Houlton Regional Hospital’s Social Service and Case Management department includes Licensed Social Workers and Registered nurses. Both of these disciplines work collaboratively with each other and the multidisciplinary team. The underlying premise is based on the fact that when a patient reaches the optimum level of wellness and functional capability, everyone benefits.
The Licensed Social Worker is involved with the process of discharge planning as well as coordinating after-care services such as home care and necessary medical equipment. They also assist a patient and family with choosing a facility to receive rehabilitation or a nursing home placement. Social Services will also assist in the transfer of patients to our Swing Bed program.
The Registered Nurse Case Manager’s role is to provide disease specific education geared to each patient’s different level of understanding, including a coordination of services for post discharge follow-up care. The Case Manager connects with the patient telephonically post discharge to minimize gaps in care along with conducting medication reviews and monitoring medication usage.
The Department offers free services such as assistance in completing Advance Directives, Notary services for healthcare related issues, Insight on the long term care Maine Care application process and a current private duty list for companion care or housekeeping chores. The department is open Monday –Friday from 7am-3:30pm.After hour appointments are offered on request. You can call 207-521-2368.