Nurse case managers
A Nurse Case Manager first makes a home visit to evaluate the patient's needs. The assessment includes interviews withthe client, family members, doctors, and other professionals who have been previously involved in the care. Level of independent functioning and living environment will also be assessed at this time.
A personalized care plan is then prepared that incorporates the physician's orders and the special social and physical needs of each individual client. By matching the patient's needs to the appropriate level of care, unnecessary costs are eliminated, and the client gets precisely the care they require. The ABC nurse case manager will maintain frequent contact with client and family, regularly observing and supervising all paraprofessional health care workers.
As the client's level of care changes, the nurse case manager will also adjust the plan of care and services. She/he will provide when requested and as needed more frequent visits to monitor the patient's progress or other potential health/social problems. ABC Certified Case Managers keep the physician and or family aware of important changes in the client's condition and service needs.
The Nurse Practitioner/Nurse Case Manager will also provide all skilled services for the client such as insulin/medication administration, dressing changes, medication and pain management, and if requested accompany client to physician's office or clinic.