Reducing preventable hospital readmission is a priority #1
We support transitional care and chronic disease management by: 1) providing a house calls visits from the NP, 2) coordinating high quality home encounters in partnership with home health agencies, 3) initiating telehealth visits for a variety patient care scenarios as appropriate.
Priority patient groups: 1) patients discharging/discharged from facilities without a PCP 2) high risk groups at risk for 3-7 day ED utilization/re-hospitalization with specific dx: acute and acute on chronic issues like PNA, CHF, COPD and management throughout the 90 day episode 3) Palliative care level patients with chronic illness with multiple unmanaged symptoms and multiple co-morbidities.
Eliminating Home Health Barriers to Care
Have you been on the hunt for someone to sign that 485? Done
Are your chronically ill patients headed back to the ER or hospital because there is no one to address acute needs when the skilled nurse identifies health issues?
Instead...Call the Housecalls NP!
Work with a collaborative, high level provider focused on helping your organization improve QUALITY OUTCOMES.