Transitional Care Management Program

Transitional Care Management Program

Our Program Can Help You

At no cost to you, CareVio is an innovative care management organization that will work with you and your healthcare team to make it easier for you to take care of yourself and stay well.

About Us

Our team includes Medical Directors, Registered Nurses, Pharmacists and Social Workers. We provide case management services to help you after an emergency room visit or an inpatient stay at a hospital, skilled nursing or inpatient rehab facility. Our goal is to ensure a smooth transition for you, whether it be back home or to another setting, so that you are well prepared to manage your health.

We Provide:

  • Assistance to your hospital team in your discharge process.
  • Support for a safe transition at discharge.
  • Education to help you understand your current health problems.
  • Help with creating goals and an action plan that is right for you.
  • Collaboration with your primary care doctor and/or specialist in your treatment plan.
  • Tools to help you better understand your medicine.
  • Connections to resources to help with things like housing, finances, food, and transportation. Referrals for social work, pharmacy, and/or other case management programs as needed.

This Program Supports You:

  • If you use CareVio.
  • If you go to the Emergency Department often.
  • If you are in the hospital for more than 5 days.
  • If recommended by your doctor or CareVio team.
  • If you were recently discharged from any of the following:
    • Hospital
    • Skilled Nursing Facility
    • Inpatient Rehabilitation Facility
    • Women’s Health (Pregnant Patient Only)

Download this information in PDF format: English | EspaƱol

For more information, call 302-320-5600 or email carevioreferrals@carevio.org.