Check out time is 12 noon on day of discharge.
Preparing for Discharge
Your doctor, nurse and other members of your healthcare team will work with you to plan the care you will need when you are discharged. Your doctor will decide when you are ready to leave the hospital. If services such as nursing or therapy, or equipment such as beds or oxygen are needed at home, Munroe case managers or social workers can assist you.
Discharge Planning for Those Unable to Return Home
With the many changes in healthcare, hospital stays are shorter for most patients, with the average stay lasting 4-5 days. While you may continue to need care, it may not be necessary for you to remain in the hospital to receive this care. There are options available that continue to provide care for patients in less intensive and less costly settings. The social workers and nurses in Munroe's Case Management department can assist you in navigating the maze of continued care. Case managers work closely with you, physicians, therapists and nurses to determine what may be needed when you are ready to leave Munroe and can assist you in completing the arrangements for needed care.
Medicare and other insurances have specific criteria that must be met for patients to be eligible for certain benefits and services.
Here is a list of useful resources to help with planning.
Skilled Nursing and Rehabilitation Centers
Patients admitted to Munroe Regional may need more rehabilitation or nursing care before returning home. There are several options for this care, the primary one being a skilled nursing and rehabilitation center. These facilities provide daily therapy and 24-hour nursing care, with the focus on your return home. There are currently nine facilities in Marion County . Families and patients are encouraged to visit the facilities and select at least three so the case manager can make referrals. Case managers will communicate with center representatives regarding your acceptance at that facility and bed availability. Important Note: During certain times of the year, a bed may not be available at your first preference, so it is important to make choices early and select facilities where you feel comfortable after visiting them.
Patients who require more intensive therapy (over four hours per day) may benefit from a rehabilitation hospital. There are no rehabilitation hospitals in Marion County , but they are available in the Gainesville , Leesburg and Orlando areas. These facilities may also be an option for patients whose insurance does not cover a skilled nursing facility.
Home Health Services
For patients able to return home, but still need some nursing and therapy, home healthcare is an option. Home health can provide visits for therapy, nursing evaluations and teaching. Therapists usually visit three times per week as a maximum. Nursing visits vary depending on the need. Home health aides are also available to assist with bathing and personal care. The aides do not assist with meals, shopping or housekeeping under insurance coverage. Medicare also requires that a patient be home bound, meaning that it is a difficult task for a patient to leave his or her home. For more information, visit Munroe's Home Health Services.
Patients that are somewhat independent and not home bound may benefit from outpatient therapy. Pulmonary and Cardiac Rehab, as well as Physical and Occupational Therapy are offered at Munroe Regional's LifeTime Centers . Speech therapy is available the Speech and Hearing Center . Other outpatient services patients may need are IV therapy and dressing changes. Home medical equipment can also be ordered for a patient's use in the home. Most insurances have specific criteria that must be met to qualify for this benefit. A physician's order is required.
Hospice care is a special service available for patients with a life-limiting illness. These services are available in the home, at a nursing facility or at the Hospice houses. Hospice provides a team approach with nurses, aides, social workers, chaplains and volunteers to assist the patient and family. Hospice also provides medical equipment in the home and can assist with some of the medications. The focus of Hospice is on pain control and supporting the patient and family during this time. Hospice will also follow up with the family for grief counseling if needed.
Long-term Care Facilities
Some patients do not meet criteria for rehabilitation, but do require 24-hour nursing care, requiring long-term care in a nursing facility. While Medicare does not cover this service, the case managers will assist you in determining whether you should apply for Medicaid coverage. The case managers will also assist in locating an available long-term care bed. If you do not meet Medicaid eligibility, private pay options are available.
Assisted Living Facilities
Patients in need of 24 hour supervision, but not 24 hours skilled nursing care, may benefit from living in an assisted living facility. These facilities offer many different services and vary from facility to facility. Patients may choose from a private apartment-type facility or home-like facility with a private or semi-private room. Assisted living facilities provide meals, laundry and personal assistance as needed. They can also help supervise medication, have social activities and outings and may offer transportation. Rent varies according to facility. Some facilities offer respite care and day care as well.
There are other services available for patients with ongoing needs. These services do not require a physician's order and are not covered under health insurance. Some patients are no longer able to manage the daily living activities, such as preparing meals, laundry and bathing. Patients who want to remain at home have the option of private assistance. There are several agencies that provide home assistance; their services are not usually covered under insurance and are an out-of-pocket expense. Senior Services is an agency that provides a variety of services for patients including Meals on Wheels, homemaker services, personal care, respite care, congregate meal sites, adult day care and transportation services. These services may be based on income and usually have a waiting list.
Transportation is an area where patients need assistance. Senior Services offers transport for physician appointments and have a set schedule for shopping trips in certain areas of Marion County . Riders usually need to be ambulatory or have their own wheelchair for transport. Senior Services requires at least three days notice and there is a nominal fee. Other private transports are available that can transport those requiring a wheelchair or stretcher. Fees are based on mileage.
Adult Day Care
Adult day care is an option for the family who want to care for their loved one at home, but still need to work. These programs vary according to need and are available to provide supervision and activities for the patient during the day. Some programs may focus specifically on Alzheimer's patients. These programs provide snacks and lunch, as well as supervise medication.
For a list of facilities, call the Case Management department at (352) 351-7208.
Medications to be Taken at Home
If you are given prescriptions for medications to be taken at home, you must have them filled at a pharmacy of your choice. Munroe's Pharmacy does not provide take-home medications.
Arrange early in your stay for someone to pick you up from Munroe.
Review any written instructions from your doctor or nurse and be sure to ask any questions you may have about medications, activities and diet after discharge.
If your doctor has given you a prescription for medications to take at home, be sure you know what the medications are and what they are for. Arrange for someone to take the prescription to the pharmacy of your choice and to get the medication.
Make sure you know when you are to return to see your doctor and how to make arrangements for any treatments you may need (i.e. rehabilitation therapy).
Collect all of your personal belongings and double-check closets and drawers. If you have times stored in the hospital safe, they can be obtained 24 hours a day by contacting Security.
When you are ready to leave, a volunteer will escort you to the front entrance and help you into your car. For after hours escort or when Munroe Regional shuttles are not running, call Security for an escort to your vehicle.