It’s widely believed that treating the frailest seniors where they currently live—whether that’s in their home of 50 years or in a newly-built skilled nursing facility—can help them avoid unnecessary hospitalizations.
Landmark Connect, the latest initiative from Buffalo, New York-based in-home medical care provider Landmark Health, certainly subscribes to this way of thinking. The business, like that of its multi-state parent company, provides medical care to “the sickest of the sick” seniors living in all sorts of settings—from skilled nursing facilities and assisted living communities to independent living communities and continuing care retirement communities (CCRCs).
Still, despite caring for seniors in their homes, Landmark insists it’s not providing home health care. In fact, neither Landmark Health nor Landmark Connect are setting out to directly compete with local home health care agencies. Instead, they hope to bolster the home health care industry by serving as valuable referral partners.
Natural home health partner
Landmark Health has offered round-the-clock medical care to seniors in their in the homes since approximately October 2014. As part of their business, qualified seniors belonging to certain health plans in a variety of places—including New York state; Portland, Oregon; Seattle and Spokane, Washington—can summon a Landmark doctor or physician’s assistant directly to their homes for a pre-planned appointment or for urgent care.
Landmark’s service is much more like a house call than home health, Janet Evoniuk, national vice president of clinical services and program development at Landmark Connect, told Home Health Care News.
“We are not home health,” Evoniuk said. Landmark does not, for instance, regularly send nurses into patients’ homes. Instead, Landmark can help determine when patients should start using home health services and get them set up so that this is accomplished in a timely manner.
“We refer patients to home health and partner with home health agencies,” Evoniuk explained.
Landmark physicians often visit seniors who have recently been discharged from a skilled nursing facility or hospital, she added. In those instances, the physicians help the seniors understand their medication regimens and create a plan to guarantee that they remain healthy at home. That plan could very well include home health.
Recently, Landmark Health launched Landmark Connect, an initiative that brings Landmark primary care doctors to seniors who no longer live in their homes, but instead live in skilled nursing facilities, independent living communities, assisted living communities and CCRCs.
“Some of the patients who were assigned to [Landmark Health] were living in nursing homes,” Evoniuk said. ”We had providers go in and see them there … and before long they were asking, ‘Can you see all the patients in the facility?”
As part of Landmark Connect, Landmark care teams are embedded into these care facilities to “focus on each facility’s gaps in quality,” Evoniuk said. This, inevitably, looks different in different facilities.
“In some facilities we’re taking over full medical management, and we’re there eight hours a day,” she said.
By embedding a Landmark care team in a facility, Landmark doctors can build meaningful relationships with residents, staff and families, as well as quickly identify any changes in residents’ conditions.
Though Landmark Health has achieved “dramatic reductions in hospitalizations,” it’s too early to share results from Landmark Connect, Evoniuk said.
Written by Mary Kate Nelson