Healthcare Coordination Services

Level of Care Transition Support

We provide guidance through changes in care, whether transitioning between settings or adjusting support at home. From assessing needs and coordinating with providers to preparing the home environment and educating caregivers, we help ensure that each transition is safe, seamless, and aligned with the individual’s health and quality of life goals.

Our services include education, assistance, and support for transitions across levels of care, including assisted living facilities, home health services, skilled nursing facilities, acute rehabilitation centers, and long-term care communities.

We are available to consult and assist with identifying appropriate facilities when a discharge is being planned. This may include subacute rehabilitation facilities, acute rehabilitation facilities, long-term care, skilled nursing facilities, and more.

Often, hospital Nurse Case Managers or Social Workers provide patients and families with a list of facilities based on insurance coverage and geographic location. This process can feel overwhelming when decisions must be made quickly. We provide clear guidance, education, and support to help clients and families make informed and confident choices.