The purpose of Care Management is to collaborate with the patient, their family, physician(s), and other hospital resource staff to plan, coordinate, evaluate, and implement the options and services required to meet the patient’s health needs. Care Management uses communication and available resources to promote quality, cost-effective outcomes in the hospital for the timely and collaborative discharge of a patient.
The Hospital Care Manager coordinates the clinical goals with the patient’s goals and manages the financial and quality outcomes of the care provided in the hospital. Nurse Care Managers and Social Workers work collaboratively in identifying appropriate providers and facilities across the continuum of health care and services while ensuring that available resources are timely, cost-effective, and efficient.
Depending on your care needs upon discharge, St. Joseph’s Health provides many options for our patients, including the following (with insurance company and physician approval):
- Home alone or with family support;
- Home with private agency support such as nurses, personal care worker, home health aide;
- Home with support from community agencies such as meals on wheels, life line, senior support services;
- Home with home care support, if eligible;
- Sub Acute Rehab short term stay, if eligible;
- Acute Rehab short term stay, if eligible;
- Return to referring hospital;
- Long Term Care (Nursing Home);
- LTAC-Long Term Care Acute, if eligible;
- Palliative Care/Hospice Care.