Assignment task: Comprehensive Discharge Plan for a 65 y/o man who is dying from congestive heart failure
Be certain to address the following components
1. Disposition Site: Describe where the patient will receive post-hospital services. Rehab unit? Long-term care? Hospice home services? with a clear rationale.
2. Care Reimbursement: Identify how care will be paid for. How to connect patient/ family to reimbursers?
3. Resources: Describe what resources are needed to safely manage the patient's care post-discharge. Where will they be obtained? Who will pay?
4. Personnel and Services: Discuss all personnel and services who will be involved in the plan and their roles as well as their time-frames of involvement. Explain clearly how each member of the team will document the plan of care.
5. 24-hour Schedule needs/ services: Create a one day 24/7 hourly plan including all services, treatments, caregivers