SERVICES

Care Coordination

Outreach

Telephone Reassurance

Health Risk Screens

Annual Care Planning

Monitoring

Home Safety Checks

Skilled Nursing Facility Deflection/Diversion

Transitional Care

 

Evidence-based Bridge Model of Transitional Care starting at hospital or SNF bedside

30-day and 90-day options

Home visits within 24-48 hours of discharge with a home safety risk assessment

specialized programs

Workshops & trainings