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Transition

Transitioning patients to a higher level of care where appropriate

Transition

works closely with Elara Caring’s clinical team to assess patients for decline, and identifies patients that could benefit from and be eligible for hospice to ensure an easy transition.

Enabled patients a longer length of stay consistent with the intention of Medicare

  • Clinical team identifies Skilled Home Health patients who need end of life care through risk stratification technology and collaboration with our home health clinicians. Patient must meet clinical floors and Hospice eligibility criteria to transition to Hospice.
  • All patients require Skilled Home Health consent to speak with patient.
  • Transitional Liaisons first start where the patient is to discuss disease progression and ultimately the patient’s goals of care.

Savannah, RN

The Role of a Transitional Liaison

Nick, RN

The Role of a Transitional Liaison

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