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Care transitions for COVID-19 patients

Through the new Healing@Home Care Transitions Program, the Area Agency on Aging is providing COVID-19 discharged patients with comprehensive care when transitioning to their home environment.

Healing@Home will focus, for a period of 30 days from discharge date, on providing COVID-19 discharged patients with timely access to in-home social support services and psychosocial support services that are of greatest need including:

  • Home-delivered meals
  • Telephone reassurance calls
  • Assistance with prescription pick-up or delivery
  • Arrangement of follow up visits with primary care providers
  • Reinforcement of discharge plan instructions

Eligibility is limited to individuals age 60 or older and those age 18-59 with disabilities who are discharged following a COVID-19 diagnosis.

Area Agency on Aging invites healthcare workers and case managers to refer eligible patients discharged from hospitals, rehabilitation facilities or skilled nursing facilities with a COVID-19 diagnosis to the Healing@Home Care Transitions Program for COVID-19 patients.

To refer patients, call the 24-Hour Senior HELP LINE at 602-264-4357. For additional program information, contact Christine Liberato, VP Program Development at 602-264-2255 ext. 266 or email her at Christine.Liberato@aaaphx.org.