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For Health Care Professionals

Private Care Services from Partners in Care

Partners in Care is private care at homeVNSNY’s private care affiliate, Partners in Care, is the New York City area’s largest licensed home care services agency, serving all of New York City, Westchester, Rockland, Suffolk, and Nassau Counties.

For patients who wish to supplement or extend home health care services beyond what Medicare, Medicaid, or private insurance will cover, Partners in Care offers an unmatched breadth of skilled, professional and paraprofessional care services at home, or in hospital, in-patient rehab, or nursing facility settings.

If any of these scenarios seem familiar, Partners in Care can help:

We can provide short-term assistance or ongoing, round-the-clock care, with flexible scheduling, no contracts or monthly retainers required. Care can often start within 24 hours of request.

Partners in Care is licensed by the New York State Department of Health, and accredited by CHAP, the Community Health Accreditation Program, signifying achievement of the highest recognized standards in healthcare. We are proud of our unplanned hospitalization rate of less than 2% (versus the 2013 national Medicare rate of 18%), and an ED rate under 1%.1

Key services include:

Private Care Nursing

Our private duty nurses—RNs and LPNs—are experienced in medically complex patients and disease-specific care, including diabetes, heart disease, and stroke. They offer expertise in coordination, assistance following physicians’ orders, pain management, medication reconciliation, guidance for self-care, and clinical assessments including PRI/Screen.

They provide supervision and clinical treatment for continuous care needs:

  • Infusion therapy
  • Wound, colostomy, and ileostomy care
  • Tracheostomy care and tube feeding
  • Catheter care
  • Pulmonary care
  • Immunization

Clinical Assessments

At Partners in Care, experience has shown that better outcomes begin with better information.

When you need a source of objective, comprehensive data and clinical insights to guide decision-making, we can provide a variety of clinical assessments and screenings:

Home Safety Screening Assessment

This instrument provides a systematic evaluation of an individual’s home environment in relation to current medical condition:

  • Physical disabilities and limitations
  • Medications
  • Cognitive skills
  • Nutritional practices

The assessment informs specific recommendations to minimize impediments to home safety, including:

  • Household modifications and improvements
  • Medical equipment
  • Community resources or new home safety procedures

Falls Prevention Assessment

To help prevent the injuries and other dangerous sequelae of falls, this multi-factorial assessment focuses on physical capabilities and limitations, and includes:

  • Patient falls history
  • Ambulation, strength, balance, gait
  • ADL confidence
  • Medications
  • Cognitive skills
  • Environmental factors

The assessment offers individual falls prevention recommendations, such as:

  • Patient and caregiver education for home safety procedures
  • Physical rehabilitation
  • Modifications in medications or nutritional regimes

Patient Review Instrument (PRI) and Screen

These instruments are required by New York State law for individuals who may require placement or continuing stay in a residential health care facility.

They provide the objective data clinicians and families need to guide difficult decisions around nursing home care with a two-part assessment:

  1. PRI component evaluates the individual’s physical condition and the level of care required
  2. Screen component assesses for possible mental illness, intellectual disability and/or developmental disability

The Skilled Nursing Facility is informed of patient’s eligibility and special requirements, including behavioral management needs, as appropriate.

Care Management

Expert private care management can enhance recovery, safety, and satisfaction for patients with complex care needs. And it can help frail, elderly patients with chronic conditions live safely at home, providing:

  • Comprehensive evaluation of health, psychosocial, functional, and environmental factors for clients needing help with IADLs
  • Expert advocacy, education, and oversight of interdisciplinary team
  • Care coordination for assistance with ADLs and IADLs, medication management, nutrition, home safety, and household arrangements
  • Family caregiver education and status updates
  • Assistance with navigating elder care options and associated paperwork
  • Connections to community resources (support groups/adult day centers)

Rehabilitation Therapies (PT, OT, SLP)

When a patient is still recovering from a surgery, illness or accident, but insurance no longer covers needed rehabilitation therapies, Partners in Care therapists can work closely in any setting of care to help your patient meet long-term recovery goals.

  • Physical Therapy. When mobility is restricted, at-home PT helps patients gain improved strength, flexibility, coordination, and balance.
  • Occupational Therapy. When a patient’s fine motor skills are impaired, OT can help them regain facility at daily activities.
  • Speech-Language Pathology. Our speech therapists create exercises to help the patient regain strength, understand and process what is being said, and provide strategies for communication.
  • Stroke Therapy. We draw up a specific client profile on the severity of each patient’s stroke to help them regain independence.

Personal Care and Companionship

Partners in Care provides customized home health aide services for patients who want assistance with the activities of daily living beyond Medicare or other insurance coverage. Frequently, patients and their families request more hours to supplement support or extend personal care after an acute home care episode including:

  • Reminders to take medications
  • Food shopping, cooking, and meal preparation
  • Ambulatory escort at discharge, or to and from medical and other appointments
  • Recording vital signs
  • Bathing, dressing, and grooming

Patients are carefully matched with highly trained, certified home health aide—or team of aides—for assistance with ADLs. Scheduling is flexible, from hourly through round-the-clock care, with no contracts or monthly retainers required. Aides are supervised by registered nurses, who oversee the care plan and update as necessary in consultation with the patient’s physician.

Ambulatory Escort Services

When an individual needs help getting to and from a medical appointment and family can’t be there, our ambulatory escort service (also called appointment companion) will send one of our home health aides to make sure they arrive safely and on time, and get back home again.

Partners in Care ambulatory escort can be used for:

  • General medical and dental procedures
  • Client testing procedures
  • Same-day surgical procedures
  • Hospital pick-up (some procedures require an escort at discharge)
  • Trips to the theater and other social events, such as weddings and parties

Health Coach Program

VNSNY has developed an innovative, evidence-based program to help at-risk, medically complex patients transition home more safely and will less risk of avoidable rehospitalization.

This program begins with experienced, high-performing VNSNY home health aides who are invited to undergo specialized training as health coaches—including the management of specific conditions such as Alzheimer’s, heart disease, cancer, and others.

The methodology involves one-on-one sessions with the patient—beginning before discharge and continuing over 30 days during transition—that include:

  • Working with the patient to establish health goals based on their conditions and previous hospitalizations
  • Identifying the patient’s current health status and tracking progress against goals
  • Making sure the patient attends and understands follow-up medical appointments
  • Providing educational material relevant to the patient’s needs
  • Discussing potential health concerns with the patient

1 Partners in Care Strategic Scorecard, 2015.

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