Care Coordination Tool for Transition to Long-Term and Post-Acute Care

This tool is designed to inform EPs and EHs of key clinical information for inclusion in summary of care records when transitioning patients to LTPAC facilities.


The material in these guides and tools was developed from the experiences of Regional Extension Center staff in the performance of technical support and EHR implementation assistance to primary care providers. The information contained in this guide is not intended to serve as legal advice nor should it substitute for legal counsel. The guide is not exhaustive, and readers are encouraged to seek additional detailed technical guidance to supplement the information contained herein.

Reference in this web site to any specific resources, tools, products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.

Practice Role
Health Info Mgmt Medical Records RHIA
Providers (MDs, DOs, NPs, PAs, RNs, LPNs)
Providers & Professionals
Setting/Practice Type
EHR Steps
Step 6: Continue Quality Improvement

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Content last reviewed on November 13, 2018
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