Most stays in Transitional Care are a few days to a few weeks, however, some patients may stay for up to 100 days if they have daily qualifying skilled care needs. The majority of patients in our program improve their health and rehabilitation status during their stay, and the majority of program patients who lived at home prior to their hospitalization are discharged back home after Transitional Care.

PHYSICIANS

Physicians care for each patient and are available 24 hours a day. These physicians may also request consultations with other specialists during your stay.

NURSES

Qualified nurses provide daily, individualized care to each patient. A Registered Nurse case manager also coordinates with the referring healthcare facility to ensure that you have a smooth transition into the program. In addition, your case manager works with your insurance company to determine eligibility and coverage for benefits.

ACTIVITIES DIRECTOR

Our Activity Director completes a comprehensive evaluation of our patient’s activity preferences, including religious activities, when they transition into swing bed. The clinical team assists in creating therapeutic activities that will keep patients physically and mentally active. Our goal is helping you return to your normal activities in preparation for your return home.

DIETICIAN

Our licensed dietician can complete a dietary evaluation to determine your nutritional needs, track your progress make dietary recommendations, and provide nutritional education. Our chef knows that meals are an important part of the rehabilitation process. That is why our patients get homemade food items, hot from the oven or grille, served with a variety of fresh fruits and vegetables.

PHARMACISTS

Our clinically trained pharmacists are available 24/7 to advise physicians on the dosages, interactions, and side effects of medications. They can also answer patient questions about prescription drugs.

Transitional Care is predominantly covered by the Medicare “Swing Bed” benefit. Some other insurance providers may cover this care as well. If you are having a planned hospitalization and think you might need care after your stay, we can check if Transitional Care would be covered so you can plan ahead of time to come to our programs.

Our program is called Transitional Care because it is a model focused on helping patients transition from a hospital stay to their highest level of independence at home or in another setting. We use hospital-level resources, team processes, best practices, and extra clinical education to support this “transition”. Since most patients receive this care under Medicare, this level of care is sometimes also referred to as “Swing Bed.”

Because we are a hospital, we can deliver Transitional Care with high levels of safety, quality, and flexibility with hospital-based resources including on-site lab, radiology, and immediate access to physicians and other caregivers. Our hospital-based Transitional Care program provides up to 2 – 3 times more available nurse hours per patient day compared to most skilled nursing facilities. We hold Bedside Rounds with patient, family, and care team together on a scheduled basis, so everyone understands your plan of care, identifies things that need to be addressed, and plans for a safe discharge.

Helping you get back to your active life.

Yes! You and/or your family or caregiver can request for you to be sent to Weiser Memorial Hospital for Transitional Care.