Our social worker meets with patients after admission to Barnert Subacute Rehabilitation Center to gain an understanding of the patient’s needs, concerns, and personal goals for return to their lifestyle and the community. During the patient’s stay, our social worker will address any issues and provide guidance and counseling to patients and family members. Discharge planning is also a focus for the social worker and the patient.
Discharge planning is the process of preparing for discharge and return to the community. The purpose of discharge planning is to transition from the sub acute facility to the community and to help maintain the benefits of rehabilitation after discharge. Discharge planning begins early in the rehabilitation stay and involves you, your family, and our interdisciplinary rehabilitation team. Discharge from our facility occurs soon after your goals for rehabilitation and recovery have been reached. As necessary, our social worker will also assist you in referrals for community services.
Planning can include:
Discussing with the patient and/or family appropriate arrangements for returning to the community
Communicating with our rehabilitation team to decide what care, assistance, or special equipment you may need
Arranging for continuing rehabilitation services or other services in your home
Determining what caregivers will provide daily care, supervision and assistance in the home as needed
Determining what community resources may be helpful now or in the future
