The Case Management department is comprised of a director, registered nurses, social workers and an administrative assistant. The department has four primary functions of assessment, planning, facilitation and advocacy as set forth by the standards of practice for Case Managers.
Through the use of an evidence-based criteria set, each patient is reviewed on admission to determine whether they meet the appropriate severity of illness & intensity of service for acute hospital level of care or are in an observation status. Families can request the assistance of Case Management at any time.
Patients are screened on admission and based on a variety of high risk criteria are determined to be appropriate for case management services. Based on the nursing admission assessment patients may also be referred for case management/social worker intervention. If appropriate a case manager (RN or SW) will be assigned to work together with the patient, family and the multidisciplinary team to facilitate the patient’s next transition as well as needed services & equipment.
Each patient that is determined to need home services, durable medical equipment or a skilled nursing facility/short term rehab services will be given a listing of all skilled nursing facilities and home care/DME companies within a 25 mile radius from which to choose. It is always the patient's choice as to where they choose to go or company they choose to use, based on availability. Our team is there to help bridge the transition from hospital to home.
If you have questions regarding case management services prior to your hospitalization or during your hospital stay, please contact Case Management at (978) 630-6383.