Patients who meet study criteria, informed consent will be obtained before hospital discharge or at the first Disease Management visit. Patients will be followed for 90 days post-discharge. Clinic visits, homecare agency and visits, heart failure education class attendance, and dates of hospital readmission will be tracked. Descriptive characteristics of patients will be recorded at the time of enrollment. Descriptive characteristics include demographics, etiology of heart failure, symptoms, physical assessment, current medications, lab results, and diagnostic test results.