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T TRANSITIONAL C ARE C OORDINATION : P PROVIDING SUPPORTIVE LINK BETWEENJAIL AND COMMUNITYHIVNovember 6, 2017CAREPresenter Disclosures Jane Fox, MPH Kathryn Barker, MPH Cheryl Bette ridge, BSW Claire
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To fill out transitional care, follow these steps:
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Gather all necessary documents and information, including medical records, insurance information, and contact details of healthcare providers.
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Start by toppling out the patient's personal information, such as name, address, date of birth, and social security number.
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Specify the reason for transitional care, including the medical condition or treatment that necessitates it.
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Provide a detailed medical history, including any previous diagnoses, surgeries, medications, and allergies.
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Fill out the contact information of the patient's primary healthcare provider and any other relevant specialists involved in their care.
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If applicable, provide information about the patient's insurance coverage, including policy number and contact details.
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Make sure to accurately document the current medications the patient is taking, including dosage and frequency.
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Include any additional information or special instructions that may be relevant for the transitional care.
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Review the filled-out form for accuracy and completeness before submitting it.
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Submit the completed transitional care form to the appropriate healthcare provider or organization.

Who needs t ransitional c are?

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Transitional care is typically needed by individuals who:
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- Have recently been discharged from a hospital and require ongoing medical attention or support.
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- Are transitioning between different healthcare settings, such as from a hospital to a nursing home or from a nursing home to home care.
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- Have complex or chronic medical conditions that require close monitoring and coordination of care.
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- Are at a high risk for readmission to the hospital due to their medical condition or other factors.
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- Are in the process of being transferred to a different healthcare provider or facility.
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- Require assistance with medication management, therapy, or rehabilitation after a procedure or treatment.
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Transitional care is a type of care that is provided to individuals who are moving between different healthcare settings or levels of care.
Healthcare providers and facilities, such as hospitals and skilled nursing facilities, are required to file transitional care.
Transitional care can be filled out by documenting the patient's medical history, current health status, care plans, and any necessary follow-up appointments or treatments.
The purpose of transitional care is to ensure a smooth and safe transition for patients between different healthcare settings or levels of care.
Information that must be reported on transitional care includes patient demographics, medical history, current health status, care plans, and follow-up care instructions.
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