Community Home Health Care

73-A Troy Road, East Greenbush, NY 12061
 
        DISCHARGE SUMMARY

Physician: Phone:
 
 
Client/Family aware of DC in their preferred method of communication: Yes   N/A

DC planning note in HHAE: Yes  


  
 
 
   
Client Diagnosis:
  
Dear:   

Thank you, for your confidence in our agency. The following is a summary of information regarding your client. We look forward to serving your clients in the future.
  • No further care necessary
  • Hospitalized
  • Moved out of area
  • Admitted to nursing home
  • Expired
  • Physicians order
  • Denied by payment source
  • Transferred
  • Change of payor
  • Client/ Family refused care
  • Client/family request
  • Request of MLTC
  • Other 



  • Optimum function achieved
  • Optimum function partially achieved
  • Progress plateaued
  • Condition deteriorated
  • Expired
  • Other 
   Yes  No  NA  Comment

   Yes  No  Comment

Recommendations and referral for follow up care, if needed Comment 
Education provided as needed Comment 
Managed by MLTC 
Physician follow up  None needed
Other   
 
R.N. SIGNATURE :
 

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