What is it: A comprehensive service, including:
- In-home assessment to identify needs
- Development of an individual care plan
- Referral to and coordination of community services (including the type of services Ross Heath Care provides)
- Monitoring of the effectiveness of services
Who can make a referral: Anyone. A physician, hospital, discharge planner, nurse, social worker, family or the patient can make a self referral.
Payment: Varies according to services provided
Rural Oklahoma can be challenging when it comes to knowing available resources offered in small communities. Ross Heath Care is well versed in numerous community resources available such as Advantage, nutrition sites, OASIS-Respite Voucher Program, Medicare Coverage, long-term care placement and many, many more.