Services

Home Health Partners Services

Our Clinical Services

HHP provides clinical care services delivered in-home during the transition of care from a hospital, managed facility, or group setting. Our goals is to provide excellent coordination of care delivery to ensure each patient receives the support and aid needed.

Discharge Review and Physician Orders

Prior to leaving the facility, our providers review the patient discharge summary and coordiante home-based needs with our partners

Initial Telehealth and Provider Home Visit

An initial phone-based conversation with the patient or caregiver is completed and an in-home visit with the patient is scheduled

Medication Review, Diagnostics and DME

Patient needs are reviewed in depth on an individual basis to properly manage medications, additional diagnostics and supporting DME

Care Gap Assessment
and Care Planning

A health risk assessment and screening for care gaps is administered by nursing staff in order to create a comprehensive care plan

In-Home Aid Support
and Therapy Services

Ongoing coordination with a partner network of home-based aid and therapy services is managed to ensure patient needs are fully met

Regular Monthly Care Coordination Services

Ongoing communication with the patient and caregivers is delivered by a dedicated nurse to address needs as they change over time

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On-Demand Clinical Support

Priority Care When Needed

As a patient under transitional care management, you and your support team are supported by our staff when needed

  • Discuss concerns or issues with a provider by telephone
  • Review medication needs and renew prescriptions
  • Skip unnecessary trips to the ER or urgent care
  • Schedule an in-home visit with your care provider
  • Message with your clinical support team as-needed