Our ‘4C’ hallmarks shine brightly when assessing a transition from hospital to home

When a senior or chronically ill adult leaves hospital, either to return home to move to a new assisted environment, often it comes with the realization that life has changed in many ways.

Our goal is to minimize that negative feeling with smooth transitions, improved outcomes and preventing hospital re-admissions. Here’s where those ‘4 C’s’ come in:


seeking a positive experience with all health/social realms and with providers, patient, and family


always ensuring the patient and family understand and approve each decision


minimizing the stress of the discharge process with healthcare providers


keeping care throughout the health care continuum smooth and documented


Identify and connect:

at risk individuals with transitional staff prior to discharge

Facilitate Interdisciplinary:

health/social team communication and coordination

Patient education:

ensure understanding of the discharge plan and process


key community players, services and supports prior to discharge of patient

Prevent re-admission:

monitor, recognize and respond appropriately to adverse symptoms post-discharge


How We Serve You and the Discharged Patient

TLCCS Care Managers can bridge the social and medical arenas effectively and efficiently with a holistic focus on your loved one’s individual needs, goals and resources as they prepare for their discharge back home. We are experts in care planning and management designed to maximize the health, independence, resources and quality of life for persons with an acute or chronic illness and/or a disability.

  • Patient and family education and engagement
  • Development of a post discharge follow-up plan
  • Transitional planning for follow-up care
  • Engagement of and communication among patient’s community healthcare provider(s)
  • Medication management
  • Coordination and management of family/community care providers.

TLCCS Care Managers emphasize coordination and continuity of care, prevention and avoidance of complications and close clinical oversight AND care management – — accomplished with the active engagement of patients, their family, caregivers, and collaboration with the patient’s healthcare providers.

"We are so glad that Cathy came into our lives. She found the perfect senior living place to care for my 'impossible to please' cousin who has memory issues.
We live out of state and before we could get to Florida, Cathy went to her house and hired a plumber and exterminator nad took care of getting her cable fixed. I don't know what we would have done without her. She is not only efficient and competent, but her upbeat personality makes hard decisions more palatable.
And, now with COVID, knowing Cathy is still able to check in personally with my cousin, when we cannot, is a reassuring feeling that brings immense peace of mind."

P.O. Box 411928, Melbourne, FL 32941
Tel (321) 752-0995  |  Fax (321) 369-9953
E-mail:  info@tlcconsultantservices.com

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