Continuity of Care Form

The continuity of care form is a health information and safe transition form that must be used when a patient/resident is transferred from one health environment to another, e.g. hospital to nursing home or to home nursing care, nursing home to hospital.

The first two pages of the form may be used alone as a hospital discharge form and meet all the discharge requirements of the hospital JCAHO accreditation.  It is permissible for hospitals to print their own name at the top of page one, but please leave the notation that it is the HEALTH form.

This is the official HEALTH form and includes all the requirements for all of our various regulations.  Providers are required to seek approval for any modifications or changes in the format or usage of the form.


UPDATE:
The Department in conjunction with Quality Partners of Rhode Island is working on a review of the continuity of care form’s current usage.  An educational event is planned for December 2009 and information regarding this event is forth coming.  In advance of that educational session, Quality Partners developed a Needs Assessment to solicit feedback on the form and it’s current use.
The Department is asking each provider to assign a staff member to complete the needs assessment by October 16, 2009.  We thank you for your assistance and participation
Continuity of Care Form - Needs Assessment