Transitional Care Management

 

When it comes to your care, our registered nurses put all the pieces together for you!

 

Horizon Family’s Transitional Care Nurses provide high quality coordination by bridging the gaps between hospital, sub-acute care and your primary and specialty providers. Each nurse will work with your specific needs and your Primary Care or Specialty provider to make sure that you always receive the best of care.

 

To make sure you receive the best care possible, the Transitional Care Nurse will:

 

Provide support to patients and caregivers by bedside hospital visits, health management education and phone contact from hospital admission through at minimum one month post discharge.

 

Make Transitional Care Management appointments with your provider before you are discharged and will arrange transportation, as necessary.

 

24 hour call center phone: 845-615-4007             Office phone: 845-360-9515

 

Population Health Management

At Horizon Family, we want to keep you healthy! Your insurance provides health maintenance testing and education through services such as mammography, colonoscopy, diabetic testing and eye exams. It’s often hard to keep track of when those services are needed. Let us do the work for you! Our team of nurses will let you know when services are recommended by your provider and can assist you in making those appointments. They are available for assistance to keep you in your best health!

 

For any questions or concerns about your preventative care or follow up please call: 845-458-8845

 

Palliative Care Consultant

Horizon Family is pleased to offer consultation for patients and families who are facing end of life concerns or who have questions about advanced planning for care. Our registered nurse is Hospice and Palliative Care© certified and is available by phone or to come to an appointment with your Horizon primary or specialty care provider. She can provide education and resources to help you make decisions that are best for YOU!

 

For assistance, please contact: Nancy Duzick, RN, BSN, CHPN at 845-458-8849

 

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