Trained Service Professionals
Coordinating Placement: Our commitment is to make an easy, smooth transition from a patient’s referral source. Our Case Manager will keep in close communication with all parties to ensure the patient is settled comfortably in their new environment.
Service Planning: Each patient under Oahu Case Management will receive his or her own individualized service plan. Service plans will be created after a thorough initial assessment of the patient’s needs. Family members, physicians and other healthcare providers will be asked to review the service plan in order to ensure the patient is able to thrive in their new environment.
Monthly Visits: A Case Manager will complete follow up assessment visits with the patient each month.
Post Hospital Visit: The Case Manager will follow up with the patient face-to-face after being discharged from the hospital.
Referrals: A Case Manager will help assist with a referral for other disciplines or services, such as Home Health, Hospice, Palliative Care, Physical Therapy, Occupational Therapy, Speech Therapy and a Dietician, if the patient is appropriate.
Training and Education to Caregivers:
Assistance with Physician Orders for Life-Sustaining Treatment (POLST) Forms