Discharge Planner

Discharge Planner

Astoria Healthcare Center in Sylmar

Job Summary

Astoria Healthcare Center is seeking a compassionate, organized, and experienced Discharge Planner to support residents and their families throughout the discharge process. The Discharge Planner is responsible for coordinating safe and appropriate transitions from our skilled nursing facility (SNF) to the resident’s next level of care. This position works closely with residents, families, nursing staff, physicians, rehabilitation services, and the interdisciplinary team to help ensure a smooth discharge process.

Essential Duties and Responsibilities

• Coordinate and facilitate discharge planning for residents transitioning from the facility to home or another care setting.

• Assess residents’ discharge needs and identify appropriate resources and services to support a safe transition.

• Collaborate with the interdisciplinary team, including nursing, physicians, rehabilitation, and social services, to develop and implement discharge plans.

• Communicate with residents and families regarding discharge arrangements, recommendations, and available resources.

• Coordinate referrals to home health agencies, community resources, durable medical equipment providers, and other post-discharge services as needed.

• Assist residents and families with understanding follow-up care instructions and discharge recommendations.

• Maintain accurate, timely documentation related to discharge planning and coordination.

• Participate in care plan meetings and interdisciplinary team discussions as appropriate.

• Identify potential barriers to discharge and work with the care team to develop solutions.

• Ensure discharge planning activities follow facility policies and applicable regulations.

• Maintain confidentiality and demonstrate professionalism when working with residents, families, and healthcare professionals.

Qualifications

• Previous experience working in a skilled nursing facility (SNF) is required.

• Experience in discharge planning, social services, case management, or care coordination is strongly preferred.

• Knowledge of discharge planning procedures, community resources, and post-acute care services.

• Strong communication, organizational, and problem-solving skills.

• Ability to work collaboratively with an interdisciplinary team.

• Ability to manage multiple responsibilities and meet deadlines.

• Proficiency in computer systems and clinical documentation.

• Compassionate, resident-centered approach to care and communication.

Work Environment

This position works within a skilled nursing facility and involves regular interaction with residents, families, and healthcare professionals. The Discharge Planner must be able to work effectively in a fast-paced healthcare environment while maintaining professionalism and confidentiality.