Post Acute Care

Patient with Healthcare Nurse

  In striving to meet the total health and wellness needs of every patient that we serve, New Era Healthcare provides post-acute care services to patient of all ages within 48 hours and up to 30 days of being discharged and are transitioning to their home from the following acute and sub- acute care settings:

  • Hospitals and Medical Centers

  • Long Term Care and Skilled Nursing Facilities

  • Inpatient Rehabilitation

  • Emergency Room Visit

  • Long Term Acute Care Hospital

Our post-acute care services team includes nurse practitioners, medical assistants, and a care coordinator that provides post-acute follow up care for all conditions that required an acute, short-term, and/or long term facility stay 7 days a week in the home and/or place of residence in Central Virginia.  Our post-acute care services include:

  • Comprehensive Health Status Assessment

  • Transitional Care Management

  • Acute Health Condition Specific Monitoring and Counseling

  • Primary and Specialty Care Facilitation and/or Referral

  • Home and Community Based Supports Facilitation and/or Referral

  • Occupational Health and Return to Work Assessment 

  • Daily Living Activities Assessment

  • Home Modification Referrals

  • Assistive Devices Referrals

  • Home Health Referrals

  • Complex Care Management and Coordination

  • Care Coordination and Management

  • Medication Counseling and Review