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.
Prior to leaving the facility, our providers review the patient discharge summary and coordiante home-based needs with our partners
An initial phone-based conversation with the patient or caregiver is completed and an in-home visit with the patient is scheduled
Patient needs are reviewed in depth on an individual basis to properly manage medications, additional diagnostics and supporting DME
A health risk assessment and screening for care gaps is administered by nursing staff in order to create a comprehensive care plan
Ongoing coordination with a partner network of home-based aid and therapy services is managed to ensure patient needs are fully met
Ongoing communication with the patient and caregivers is delivered by a dedicated nurse to address needs as they change over time
As a patient under transitional care management, you and your support team are supported by our staff when needed
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