Onsite Senior Health Care
Caring for seniors across the community
Planning care for loved ones and neighbors in assisted living and skilled nursing facilities can be difficult and often confusing. That’s why we have an in-house Community Care Team dedicated to visiting our senior patients at a number of facilities throughout Northern Colorado. This designated team of medical providers, nurses, pharmacists, and care coordinators offers attentive, compassionate, onsite senior health care services to help patients experience individual wellness and a greater quality of life.
Why onsite senior health care?
Seniors in assisted living and skilled nursing facilities are more vulnerable to certain diseases that can have serious impacts to physical, mental, and emotional health. Yet it can be incredibly difficult for them to visit primary providers in offsite clinic locations. By offering community-based services for seniors right at assisted living and skilled nursing facilities, AFM is able to proactively prevent and detect harmful conditions. Our medical professionals and care coordinators on our Community Care Team deliver the personalized care older individuals need and deserve.
Better communication between providers, patients, & family
Reduced patient travel for office visits
Coordinated care for medical, mental, & emotional needs
Less stress for everyone involved in the patient’s care
- Services at assisted living facilities
- Services at independent living facilities
- Services at skilled nursing facilities
- Services at memory care units
Services at assisted living facilities
- Assess acute, medical, and psychosocial care needs
- Follow up after hospitalization or rehabilitation stay in skilled nursing facility for transitions of care
- Coordinate care and follow up with primary care provider and specialists
- Administer immunizations as needed
- Work closely with patients and their families to create a medical plan of care that encompasses both medical and emotional needs
- Assess the safety of patients’ living situations; assist patients and families with transition into higher levels of care when needed
- Assess patients who have physical limitations or memory deficits that limit travel to clinic and communicate with family to discuss findings and changes in patient’s plan of care
- Discuss advance care planning including MOST forms, living will, and POA documentation
- Conduct home visits for homebound/hospice patients as needed
- Collaborate with the staff geriatrician for complex geriatric patients
- Provide routine weekly & monthly visits to patients – including Coumadin management and INR checks
Services at independent living facilities
- Assess acute, medical, and psychosocial care needs
- Follow up after hospitalization or rehabilitation stay in skilled nursing facility for transitions of care
- Coordinate care and follow up with primary care provider and specialists
- Administer immunizations as needed
- Work closely with patients and their families to create a medical plan of care that encompasses both medical and emotional needs
- Assess the safety of patients’ living situations; assist patients and families with transition into higher levels of care when needed
- Assess patients who have physical limitations or memory deficits that limit travel to clinic and communicate with family to discuss findings and changes in patient’s plan of care
- Discuss advance care planning including MOST forms, living will, and POA documentation
- Conduct home visits for homebound/hospice patients as needed
- Collaborate with the staff geriatrician for complex geriatric patients
- Provide routine weekly & monthly visits to patients – including Coumadin management and INR checks
Services at skilled nursing facilities
The medical professionals and care coordinators on our Community Care Team serve long-term care and rehab patients at skilled nursing facilities throughout the Northern Colorado community. Our services and care for patients in these facilities include:
- Enhanced communication with patient’s primary care provider while they’re in the facility
- Assisting with transitions of care in all settings, including hospitals, rehab, long-term care, as well as assisted and independent living
- Providing routine weekly and monthly visits to patients in rehab, skilled nursing, and memory care units, including Coumadin management and INR checks
- Coordinating services with community resources or specialists
- Communicating with families regularly about their loved one’s status and updates
- Coordinating assistance with our licensed clinical social worker for complex levels of care, advanced care planning, and transitions of care when needed
- Administer immunizations as needed
Services at memory care units
- Assess acute, medical, and psychosocial care needs
- Follow up after hospitalization or rehabilitation stay in skilled nursing facility for transitions of care
- Coordinate care and follow up with primary care provider and specialists
- Administer immunizations as needed
- Work closely with patients and their families to create a medical plan of care that encompasses both medical and emotional needs
- Assess the safety of patients’ living situations; assist patients and families with transition into higher levels of care when needed
- Assess patients who have physical limitations or memory deficits that limit travel to clinic and communicate with family to discuss findings and changes in patient’s plan of care
- Discuss advance care planning including MOST forms, living will, and POA documentation
- Conduct home visits for homebound/hospice patients as needed
- Collaborate with the staff geriatrician for complex geriatric patients
- Provide routine weekly & monthly visits to patients – including Coumadin management and INR checks
Meet our Community Care Team
Physicians
Dr. Mark Unger, CCT Medical Director
Nurse Practitioners
Joe Kauffman, NP
Melanie Vanhook, FNP-C
Lindsay Conway, FNP-C
Nurses
Rhonda Lund, LPN
Anna Robertson, RN
Care Coordinators
Shauna Flowers, MA
Erin Trebon, LCSW
Katie Rice, MSW
Pharmacists
Jill Mullendore, PharmD
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