Transitional Care/Care Management Services

Future Goals:

VaughnGage Healthy Aging Center (VG) will be partnering with local hospitals to offer the value added services of care management and assistance to members as the transition from the hospital and/or rehab facility back home.

i03VG Case Managers will help bridge the gap between the member and all of the people who make up the care team. This may include the physician, rehab specialist, pharmacist, podiatrist, wound care doctor, etc. Transitional care allows our care management team to be an “overseer” of sorts for our members. We become the eyes and ears for the member and their family and assist in making the transitional process back home more efficient. Another major goal is to seek to prevent the member from returning to the hospital by assisting with the coordination of care.

VGHAC Care Managers help to identify what care needs a person has by performing an assessment of their needs and resources. We then work with the individual or family to determine their options for getting needed care.

We believe that the person needing care or authorized to represent them make the decisions about their care. How to best adjust back to life can become confusing with so many people involved in the care process. Our goal is to help structure the circle of care while also keeping these individuals linked together so that proper care can be given in a consistent and efficient manner. Please call our Assessment Team to discuss our Transitional Care and Care Management Services.