Nurse helping patient transition home
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NaviCare Services

Transitional Care Management

The period after a hospital discharge is critical. NaviCare ensures every patient has the support, follow-up, and resources needed to recover safely at home and avoid readmission.

Our Process

How NaviCare Manages Your Transition

01

Pre-Discharge Planning

NaviCare coordinates with hospital staff before you leave to ensure a safe, well-prepared transition home.

02

Medication Reconciliation

We review and reconcile all medications to prevent dangerous interactions or missed doses after discharge.

03

Follow-Up Scheduling

Appointments with your primary care physician and specialists are scheduled and confirmed before you leave the facility.

04

Home Visit & Check-Ins

A care coordinator visits or calls within 48–72 hours of discharge to assess your recovery and address any concerns.

Why It Matters

Preventing Readmissions, Protecting Recovery

Hospital readmissions are costly, stressful, and often preventable. NaviCare's transitional care program closes the gap between discharge and full recovery — keeping patients safe and on track.

  • Reduced 30-day readmission rates
  • Faster, safer recovery at home
  • Clear medication instructions
  • Timely specialist follow-ups
  • Peace of mind for families

"The transition from hospital to home is one of the most vulnerable moments in a patient's care journey. NaviCare is there every step of the way."

Refer a patient

Ready to Plan a Safe Transition?

Contact NaviCare to get transitional care support in place before or after discharge.

Call (702) 447-0770