The transitional care network offers a supportive environment for people who no longer require all the resources of a hospital, but who are still unable to return home.

Most people come to a participating Network location  from an acute care unit of a hospital or for continued, less intensive care after surgery. This healing environment helps ease the transition back to home or to an alternative care setting, while encouraging each person to be as active and independent as possible.

Our doctors and nurse practitioners work with you, your family and the rehabilitation staff to develop an individualized care plan. You will receive all of your primary health care services from this team. They will be your team: a team that knows you, your medical history and health concerns.

When you get to the transitional care unit your doctor and nurse practitioner will work with you to agree on goals you need to meet. How long you stay depends on how long it takes you to meet these goals.

Once you are ready to leave transitional care, the doctor and nurse practitioner will communicate with your primary doctor so that he or she is aware of what went on during your stay, including an update on any medication changes. If any additional services are needed, the transitional care unit social worker will arrange for them.

With our program, you can rest assured you are receiving the best care possible as you move from the hospital to one of our transitional care units and then home or to an alternative care setting.

If you have questions please review our commonly asked questions or contact us directly.