To receive services, a patient will: Have a life-limiting disease e.g., cancer, COPD, CHF, etc. For general inquiries, contact us at310-2222 (no area code required). The Cancer Centre is part of theSouth East Regional Cancer Program, which is a network of service providers that offer cancer services for residents of Hastings, Prince Edward, Lennox and Addington, Frontenac, Leeds and Grenville counties, Kingston, Belleville, Brockville, Smiths Falls, Prescott, and parts of Lanark and Northumberlandcounties. He completes the form and clicks Submit to send the referral request details the Service Providers Referral Management System (i.e. PDF Lehigh County Residential/Mprs Referral Form The RMS Target notifies the RMS Source of the acceptance. Kingston, Ontario K7K 5W7, Patients with mTBI Needed for Research Studies, Tips for Providing Services to Someone with an ABI, Concussion Guides for Clinicians and Primary Care Providers, Southeastern Ontario ABI Resource Directory, ABI, Addiction/Mental Health Collaboratives, Consent and Capacity Board and Consent, Capacity and Substitute Decision Making. Mariensule at Marienplatz Aerial view of the old town Lion sculptures by Wilhelm von Rmann at the Feldherrnhalle Alps behind the skyline. He discusses this possibility with Jane on her subsequent scheduled visit and Jane agrees to consider this possibility. The form should clearly indicate "Community Stroke Rehab Program" and include suggested therapy plan with focus of intervention. 014-4768-69e-lhin. PDF South East Lhin Home & Community Care Community Stroke Rehab Program For HNHB Hospital and Primary Care Partners. South East LHIN Health Link Referral Referred by: Referral Source and Date: (please print) _________________________________________________ Phone Number: _________________________________Fax: ____________________________ Individual Information: Name of Individual: ___________________________________ Phone #: __________________ PDF South East Lhin Home & Community Care Community Stroke Rehab Program Munich - Wikipedia This email is not for patient feedback or referrals. Part one of the form is based on the service details in the Services Catalogue, and some of the data in the form has been automatically filled-in from the integrated EMR. Tel: (613) 966-3530 LaSalle Mews, Suite 401 They can be found in: Hospitals Community Clinics Some Doctor's Offices LHIN offices HOW DO I CONTACT THE LHIN? Offloading Pathway- Primary Care. Form Number. Referral Forms; ABI Links; Brain Injury Publications; Caregiver Resources. your call or complete a referral form and fax to South East LHIN Home and Community Care Phone: 1-888-547-7744 Fax: 613-544-1494 PPSMC Referral Form There is no charge for this serviceThis service does not include responding to inquiries or education activities for Consultation Program Central East Community Care Access Centre Referral Form Health Assessment - Local Health Integration Network (LHIN) For all media-related enquiries, please contactHCCSSmedia@hccontario.ca. Tel: (613) 283-8012 South East Medical Assistance in Dying Assessment Record, South East Medical Assistance in Dying Prescription/Order Form, South East Medical Assistance in Dying Procedural Record, South East Mental Health and Addiction Nursing referral form. Bavarian language - Wikipedia Hospital teams need to complete the South East LHIN Referral Form a minimum of 24-48 hours prior to discharge. Rouge Valley General Neurology Referral Form 2017; Rouge Valley Shoniker Clinic Child and Adolescent Mental Health Referral Form 2017; AIM Centre for pain management 2017; Grandview Children's Centre Referral form; Humber River Regional Hospital MRI Requisition 2017; Rouge Valley Outpatient Mental Health Referral 2017 24 Huron St East, South Huron Hospital, Exeter (Huron) 1100 Dearness Drive, Unit 15, London (London Middlesex) 695 Canterbury St., Unit 5, Woodstock (Oxford & Norfolk) Referral Date: (dd/mmm/yyyy) FAX: (855) 519-6611 Tel: 1 888 310-8881 ext 5430 Consultation Options - select one or referral will be processed as "next available" Next available appointment in (City): Preferred Site Bluewater Health Chatham-Kent Health Alliance Windsor Regional Hospital All information must be complete Alt Tel: Weight (kg): Copyright2023Home and Community Care Support Services. Dr. Jones continues to fill out the form by identifying the primary diagnosis, the reason for referral, any allergies Jane may have. South West LHIN referral form that highlights need for offloading device. The South East LHIN's HPCNP Program is a dedicated team of Nurse Practitioners providing direct clinical care to patients with complex palliative care needs including pain and symptom management. Dr. Jones is notified in his EMR (out of scope for this workflow) that Jane condition has changed and she is now admitted to an in-patient unit at the local hospital. Home and Community Care services remain in place and continue in the Ajax area as before, however in order to access the nearest supports available in Ajax and surrounding area, please call 310-2222 (no area code required), to be connected to an office closest to your calling location. The RMS Target prompts April to select service plan items to be included as a service summary in the completion message. Upon submitting the initial referral Dr. Jones determines Jane should also be assessed for Long Term placement by the SE LHIN. Tel: (613)544-8200, 470 Dundas St. E., Bay View Mall, Belleville ON, K8N 1G1 Local Health Integration Networks (operating as Home and Community Care The NP completes and submits the first part of an appropriate form, provided by the NPs RMS for the selected service, to the Service Providers Referral Management System (RMS). The RMS Source System determines that Jane has signed up for email notifications and sends Jane an email to confirm that the referral has been requested. The Service Providers RMS immediately provides the second part of the form for the Patient and NP to complete. April then contacts Jane over the phone to find out a few more details about her home setting. Upon consultation, the Patient and PCP agree that the Patient would benefit from home care services. Upon consultation, the Patient and PCP agree that the Patient would benefit from in-home housekeeping services. We aim to respond within 72 hours, however, this email account is not checked on weekends or statutory holidays. Tap or escape to close. 279 Palliative Care Hospice - In-Patient Referral. [emailprotected], Acquired Brain Injury System Navigation of Southeastern Ontario, 303 Bagot Street What If Surgery or Additional Tests Are Required? 5081; Inquiries: 613-544-3400 ext. 613-544-4900 ext. . Medical Orders. Ontario eReferral HL7 FHIR Implementation Guide - Draft v0.10.0, Patient visits Primary Care Physician (PCP) as a follow-up from an ER encounter. Note that for LTC, PT is provided by the LTCH. Erie St. Clair. In consultation with the Patient the NP selects an appointment date, completes Part 2 of the form and submits it. Health Assessment - Local Health Integration Network (LHIN) Description. All of Southeastern Ontario. 119 Isabella St, Suite 4, Lindsay, ONK0L 1L0. Please direct all enquiries and completed forms directly to the appropriate Diagnostic Assessment Program. Dr. Jones suggests that she might benefit from some personal support services and maybe other home related services to help her cope with her condition. PDF South West LHIN Referral/Request for Assessment Perth counties, please RMS Source sends the cancellation message to the RMS Target and notifies Jane by email that her initial referral has been cancel due to her stay in the hospital. This also sends an email to patient, confirming the referral request. The Care Coordinator confirms the referral acceptance in RMS Target and the message along with any optional note is conveyed to the PCP by the RMS Source. Ontario LHIN Services | Plan Your Care | Durham Health Care Resources Toll Free: 1-800-668-0901, 555 California Ave., Unit #1, Bag Service 7000, Brockville, ON K6V 7K6 John could use some exercise, but really the NP wants to give him a reason to leave his home and socialize. You have the option to complete all orparts, electronically. Fax/forward completed medical orders with South East LHIN referral Form to 1-866- 839-7299. Upon reviewing the initial referral details, April determines more information is required because an Occupational Therapy (OT) report should be attached to the referral. South East Local Health Integration Network (LHIN) Summary . In this pattern however, the health service information and requested data noted in the Health Services Directory can be supplemented in real time with service-specific clinical decision support information and additional data requirements such as available appointment slots - to support the request and enhance the business process. RMS Target). South East Regional Palliative Care Network Work, Palliative Care Specialists, Consultants & Programs, Queens Palliative Medical Program Guide 2021. For non-media-related enquiries about Home and Community Care Support Services and to serve you best, please visit the Contact Us page to access additional contact information. Dr. Jones knows from previous experience that this referral will not get lost like a fax, and he can expect an update on the request via his email and within the patient record. South East LHIN confirms service plan with the patient/family, referral source and primary care provider. Should you have any questions or concerns, please contact the Manager of the WW Integrated Hospice Palliative Care Regional Program, Barbara Blocki, at 519-748-2222 ext. The RMS Source notifies Dr. Jones of the referral completion and sends an email notification to Jane to keep her informed of the referral outcomes. Please share your feedback with your care coordinator. The RMS Target notifies April, the Service Provider representative, of the incoming request who contacts Jane using her preferred method of communication and arranges the appropriate services. The NP searches for and selects an appropriate Exercise Program from a Services Catalogue, which is integrated with the EMR and with the NPs Referral Management System (RMS). You may also share compliments or concerns in the following ways: Mail: Home and Community Care Support Services South East Compliments and ConcernsAttn: Senior Manager, Quality470 Dundas St. East Bay View MallBelleville, ON K8N 1G1. He is presented with a referral form which is prepopulated with some of the patient information from his EMR. April receives the referral update in RMS Target and processes the referral to completion using the remaining steps in the basic flow. As such, the patterns in scope are derived from the following use cases and intended to provide generic guidance for various pathway implementations: Basic Referral Directly to a Service, in which a referral is sent directly to a specific health service described in a shared Health Services Directory. How Does the Referral Process Work? Open detailed region map. Diagnostic Assessment Program Referral Forms - Cancer Care Ontario Forms - wwpalliativecare.ca Afterwards she prints off what he needs to take home, and also knows that an email will be waiting for him when he gets home. Dr. Jones initiates a search for the service from his EMR, which is integrated with a Referral Management System (i.e. April receives the updated referral request including the new service in her RMS Target system and processes the modified referral request to completion using the remaining steps in the basic flow based. OBIA: Resources & Free Group; . Case managers and in-home services are provided by regulated health professionals who are members of their respective Colleges. You have the optionto . Transplant Centre LHIN Referral Catchment Area London Health Sciences Centre Erie St. Clair South West Waterloo Wellington PDF Palliative Pain and Symptom Management Consultation Program Central West Wait Times and Wait List Information. The RMS Target notifies April May, a South East LHIN Care Coordinator, of the incoming referral. Jane admits she is struggling with keeping up with laundry and other chores due to her injury and Dr. Jones believes she would benefit from some housekeeping services. The NP knows that if left up to him, he will not pursue this further, so she wants to send him home with a day, time and location for at least one class. He wants to quickly search housekeeping, pick a community service close to Jane and send a referral. 37165 Physiotherapy Services - Publicly Funded Clinics - South East. Toll Free: 1-800-267-6041, Michelle Pangilinan, Forms and Referrals | Home and Community Care Support Services PCP is notified in their RMS and EMR of the date of the first patient encounter when it is arranged by the Service Provider. When completed, please print and fax to South West LHIN counties, please return this form to the South West LHIN via fax # 519-472-4045 (London Office) Home Resource Directory South East Local Health Integration Network (LHIN), South East Local Health Integration Network (LHIN), Case management of publicly funded community support services including: long term care, home support, and rehab services, (physiotherapy, occupational therapy and social work). He has a Nurse Practitioner(NP) who is working very closely with him with both medical and social issues. Referral Form Please fax to (1)-613-542-8639 South East Ontario Vision Rehabilitation Service Referrals: 613-542-4975 ext. Government-funded physiotherapy that helps people recover from illness, surgery, or injury. ; Be aware of their palliative care diagnosis, with a life expectancy of 6-12 months; Be identified as having HPC needs currently or have the potential to need complex pain and symptom management in the future; Be receiving, or being referred for Home and Community Care Program services; and. Additional information Local Health Integration Networks Rapid Access Clinics for Low Back Pain Quorum: An Online Community QUALITY STANDARDS PDF INDWELLING PleaseCATHETER see community protocol on back of this page If the Service Provider is unable to provide the requested services, this is noted in Part 2 of the form, the NPs RMS, and in the integrated EMR, If the Patient cancels the service, this status is noted in the NPs RMS, and in the integrated EMR. In a follow-up appointment, Dr. Jones, her family doctor, notices her appearance is not as crisp as usual. Kingston, Ontario K7L2V7, Because of you, patients get the care they need, close tohome, Autologous Referral Form (Stem Cell TransplantProgram), Hereditary breast orovarian cancer referralform, Hereditary colorectal cancer referralform, South East Colorectal Diagnostic Assessment Program ReferralForm, South East Esophagogastric Diagnostic Assessment Program ReferralForm, South East Lung Diagnostic Assessment Program ReferralForm, Patient follow-up care afterBreastCancer, Patient follow-up care after ColorectalCancer, Immune Checkpoint Inhibitor Side EffectToolkit. Jane Doe is an independent senior who lives alone. Munich (/ m ju n k / MEW-nik; German: Mnchen [mnn] (); Bavarian: Minga [m()] ()) is the capital and most populous city of the Free State of Bavaria.With a population of 1,578,132 inhabitants as of 31 May 2022, it is the third . Patient Assessment and Management What Happens During an Assessment? Be supported by a Most Responsible Physician or Nurse Practitioner who agrees to a Shared Care Model including the provision of after hours, on call support. The Care Coordinator updates the referral status to Completed in the RMS Target and includes the ordered service details in the communication as a service summary, identifying that ACME will start delivering the requested services on a certain date. For all patients discharged from acute, a referral to the Rapid Response Nurse should be included. Champlain Wait Times and Wait List Information. Timing and placement of the Symptom Response Kit requires careful consideration with a goal of avoiding emergency room visit or hospital admission. The RMS Target also updates Dr Jones RMS Source, which in turn updates Dr.Jones EMR that Jane has had services set-up, and with their on-going status. Hospital teams need to complete the Southeast LHIN Referral Form a minimum of 24-48 hours prior to discharge. ; Please call us directly at the numbers listed above. The amount payable for this service is in addition to the assessment fee payable, where applicable. She is confident that the referral recipient will get all the information they need, pulled from her EMR, and together they find a location, date and time that will work for him. South East LHIN confirms service plan with the patient/family, referral source and primary care provider. PCP searches for and selects the appropriate services. Alternate Flow #1 Request For Information (RFI). 1471 John Counter Blvd, Suite 200 Kingston, ON K7M 8S8 The Cancer Centre of Southeastern Ontario provides treatment and care to cancer patients from across the South East LHIN. You must have a valid Ontario health card and a referral from a physician or nurse practitioner, and be age 19 or younger, or age 65 or older, or any age after overnight hospitalization for a condition that requires physiotherapy, or a recipient of Ontario Works or the Ontario Disability Support Program. M-H LHIN Main Office - 2655 North Sheridan Way, Mississauga, ON Main Office Fax: (905) 855-8989 Toll Free 1-877-298-8989 - for Community and Hospital Emergency Departments *Hospital in-Patient please use Hospital LHIN office Fax# Main Office Phone: (905) 855-9090 Toll Free 1-877-336-9090Form # CS ACCESS 001 revised . Central East LHIN Number: 310-2222 - No area code needed **Toll Free: 1-800-263-3877** While talking to Jane April documents the responses in the InterRAI Contact Assessment tool/form. The service rendered by the most responsible physician for completion and submission of a home care service request form to a Local Health Integration Network (LHIN) on behalf of a patient for whom the physician provides on- going medical care. Referral form for administering COVID-19 antivirals in South East community nursing clinics. The message is conveyed to the Dr. Jones in the RMS Source system. Please call us directly at the numbers listed above. Hospital teams need to complete the South East LHIN Referral Form a minimum of 24-48 hours prior to discharge. She is happy that she does not need to duplicate the information from the referral in his patient record as this has automatically updated for her in her EMR. Once Jane consents to being referred for home care services Dr. Jones searches for homecare services from his electronic medical record (EMR), which is integrated with a Referral Management System (i.e. Bereavement support A service that provides support and education to bereaved families, friends and anyone whose life has been touched by death. Bavaria (/ b v r i / b-VAIR-ee-; German: Bayern ), officially the Free State of Bavaria (German: Freistaat Bayern [fatat ban] ; Bavarian: Freistoot Bayern), is a state in the south-east of Germany 2 largest German state by land area, comprising roughly a fifth of the total land area of Germany The form should clearly indicate "Community Stroke Rehab Program" and include suggested therapy plan with focus of intervention. Then he includes the contact information for Jane's daughter that lives in the Barrie. This will connect you to the office nearest to your calling location. Dr. Jones decides the information selected on the form is appropriate for Jane's condition and he clicks Submit to send the referral request to South East LHIN Referral Management System (i.e. Dr. Jones reviews the RFI request in the RMS Source system and decides to update the referral with an attached OT Report (the document attachment is attached to the referral by RMS Source). Please call us directly at the numbers listed above. Rapid Access Clinics for Musculoskeletal Care PCP completes and submits the appropriate form to the Service Providers RMS. RMS Target), and an email to Jane confirming that the referral has been requested. After this, April documents the encounter in her system of record and determines that Jane is eligible for home care services offered through the South East LHIN. Have a life-limiting disease e.g., cancer, COPD, CHF, etc. Health professionals may have varying degrees of training in acquired brain injury. She suggests Gentle Exercise classes, and he begrudgingly agrees. Address Date of Birth HCN* Phone* v.c. Case management of publicly funded community support services including: long term care, home support, and rehab services, (physiotherapy, occupational therapy and social work) . . PDF South West LHIN Referral/Request for Assessment - WordPress.com SOVRS is supported by the South East Local Health Integration Network (LHIN). Anyone can make a referral to a Home and Community Care Support Services organization - an individual requiring service, a family member, caregiver, friend, physician or other health care professional. This form is for use effective the . Health Assessment - Local Health Integration Network (LHIN - Ontario Also included below issupport information for primary care physicians andhospital healthcare practitioners to assist support you when patients return to yourcare. With the unification of Germany into the German Empire in 1871, the kingdom became a federated state of the new empire and was second in size, power, and wealth only to the . Bavarian (German: Bairisch [ba] ()), or alternately Austro-Bavarian, is a West Germanic language consisting of a group of dialects, part of the Upper German family, together with Alemannic and East Franconian.. Bavarian is spoken by approximately 12 million people in an area of around 125,000 square kilometres (48,000 sq mi), making it the largest of all German dialects. From the list of available services on the referral form Dr. Jones selects the personal support service option and the home safety assessment option. Local Health Integration Network. The community service provider is notified that John has signed up for this specific class and is able to take appropriate action. Jane admits she is struggling with keeping up with the house chores due to her injury and that she is also afraid of falling again. PDF South East Local Health Integration Network (Bancroft) Vous pouvez choisir jusqu cinq (5) foyers de soins de longue dure. April proceeds to create a service plan for Jane and orders personal support services and occupational therapy services (for the home safety assessment) from the Acme Care Enhanced Services Inc. (ACES) agency. Not currently accredited. If the Service Provider is unable to provide the requested services, this status is noted in the Referral Management System, and automatically forwarded to the PCP EMR, If the patient declines the service, this status is noted in the Referral Management System, and automatically forwarded to the PCP EMR, PCP EMR is integrated with Referral Management System. Upon assessing the patient for home care services the Care Coordinator creates the service plan and orders services from an SPO. South East LHIN carrying on business as Home and Community Care Support Services South East; Toronto Central LHIN carrying on business as Home and Community . Erie St. Clair Wait Times and Wait List Information. April receives the referral cancellation notification in the RMS Target. All rights reserved. Facts about LHINS; School Health Support Services Review; Home, Community and Residential Care Services . Champlain. He is a busy physician with one secretary who is kept busy answering the phone most of the day. PROCEDURES WILL BE TAUGHT TO PATIENT OR RELIABLE PERSON. c/o South East Regional Cancer Program PDF South East LHIN Health Link Referral - southeasthealthline.ca Day Hospice A weekly day program offering participants an opportunity for social interaction, therapies, recreation activities, emotional support and consultation with Palliative Care nurses. Patient visits Nurse Practitioner (NP) as a follow-up from previous discussions. PDF South West Primary Care Alliance: Oxford November 29, 2017 South EastNegative Pressure Wound Therapy Order form cannot be initiated without negative pressure setting, therapy setting and contingency dressing orders. John Doe is a complex senior patient who lives alone. Kingdom of Bavaria - Wikipedia South West LHINReferral/Request for Assessment This is a PDF Interactive form. Last updated May, 2016 Pg 1of 2 Community Mental Health and Addictions Services Referral Form . We aim to respond within 72 hours, however, this email account is not checked on weekends or statutory holidays. The RMS Target sends the completion notification to RMS Source, including the service plan summary and any additional details April chose to include. We have developed a number of supportdocuments to assist with referrals to cancer relatedservices. April upon receiving the notification reviews the referral information, marks the referral "Accepted" in the RMS Target and includes a note to indicate the patient will be assessed for home care services over the phone. Please return this form to the South West LHIN via fax to: London: 519-472-4045 (for clients living in London/Middlesex and Elgin counties) Stratford 519-273-2847 or toll free: 1-855-223-2847 (for clients living in Grey/Bruce, Huron . The Kingdom of Bavaria (German: Knigreich Bayern; Bavarian: Kinereich Bayern; spelled Baiern until 1825) was a German state that succeeded the former Electorate of Bavaria in 1805 and continued to exist until 1918. Title. PDF South East Lhin Home & Community Care Community Stroke Rehab Program
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