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Anticipated Discharge Date:
Confirmed
Primary Contact and Address:
Ok to Text
Urgent Request
Discharging With:
Alone
Spouse
Family
Caregiver
Discharging Destination:
Home
Home Health
SNF
IRF
LTAC
Skilled Nursing Facility
Anticipated 3-Days Waiver
Anticipated SNF LOS:
Home Health (Patient Choice Form completed)
Skilled Nursing
PT
OT
HHA/CNA
MSW
DME
RW
3:1
WC
Oxygen
Cane
Private Duty Consult
SDOH Consult
Transportation (PCS Form not completed)
Ambulatory
Wheelchair
Stretcher
Ambulance
Hospice
PCP Appointment
Monday
Tuesday
Wednesday
Thursday
Friday
Morning
Midday
Afternoon
Confirmed
Last Updated Today
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