CCM FOR SNFs
Carehub Chronic Care Management (CCM) Services for SNFs
Carehub offers Chronic Care Management (CCM) services to support patients transitioning home after discharge from Skilled Nursing Facilities (SNFs). Through telephonic care coordination, we ensure eligible patients receive comprehensive support to navigate their recovery and prevent unnecessary readmissions.
Our program addresses both clinical needs and social determinants of health (SDOH), achieving a 30-50% reduction in preventable readmissions.
Why CCM is Essential for SNFs
- Improved Patient Outcomes
- Enhanced Quality Metrics
- Compliance with Regulatory Standards
Program Highlights
- Cohesion With Other Programs: This program works alongside other care programs, providers, and caregivers. It complements home health services and assists in coordinating them as needed.
- Flexible Program Duration: Patients can remain in the program for as long as they require support.
- Simple Eligibility: Open to patients with two or more chronic conditions.
How patients Are Assisted
- Follow-Up Care Coordination arranges follow-up visits and transportation when needed.
- Medication Support ensures reconciliation, management, and timely refills.
- Wellbeing Monitoring provides regular check-ins to assess recovery progress.
- Patient Education empowers patients with knowledge for better self-care.
- Community Resource Coordination links patients to services like Meals on Wheels and other local organizations.
Why Partner with Carehub?
- Expertise in implementing CCM programs in SNFs.
- Proven track record of improving patient outcomes and facility performance.
- Comprehensive Support with staff training and resources for seamless integration.
Discover how Carehub's CCM services can transform care for your patients and drive better outcomes for your SNF.