Supported Independent Living (SIL)
A home with support built around you, from daily drop-ins to 24/7 support including overnight. See our current homes and vacancies.
See our SIL homes →
Hospital Transitions · Our flagship service
Leaving hospital, with everything ready.
The plan, the home, the support team. We coordinate every part of your hospital discharge with you, your family, the hospital and the NDIA. We start the moment you or the hospital contacts us.
NDIS Registered Provider
NDIS Worker Screening
VIC · NSW · QLD · TAS
What this service is
One team carries the whole transition.
Also known as our Rapid Hospital Discharge Program.
A hospital stay changes things. The support that worked before may not be enough now, and the gap between leaving the ward and having the right care at home can feel overwhelming. Hospital Transitions closes that gap.
We take on the coordination: talking with the hospital team, working through the NDIS side, finding accommodation where it is needed, and building a support team that is ready on discharge day. You and your family stay informed the whole way, without having to chase anyone.
Who we work with
- Participants preparing to leave hospital or rehabilitation, with or without an NDIS plan in place
- Families coordinating a discharge for someone they love
- Hospital social workers, discharge planners and NDIS liaisons
- Support coordinators looking for a provider who can take on complex discharges
The process, mapped
How a hospital transition works with us.
Every discharge is different, but the path is the same. Here is exactly what happens, step by step.
-
First meeting
In hospital or by phone. No forms first, just a conversation about you and what you need.
-
Hospital liaison
We work directly with the hospital team and the NDIA so nothing is lost in handover.
-
Match The Right Support Workers
Workers chosen for personality, language, culture and the care you actually need.
-
Support planning
Planning meetings with you, your family and the hospital to map the supports you will need at home.
-
Housing, where required
SIL, SDA, Medium Term or Short Term Accommodation options lined up before discharge.
-
Discharge day
Everything is ready. Your home is set up and your support team is at the door, not on a waiting list.
-
Settle in and check-ins
Support continues at home, with regular check-ins and adjustments as your needs change.
Complex needs
Complex needs we support.
Discharge teams ask one question first: can you take this participant? This is what our teams are trained, rostered and supervised to support.
Every referral is assessed on the person in front of us, not the diagnosis on the file. Tell us what the participant needs and we will give you a straight answer on whether we can cover it.
Discuss a complex referral
Draft capability list. Pending clinical sign-off.
Restrictive practicesSupport for participants with restrictive practices in place, delivered to a positive behaviour support plan with NDIS Commission reporting.
PEG and enteral feedingPump and bolus feeding, medication via tube, site care.
Spinal cord injuryQuadriplegia and paraplegia, including full physical assistance.
Acquired brain injuryCognitive, behavioural and physical support in one plan.
Bowel and catheter careBowel programs, indwelling and intermittent catheters.
Epilepsy and seizure plansSeizure management plans including midazolam administration.
Behaviour supportDelivered to a behaviour support plan, with restrictive practice reporting.
+ moreIf a need is not listed here, ask us. We assess every referral on the person in front of us.
Every complex support runs to a written care plan with registered nurse oversight, and no worker delivers a high intensity support until their competency has been signed off.
If a need is not listed, ask us. We would rather tell you honestly that something sits outside our scope than accept a referral we cannot support properly.
Housing
Where will you live after discharge?
For many people leaving hospital, home is the biggest question. We connect participants to Supported Independent Living, Specialist Disability Accommodation, Medium Term and Short Term Accommodation across Victoria and Queensland.
Specialist Disability Accommodation (SDA)
Purpose-built accessible housing for participants with SDA funding. Resilient Life Care is a registered SDA provider with our own homes.
See our SDA options →
Your support team
Download or print our capability statement
Matched for personality, language and culture.
Our support workers come from all over the world. That means we can match you with workers who speak your language, understand your culture and fit the way you live, not just whoever is available.
Every worker holds current NDIS Worker Screening and the training your care requires. For complex and high intensity needs, clinical oversight is part of the team from day one.
By the numbers
Depth behind every discharge.
200+
Support workers
4
States covered
24/7
Complex care capability
2
Offices
NDIS Worker ScreeningEvery support worker screened
My Aged CareRegistered Provider
In their words
David came home.
I was in a rehabilitation hospital for nine months. Resilient Life Care organised my discharge, accommodation and my awesome support team.
Two ways to start
Tell us who you are, and we will take it from there.
Families & participants
Tell us your situation in plain words. We will explain what is possible, what the NDIS side looks like, and what happens next. No forms first, and no obligation.
Start a conversationHospital social workers & coordinators
Send us a referral with the participant's situation and anticipated discharge. We liaise directly with your discharge planning and allied health teams.
Make a referral
Common questions
The things people worry about before discharge.
What if there is no NDIS plan in place yet?
That is common, and it does not stop us. We work with you, the hospital and the NDIA through the planning process, join planning meetings where helpful, and make sure the supports you need are reflected in the plan before you leave.
Who talks to the hospital?
We do, with your consent. Our team liaises directly with social workers, discharge planners, allied health staff and the NDIA so information is handed over properly and you are not stuck relaying messages between everyone.
What if family cannot be there in person?
We meet by phone or video whenever that works better, and we keep family updated wherever they are. Distance does not stop a family from being part of the planning.
How quickly can this happen?
Every situation is different, so we do not promise a set time frame. What we can tell you is that urgent discharges are treated with urgency, and you will know exactly where things stand at every step.
What if accommodation is needed?
Where a new home is required, we line up options before discharge: Supported Independent Living, our own Specialist Disability Accommodation homes, or Medium Term and Short Term Accommodation as a bridge.
NDIS Worker ScreeningAll support workers screened
200+ support workersVIC · NSW · QLD · TAS
Capability statementPrint or download
Planning a discharge? Start today.
The earlier we are involved, the smoother the transition. Tell us the ward, the participant and the discharge picture, and we will take it from there.