Care Coordination
Initial Assessment
Our Owner or Nurse will visit each client at their place of planned residence to evaluate condition, discuss options, and develop a customized care plan.
Select the Care You Need
Development and Ongoing Care Plan
We love working with the Rehab staff to coordinate the Physical Therapy, Occupational Therapy, and Speech Therapy notes into the customized care plan. If the client is coming home directly from the hospital, we will carefully go through the discharge plan, including verification of all meds. This care plan will describe all the services required, the proposed frequency, cost of each service, potential equipment and supplies needed.
- This process should start before the client is discharged from the hospital, rehab or other healthcare facility.
- We will work the attending physician, discharge planner, family and the client to determine the proper Plan of Care and agree on the specific goals to maximize the healing process.
Care Management
Assisting Hands provides Non-Medical Home Care services in the comfort and safety of your own home. We will also assist in coordinating and referring other services needed such as:
- Durable Medical Equipment
- Home Modifications
- Medical Alert System
- Community Based Programs
- Transportation Services
- Coordinating Doctor’s Appointments
- Palliative Care and Hospice Services
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Benefit Determination
We help identify any programs, community resources, or benefits that might be available for our clients such as: Long Term Care Insurance, VA pensions, Medicare Advantage Programs, Medicare/Medicaid Services, and others.
