TOLEDO, Ohio (PRWEB) August 09, 2013
Senior Independence, a leader in innovative, quality living services for older adults, is partnering with Northwest Ohio ACO (NW Ohio ACO) to improve the health of the greater Toledo community.
Senior Independence, established in 1980, supports seniors with home and community based services and is a division of Ohio Presbyterian Retirement Services (OPRS), Ohio's largest and most experienced not-for-profit provider of continuing care retirement communities and services.
NW Ohio ACO is a Medicare Accountable Care Organization (ACO) and is a joint venture between the Toledo Clinic, Inc., and the University of Toledo Physicians, LLC. Medicare beneficiaries receive better, more coordinated care because ACO doctors, hospitals, and other care providers work together to give the right care at the right time with the goals of improving quality, reducing duplication of medical services and preventing medical errors.
Senior Independence and NW Ohio ACO are coming together to improve beneficiaries' health with the no-cost Home to Stay care transition program. Home to Stay care teams teach older adults how to prevent and/or manage chronic diseases with the goals of improving quality and reducing unnecessary health care costs.
"This partnership lets OPRS expand our proactive relationship with Toledo-area seniors. We're there for them prior to emergency care or following a hospital stay — a time when they most need care and support," says OPRS President/CEO Laurence C. Gumina. "We recognize the worthiness of providing this level of care to all beneficiaries regardless of their ability to pay."
"We're pleased to announce the relationship between our organizations. We believe this relationship will enhance quality and improve the patient experience for beneficiaries served by Northwest Ohio ACO," says Gregory Hawkins, executive director of NW Ohio ACO.
When a beneficiary is healthy enough to leave the hospital, a Home to Stay team goes into action. The team first determines whether the beneficiary requires skilled home-health care. If yes, a Senior Independence home-health care nurse visits the home within 24 hours and provides ongoing care.
If no, the team explains how Home to Stay works: An RN or LPN visits the patient at her home within the next 72 hours and again seven to 10 days after discharge. The nurses do thorough medication reviews and resolve issues, take vital signs, talk about personal emergency plans, establish personal health records, teach disease signs and symptoms, confirm follow-up appointments with primary care physicians, ensure transportation to those appointments and more. After those in-home visits, a nurse or social worker calls the beneficiary three times during the next 21 days, following up on his care and wellness.
"Before Home to Stay, many seniors were left on their own -- some with dementia," says Senior Independence President Rich Boyson. "Now, they're getting help with medications, being provided an evaluation of their home setting, learning which questions to ask at doctor appointments, and creating lifesaving personal health records."
If the beneficiary isn't suffering from a chronic illness, Home to Stay offers one in-home visit by a nurse or social worker within 72 hours and one phone call seven to 10 days after he leaves the hospital.
Home to Stay's personal emergency plan helps seniors determine who to call for care (Home to Stay nurse, doctor's office or 911) and what to tell the provider (signs and symptoms and medical background).
"Nurses work with the patients to create the plans, which help reduce hospital readmissions and ER visits because they know who to call in each situation," Boyson says.
The Home to Stay care teams are employed by Senior Independence of Greater Toledo, which has received four consecutively perfect (deficiency free) surveys from the Ohio Department of Health. The Toledo office currently is at 5810 Southwyck Blvd., Toledo, but will relocate to an expanded space in early September.
"By working closely with like-minded, progressive groups, such as NW Ohio ACO, we're giving our patients and their families even higher quality, better coordinated and more efficient care," says Wendy Price Kiser, executive director of the Toledo regional office. "We're improving quality of life while containing costs."
Technology and information-sharing play big parts in the partnership, says Boyson.
Electronic medical records streamline communications, improve care, and provide data to create better outcomes and reduce costs.
The Home to Stay program means new jobs are coming to the Toledo office.
"To provide this care, we're looking at creating 15 full-time positions. That's economic impact in the Toledo market," Boyson says.
"As a not-for-profit provider of senior-living services, OPRS is bringing its own resources to the table to ensure all beneficiaries receive high-quality, better-managed care. We're committed to our Toledo neighbors, and because we're working smarter and giving cost-effective care, doing the right thing will be good business for OPRS," Gumina says.
Ohio Presbyterian Retirement Services (OPRS) serves more than 90,000 people annually through its wholly owned subsidiaries OPRS Communities and Senior Independence. OPRS Communities operates 11 retirement communities. Senior Independence provides home and community based services, operates 13 adult day centers and manages six senior centers, in partnership with local governments. In addition, Senior Independence services are extended nationwide through its iPartners. Another wholly owned subsidiary, the OPRS Foundation raises several million dollars annually to support charity care, special programs, capital expansion and endowment.