Continuum of Care

About Continuum of Care

The post-acute continuum of care — which includes inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities, and home health agencies — is vital to the health care delivery system. Post-acute care providers offer essential medical and rehabilitative care to individuals following a stay at a general acute care hospital and contribute to improved outcomes while reducing health care costs.  

To assist in the transition, hospital case managers serve as advocates to identify, support, and guide care for patients, families, and caregivers. Successful case management includes communication and coordination with post-acute care providers and home and community-based services. It also includes the development of a discharge or transition plan that addresses the patient’s goals, needs and treatment preferences, and prepares patients and caregivers for post-discharge care. 

Ribbon-cutting Ceremony Held for New Rehabilitation Hospital

Who What A ribbon-cutting ceremony for the new UC Davis Health Rehabilitation Hospital took place on April 18. This facility is a joint venture between UC Davis Health and Lifepoint Health (formerly Kindred). It has 52 beds, including a locked unit for people with traumatic brain injuries, a transitional “apartment,” and an outdoor garden with varied […]

Addressing Challenging Discharges in Santa Clara County

Who What Several of the hospitals in Santa Clara County have expressed concern about discharge challenges and have asked Hospital Council to bring together hospitals, health plans, and county services to discuss possible solutions. As our population gets older, there is a lack of skilled-nursing beds to serve the aging population in the county. In […]

Retired Firefighter Thankful for Recovery

Following a life-threatening injury, Tim Scott is determined to make the best of his situation, fueled by the support of his loved ones and the guidance of his physical and occupational therapists at Enloe Medical Center.