Reason To call for Case Management:

    Checklist for Care Management

  •  Evaluation of health status, home safety, medications, services in place
  •  Local or long distance care-giving responsibilities
  •  A decline in condition, memory or ability to perform self-care
  • Challenges in obtaining health information and resources to address needs
  •  Multiple physicians being utilized
  • Confusion or concern about medications or treatments
  • Increasing falls (with/without injury)
  • Limited health care benefits
  • Escalating healthcare costs
  • Major illnesses – dementia, stroke, diabetes, cancer, etc.
  • Multiple disease processes
  • Questionable adherence or lack of progress with treatment
  • Increasing number of hospital stays
  • Extended hospitalization due to a major illness or complications
  • Communication issues with healthcare providers

 

Care Management Services Offered

  • Education on disease processes, medication management, home safety, diet, wellness etc.
  • Ongoing, consistent assessment of care needs and/or treatment
  •  Facilitation of communication between client, physicians, providers
  • Identification of community resources to address care needs
  • Relocation assistance when moving to the area
  • Healthcare services coordination
  • Transitions of care assistance
  • Individualized care plan development
  • Onsite visits/contacts for ongoing monitoring purposes
  • Medicare and Health insurance education
  • Medical bill review
  • Health and wellness coaching
  • General consultation services and educational programs on request