A Combined Solution to Ensure a Much Safer Transition Home

Ideal patients and referrals for Dual Discharge with Home Care and Home Health Agencies are those who:

  • Clearly need more than what Medicare covers
  • Do not have a solid support system in place
  • See multiple physicians
  • Are at high risk for readmission to the hospital
  • Make frequent trips to the emergency department
  • Have multiple chronic conditions
  • Need support transitioning to their home

Freedom Home Care partners home care with the services of a Home Health Agency to provide a combined solution.

Freedom Home Care provides the following services to collaborate with the Home Health Agency to coordinate a safe discharge and prevent re-hospitalizations.

  • Identify patients at a greater risk for readmission (cancer, pneumonia, certain cardiovascular diseases, etc.) and monitor them closely
  • Communicate with staff to ensure they are aware of high risk patients so staff can watch for worsening symptoms like infection, pain and medication compliance
  • Help patients understand discharge instructions related to their conditions to ensure compliance
  • Providing supplemental services outside of what Medicare covers and long after the Visiting Nurse Services through the Medicare Home Health benefit have ended to keep patients supported
  • Collaborating with the home health provider to provide additional care around the Medicare benefits
  • Offering support to therapy services by assisting clients with at-home rehab exercises
  • Presenting a combined solution