Care Management

Our Social Work and Case Management staff will work with you and your family to establish an individualized discharge plan. Most patients are discharged from MidState Medical Center to return home, without need for any additional services.

The Social Work and Case Management staff consists of social workers and nurse case managers who are knowledgeable on available resources and services to assist patients in transitioning from hospital-level care.

There are several levels of care after hospitalization: home health care services, outpatient rehabilitation services (physical therapy, occupational therapy, and speech therapy), short-term rehabilitation, sub-acute care and skilled nursing facility.

Based on the level of care you may need, either a social worker or a nurse case manager may be the primary person coordinating your discharge plan.

Planning for any needed after-care or services should begin early in your hospital stay to assure that you have a safe and appropriate discharge plan. Also, discharge plans need to be coordinated with your health insurance, as some services may not be covered.

Social workers and nurse case managers are available 7 days a week to answer questions, consult with family members, offer counseling and make community referrals as needed.

For more information on our services, call 203 694 8244.

• Nurse Case Manager

A nurse case manager assists with discharge planning for patients returning home who need in-home medical services (such as home health care), outpatient rehabilitation services (physical therapy, occupational therapy, speech therapy), or medical equipment.

Selection of specific home health care agencies and medical equipment suppliers may be limited to those approved by your insurance plan.

The nurse case manager is also responsible for a utilization review function, whereby inpatient stays are reviewed to ensure that they are medically appropriate and do not last longer than medically necessary. Your insurance plan will not pay for days spent in the hospital that are not deemed medically necessary.

• Social Work Services

The social work department at MidState Medical Center is available to assist in discharge planning for patients who are not ready to go home. This may include, but is not limited to, transfer to a skilled nursing facility for inpatient rehabilitation, long- term care, inpatient hospice care, and inpatient psychiatric care. The selection of a skilled nursing facility, long-term care, and psychiatric placement may be limited to those facilities as specified by your insurance.

The social work department is also available for counseling and referral services that are identified during your hospital stay. Referrals can be made in a variety of ways and do not need a referral from your physician. These may include but are not limited to:

• Adoption
• Adjustment to Illness
• Advances Directives
• Behavioral Health Issues
• Bereavement / Grief Counseling
• Child Abuse
• Crisis Intervention
• Discharge Planning
• Domestic Abuse
• Financial / Insurance Issues
• Pregnancy
• Substance Abuse
• Pastoral Care Services

Through our Pastoral Care program, sensitive and compassionate care is provided to patients and families of diverse spiritual and cultural backgrounds. We recognize that each person is unique and comprised of body, mind and spirit.

Our chaplain, a valued member of the health care team, works closely with local clergy to ensure that patients and family members receive spiritual/pastoral care that contributes to their health and healing.
There is a chaplain in the hospital Monday through Friday, 8 a.m. to 4:30 p.m., to respond to the pastoral/spiritual needs of patients and families. An on-call chaplain is available upon request in the evening, on holidays and during the weekend.

The Napier Chapel is located on the first floor of the main building and is open 24 hours a day. It is quiet space for prayer, meditation and reflection appropriate for persons of all faith traditions. There are written materials on display, which may be taken for use in the hospital or at home.

The Pastoral Care office can be reached by calling 203 694 8369. The chaplain is available by beeper at 860 279 2680.

The on-call chaplain can be reached by contacting the hospital switchboard, at 203 694 8200.