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Case Management at St. John’s Health

Inpatient social services and case management

At St. John’s Health, we want to make sure that both our patients and their families have resources that can meet any of their needs. The case management department at is a team of licensed professional counselors, registered nurses (RNs), and social workers who provide support to patients and loved ones.

The goal of case management is to communicate with, listen to, and support patients, so that they:

  • Receive coordinated care
  • Stay healthy and avoid readmission
  • Experience lower health care costs

Arranging for additional services in the home

  • Senior Center services such as Meals on Wheels, caregivers, and durable medical equipment
  • Home health or hospice services
  • Home IV therapy (such as antibiotics)
  • Private caregivers

Facilitating patient treatment services

  • Addiction/mental illness treatment center placement
  • Geriatric/dementia facility placement
  • Juvenile psychiatric services

Emergency services

  • Home health services for those who do not require admission
  • Case management for frequent emergency department users
  • Outpatient test coordination (stress tests, pulmonary function tests, radiology studies, etc.)

Additional services

  • Anticipate patient needs upon discharge
  • Provide grief support
  • Make follow-up calls after hospitalization
  • Coordinate care and perform required assessments for Swing Bed Program patients
  • Arrange specialty physician appointments and testing
  • Act as a liaison for patients and caregivers to help them understand their diagnosis and treatments
  • Assist patients in implementing any prescribed treatment plans after they arrive home
  • Provide family/caregiver education

Helping You Figure out What You Need

Too often patients do not receive counseling or emotional support because they cannot see past the problem to find a solution. We do not want the burden of figuring out what you need to be put solely on you. By speaking with a patient or their family, a member of the case management team can help you explore options for support. Often talking through a situation and learning more about available resources can be a tremendous help, and we want to make sure you know about all of your options.