Our Case Management Department provides both Case Management and Clinical Social Work services.
Case Managers help the patient and family navigate the healthcare system. They act as the liaison for the interdisciplinary team and the patient and their family, and work to connect them with necessary services and resources. The goal is to return the patient to the highest level of well-being by guiding the patient and family through their hospitalization and the care continuum.
Case Managers are responsible for facilitating and coordinating the care of the patient and family during the hospital stay. They assure that mutual goals and outcomes are established between the interdisciplinary team and the patient and family and assist in preparation and planning for discharge. Since discharge can sometimes be a very involved process, the planning for discharge begins early during the admission phase, driven by the goals developed by the patient, family and the entire interdisciplinary team.
While the ultimate goal is to return home, some patients leave our hospital to continue care and therapy in another facility (sometimes called a sub-acute or skilled nursing facility) and the Case Manager coordinates this process. In addition, the Case Manager is the liaison with the insurance companies regarding financial coverage for the hospital stay and for post-hospital care.
Clinical Social Workers are responsible for addressing the social, emotional, and interpersonal needs of patients and their families through both individual support and family support groups. They focus on adjustment to the changes that illness, and often new disabilities, have introduced to the lives of families. The Clinical Social Worker helps plan for long-term management of health care needs, including referrals to resources in the community to promote the highest level of independence. Our Clinical Social Workers also provide consultation and support to members of the interdisciplinary staff.