- Are you need support getting the healthcare and social services you need?
- Do you frequently end up in the Emergency Room because you don’t have a provider?
- Do you have trouble remembering your appointments or have a hard time getting there?
- Are you in need of a safe, healthy place to live?
If you answered yes to any of these questions, you may benefit from Glens Falls Hospital’s Community Care Coordination Program.
Our Community Care Coordination Team continues to serve the highest need adults and children, providing everything from chronic disease management and behavioral health support, to linkages with community services, such as housing and transportation. Our Care Coordinators participate in rigorous trainings to ensure appropriate care for our most vulnerable populations.
Along with our Community Care Coordinators we also have a team of Embedded Care Managers who are Registered Nurses that work collaboratively with your provider at the Glens Falls Hospital Health Centers The primary goals for the embedded nurse care managers include chronic disease management and avoidance of hospital readmissions.
Our Care Manager provide Longitudinal Care Coordination to support improved health outcomes for patients of our regional Medical Centers, most notably completing risk stratification to prioritize our highest risk patients.
Every month, our team works with more than 1,000 adults and youth to support improved health for individuals and families in our region.
Our Care Team can:
- Assist in finding a primary care provider or specialist
- Assist in finding transportation to and from medical appointments
- Help to keep track of your appointments
- Help to avoid visits to the emergency room by keeping you healthy
- Assist in obtaining the medical care and social services you need (such as food, benefits, and housing)
- Empower you to get involved in activities that improve your overall well-being
- Assist in managing crises in your life
Our goal is to ensure that you receive the services you need to stay healthy and active in the community.
"The moment my husband, mother and I walked into the Cancer Center I knew this was the place I was meant to be. Vickie was a tremendous help to us in our darkest days. I then went on to meet with Dr. Stoutenburg. I knew the moment I met him that he was the one who was going to save my life."