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Post-Discharge Follow-up


starts after discharge from Skilled Home Health to provide personal follow-up. This program helps patients get the care they need in a timely fashion.

Averaging over 200 patient engagements per day with patients previously on service with Skilled Home Health.

  • Program begins two weeks after patient is discharged from Skilled Home Health services.
  • Follow-up occurs monthly for four months postdischarge – 30, 60, 90 and 120 days.
  • When a potential need is identified, a clinician verifies the skilled need and begin the admission process.
  • Orders are requested from physicians and other referring facilities to ensure the appropriate level of care is received.

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