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TAYLOR FRITZ's Discharge Plan
Please provide all transitional service and equipment details below.
When will the patient be leaving?
What is the patient's discharge disposition?
Home (No services)
Home Health
SNF
IRF
LTACH
Other
Will they require Durable Medical Equipment (DME)?
RW
WC
Shower Chair
Cane
Additional DME Items
Please provide additional Skilled Nursing transfer details.
Respiratory/Trach Care
Dialysis
Wound Care
Contact Precautions
Other Special Instructions
Is this patient a BPCI-A or ACO/MSO patient?
Anticipated 3-Day Waiver
Anticipated SNF LOS:
Would the patient like us to additionally coordinate with a caregiver or family member?
Yes
No
Please provide any additional urgency details.
Submit
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