MILESTONE INC.

GROUP HOME HOSPITAL DISCHARGE ORDERS

Date

Individual Home______

Hospital discharge diagnosis

The following tests were completed. (Please attach / send us the results)

□ Labs

□ EKG/ECG

□ MRI/CT SCAN, X-RAY

□ Other

Medications

□ Continue all current medications.

□ The following medication changes have been made—see MAR/ update forms

Date they can return to day training__

Follow up appointments that need to be made

□ Primary MD

□ Specialists

Any other changes that have been made

Nurses Signature ______

MILESTONE INC.

GROUP HOMES

Patients Name ______Room # ______

To: All Hospitals & Nursing Homes

From: Milestone Group Home Nurses

Re: Discharge orders back to Milestone group Homes

In order to help meet the medical needs of this individual & to meet the criteria of our regulations; there are certain orders that must be in place.

We must have signed MD orders on any discharge-otherwise our pharmacy can not dispense the medications needed. Prescriptions are preferred versus signed POS’s.

Because we do not have nurses administering the medications the MD orders must be very specific (ie: we can not have orders that give choices-1-2 tablets 4-6 hours PRN or apply to affected area)

If this discharge is from a nursing home-please make sure to send any of the medications that this person has been taking. Pharmacy can not dispense any more since they have already been billed for.

It would also be helpful if we had the name of the MD that gave the orders for the medications-pharmacy needs that before meds can be dispensed & sometimes it is difficult to read.

We use Genoa Pharmacy-they are only open Monday-Friday 8AM-5PM. If an individual is discharged after 2 PM or on the weekend there can be difficulties obtaining their medications or having to utilize the On-call pharmacy.

Genoa Pharmacy Phone number 815-516-0246

Fax number 779-221-2244

We appreciate the care that you have given to our individual and if we have the necessary information as outlined above, it will make the transition back to their group home much easier. If there are any other questions you can call the appropriate on call cell and the supervisor will assist you (staff circle appropriate AOD cell) 815-979-0618 or 815-979-0619.

Thank you,

RN Name ______Phone number ______

*Staff need to FAX this immediately upon return to the Primary Physician and also the GH Nurse*

HS. 90b Rev. 1/13