Professional referral coordination for Chicagoland familiesReferral line: (773) 261-8359

Hospital Discharge & Care Transition Referrals

Help families put practical non-medical support in place around the return home.

When we may fit

Non-medical support that helps the daily plan work.

  • Personal care, dressing, grooming, and toileting assistance
  • Meal preparation, light housekeeping, errands, and prescription pickup
  • Mobility support and supervision within the established care plan
  • Appointment transportation and accompaniment
  • Overnight, live-in, or 24-hour coverage when available

Information that helps us respond

  • Expected discharge date and home address
  • Family decision-maker and best contact number
  • Requested start date, days, and hours
  • General assistance required with daily activities
  • Mobility equipment and transfer considerations
  • Whether licensed home health, therapy, or hospice is also involved
Scope boundary

Clinical discharge instructions, medications, warning signs, skilled procedures, and follow-up care remain the responsibility of the treating team and appropriate licensed providers.

What happens next

Review

We evaluate the location, timing, schedule, and non-medical requirements.

Consult

We speak with the family or authorized contact to clarify priorities.

Plan

We outline services, expectations, and caregiver instructions.

Coordinate

If coverage is available, we confirm the caregiver match and start plan.

CallMake referral