After discharge from the hospital

The Musculoskeletal Service of UVA Hospital is available to help you and your family to plan for your care after your hospital stay. Our staff of nurses, therapists, social workers, and financial coordinators will work closely with you in planning your discharge care. The UVA care system offers several different services after hospitalization through Continuum, our home health agency, and UVa-HealthSouth, the new Rehabilitation Hospital located just a few minutes from the hospital.

  1. Home with Home Health Services: Continuum provides nurses and physical therapists to come into your home. They will visit on a regular basis to help you regain your strength and independence. Occupational therapists and nursing aides are available as needed. Continuum Home Health provides services to patients in the counties of Albemarle, Augusta, Buckingham, Greene, Fluvanna, Louisa, Nelson, Orange, Rockingham as well as the city of Charlottesville. These services can be initiated in your home within 24 hours of hospital discharge and continued as determined by your physician. Medicare covers all of the services mentioned above and many other insurance companies provide coverage for most of the choices as well.
  2. Home with Outpatient Services: For many patients receiving a total hip replacement, what is needed are regular visits for outpatient physical and occupational therapy in addition to your follow-up visits to the doctor. These visits are designed to help you regain strength, endurance, and independence. UVa HealthSouth Rehabilitation Hospital provides outpatient therapy programs to meet a variety of patient needs. If you live within a 15-20 mile radius of Charlottesville, transportation can be provided.
  3. A Stay in a Rehabilitation Hospital: UVa-HealthSouth Rehabilitation Hospital is a state-of-the-art, 50 bed inpatient facility located next to the Orthopaedic Outpatient Clinic, on Fontaine Avenue in Charlottesville, Virginia. Services provided include, nursing, physical therapy, occupational therapy, therapeutic recreation, respiratory therapy and case management. Both inpatient and outpatient services include access to the heated aquatic therapy pool. For patients with tranportation limitations there is a van service available. This service is on a case by case basis. Tours are available to help you make your post-surgical care decision.
  4. A Stay in a Skilled Nursing Home: Another option available to many patients is a short stay in a skilled nursing home while they regain strength. This is only a temporary stay that will allow for active nursing care and increased therapy.

Medicare and many other insurance providers offer coverage for all of the choices listed above. The following are additional areas of which the discharge planning team may be of assistance: Pre-op home assessment referral, Medical equipment, Home Health Referral, Medicare/Medicaid information, Extended care facility placement (such as nursing home, adult home), Financial screening, and Special Needs (Hospice, Support Groups).

A list of alternative services provided by non-UVA providers that are in our community as well as in the state is available. Our discharge planning team will be glad to assist you in arranging a discharge plan suitable to your needs.

If you have any questions, you can contact your Social Worker at: (434) 924-2713 or Outcomes Manager at (434) 924-2485


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