Transitional Care Programs

Population Health at Home Transitional Care Program

Population Health at Home provides a level of assurance that the medical care and attention you received in the hospital does not stop but continues after you are discharged.

Our team of board-certified advanced practice providers come to your home to review and manage your medical, social and behavioral needs. We take a patient-caregiver centered approach by including you and your caregiver in creating your post-discharge plan.

The team will update your primary care provider on your status and plan of care following the initial visit and continue to communicate and collaborate as needed. Our in-home providers may manage your care for up to 30 days with the primary goal being a safe transition back to your primary care provider

Our advanced practice providers will work with you and your caregiver to:

• Review your discharge instructions and plan.
• Discuss your medications with you and make changes as needed.
• Review how you have been feeling since discharge and address any new or worsening symptoms.
• Perform a physical exam.
• Order any blood work or tests you may need after discharge.
• Stay in constant communication with your doctor/provider about your care and health.
• Work with you on how you can self-manage your condition to increase your independence and effective coping.
• Provide emotional counseling to you and your caregiver.
• Identify challenges that could interfere with your ability to best care for yourself and help find resources to assist you.

Am I eligible for an in-home primary care provider?

You may be eligible for in-home provider services visits if you have:

• A chronic disease or illness that affects your health and daily activities.
• Difficulty attending office visits with your primary care provider due to the severity of your illness or health condition.

You do NOT have to be home bound to be eligible for in-home services.

For questions or more information, call us at 856.382.6686.

Population Health at Home Primary Care Program

The Cooper Population Health at Home team delivers high quality care to you in your home. We will provide you with preventative, comprehensive and compassionate care to improve your health and well-being while keeping you in the comfort of your own home.

Our team of board-certified Advanced Practice Providers (APPs) come to your home to review and manage your medical, social and behavioral needs. We take a patient-caregiver centered approach and include you and your caregiver in creating your treatment plan. 

The APPs will communicate and collaborate with your care team on your status as needed. Our in-home APPs apply their clinical expertise in diagnosing and treating your health conditions with emphasis on disease prevention and health management, with a personal touch.

Our Advanced Practice Providers will work with you and your caregiver to: 

• Perform a patient history and physical exam.
• Develop an individualized treatment plan.
  • Deliver preventative care and provide education on health and wellness.
  • Manage health conditions with pharmacological and non-pharmacological therapies.
  • Order any blood work or test you may need.
• Work with you on how you can self manage your condition to increase your independence.
• Provide emotional counseling to you and your caregiver.
• Identify challenges that could interfere with your ability to best care for yourself and connect you with resources to assist you. 

Am I eligible for an in-home primary care provider? 

You may be eligible for in-home provider services visits if you have: 

• A chronic disease or illness that affects your health and daily activities.
• Difficulty attending office visits with your primary care provider due to the severity of your illness or health condition. 

You do NOT have to be home bound to be eligible for in-home services. 

For questions or more information, call us at 856.382.6686.

Patient Testimonials

“Our home visit was so helpful. The Nurse Practitioner answered all my many, many questions and was so thorough. The office staff were more helpful than anyone we have ever talked to about what to do next. With us being in our 90s this made our discharge so much smoother than past hospital stays and makes us feel so much more comfortable knowing these services are available.”

“All the nurses are excellent. They have good experience and explain everything to me, also very kindly. I am here to say, thank you very much to all of the nurse practitioners.”