Transitional Care
30-Day Safe Transition Home Program
SAFER TRANSITIONS. STRONGER OUTCOMES
At EPIC Clinical Partners, our Transitional Care program helps bridge the gap between discharge and home. We provide timely follow-up, clinical oversight, and personalized support to help patients recover safely, avoid complications, and stay on track after leaving the hospital or skilled nursing facility.
Our goal is to make the transition home smoother, safer, and less stressful for both patients and families.
DID YOU KNOW?
Did you know 1 in 7 patients is readmitted to the hospital within 30 days of discharge? Limited outpatient follow-up is one of the leading reasons this happens.
Our Transitional Care services are designed to reduce that risk by providing close follow-up, medication support, care coordination, and access to a medical provider when it matters most.
Services we provide
Our 30-Day Safe Transition Home Program includes:
Initial Assessment
Within 24-48 hours of your discharge, our team reaches out to review your hospital stay, confirm your current health status, and ensure you have everything needed for your first days home.
Safety Visit
A medical provider visits you in-person within 7 days. We reconcile your medications, coordinate follow-up appointments, and address any immediate recovery concerns in the comfort of your home.
Continuous Oversight
Throughout the 30-day program, we manage diagnostic tests and treatments. You have 24/7 access to medical providers, giving you and your family peace of mind as healing progresses.
Graduation
As you stabilize, we ensure a seamless handoff back to your primary care physician. We provide a final review of your recovery progress, ensuring you are confident and safe for the long term.