin planning for a safe and effective discharge.

Transition of Care Services

Our discharge team provides a comprehensive range of services to support you and your family, including:

• Clarifying discharge instructions for patients and families
• Explaining insurance coverage and benefits
• Scheduling follow-up appointments with your primary care doctor or specialists
• Coordinating care through insurance companies for managed healthcare plans
• Assisting with discharge medications at the hospital pharmacy
• Helping select alternative living arrangements such as skilled nursing or assisted living facilities
• Providing community resources and support services
• Coordinating home health agency caregivers
• Answering questions throughout the discharge process

Our Discharge Transition Team

Our team is made up of physicians, nurses, social workers, discharge planners, and case managers who specialize in transition management. They collaborate closely with you and your family throughout your hospitalization to ensure a successful transition to the next stage of your care.

Contact Us

For questions about transition of care or discharge planning, please contact our Case Management Office at (310) 836-7000.