Innovative Solutions for Medically Complex Populations
We help patients stay healthy at home after discharge from a hospital or skilled nursing facility. Continue Care provides a continuum of care, including skilled nursing, personal care and pharmacy services to manage the full spectrum of complex patients’ health. We are with our patients every step of the way to ensure they receive the right care at the right time – when they need it most.
Our nurse-led transition of care includes:
Longitudinal Care Navigation – Continuing nurse-led patient and health care provider engagement and care management assuring care plans, transitions of care, and escalations of care are appropriately monitored and executed.
In-Home Nursing Services – Skilled Home Health services as well as in-home nurse assessments, social determinants of health, and medication reconciliation.
Medication Therapy Management – Consultant pharmacist med regimen reviews both at start of service and as necessary with change of condition.
Medication Fulfillment – Including easy to use multi-dose adherence packaging delivered to home via closed-door mail-order pharmacy.
Coordinated Health Services – We have the ability to intra-refer within our network to assure comprehensive scope and availability of services as well as providing patient choice.
Access to on-call nurse consultants
Our direct pharmacy services:
- Deliver prescription medications directly to patient’s homes
- Ensure medication adherence
- Provide ongoing medication management and review
We provide the continuity of care that patients need to stay healthy at home. Additionally, we offer enhanced benefits to patients with chronic conditions. Our care coordination increases quality of care and helps minimize avoidable rehospitalizations. We are dedicated to providing innovative solutions that keep patients healthy at home, improving outcomes and lowering costs.