We manage the simplest of knee replacements to chronic and complex medical situations in the home. We meet the needs of patients with conditions such as weakness, frequent falls, post-surgical care, cancer care, heart failure care, lung and liver disease care, chronic pain management, diabetes care and dementia symptoms.
Home health has historically been one of the very best resources for geriatric or disabled individuals to improve their health and stay as independent as possible!
According to AHHQI 2015 Chartbook, the number of patients who received care any time during 2015: 4.9 million (2013)
The AHHQI says, more than 80% of home health care patients aged 65 and better have a primary caregiver outside of the home. Services commonly used by home health care patients aged 65 years and over included skilled nursing services (84%), physical therapy (40%), occupational therapy (37%), CNA (assistance with activities of daily living-ADL’s) 17%.
Historically, only 12% of individuals that can qualify for Home Health benefits actually utilize the service. This small amount of participation can be linked to lack of education to the eligible beneficiaries, lack of education in our medical system on the benefits of Home Health, and even individual refusal.
Many individuals have the misconception that you need to have a 3-night stay in the hospital to receive in home medical care. This is FALSE. In fact, Medicare recognized the benefits for both the patient and the Medicare dollars, therefore Medicare allows individuals to obtain home health, and fully covers the costs if a physician says they meet specific criteria such as:
We are impacting our medical care system by raising the standards of how Home Health and Chronic Care are done for the benefits of the individuals and families by reducing hospitalizations!
Our partnership includes: MD’s, NP’s, RN’s, Physical Therapists, Occupational Therapists, Speech Therapists, Registered Dietitian, Pharmacist, Medical Social Worker, CNA’s, chaplain as needed.
Transitions Health Partners is able to reduce hospital readmissions and ER visits by evaluating and managing complex care needs at home. In 2014 76 high risk patients were referred to Transitions Chronic Care. Only 3 of these high-risk patients was admitted to the hospital during the year. This astounding statistic points to the critical need for at-home management of early symptoms, and appropriate medical oversight. This success was repeated in 2015.
Our nurses focus on medication management, wound care, education, care coordination, chronic pain or chronic disease management and keeping you out of the hospital. With the most compassion and knowledge, you can have peace of mind that our nursing team is here to support you and help you manage your health by understanding your diseases, the impact of your choices and the trajectory of your diagnosis.
With years of combine experience, our therapy team loves meeting people where they are. Focusing on fall prevention, increase independence with activities in daily living, pain management, and recovery from surgery, home safety evaluations. Our therapists want to build on everything you have left and we value your goals. We will work with you in the privacy of your home and help you reach your fullest potential!
Social Worker in senior care are such a special piece to support our patients and families! Our support is to help cope with depression and anxiety, caregiver stress, advocacy, community resource specialist and much more.
Our organization is physician owned and operated by Dr. Mark Sarinopolous. We have a team of outstanding Nurse Practitioners who are passionate about geriatric care and chronic disease management. We provide education, care coordination, chronic pain or chronic disease management, advance planning conversations in the comfort of their home.
Home Health is generally covered 100% by Medicare A. Chronic Care management generally is covered 80/20 by Medicare B, with co-pays similar to specialists. Please speak to us further to be sure we are in network with your Medicare plan.
