Geriatrics and Extended Care - Providence VA Medical Center, Rhode Island
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Providence VA Medical Center, Rhode Island

 

Geriatrics and Extended Care


Geriatrics and Extended Care
401-273-7100 x6129

Geriatrics and Extended Care (GEC) at Providence VAMC provides Home and Community Based Services, which are part of the Veterans Medical Benefits Package under Title 38 U.S.C 1717 and 1720C, to ensure that all enrolled Veterans for whom it is determined by appropriate healthcare professionals that the care is needed to promote, preserve, and restore the health and well-being of Veterans with multiple chronic conditions, life-limiting illness, frailty or disability associated with chronic disease, aging, or injury.

GEC service utilizes a Veteran centered interdisciplinary (NP, RN, SW) care model which focuses on improving the quality of life, minimizing the effect of life-changing disabilities and transformative individualized care using the Holistic Approach. GEC is also supported by other Interdisciplinary team members who repot to other Health Care Groups or Service, such as Physical Therapist (PT), Psychologists, Clinical Pharmacists, and Dietitians.

Gabriel Figueroa, LCSW
Associate Chief, Geriatrics and Extended Care (GEC) Service Line

Thomas Rock,
Administrative Officer
David Faria,
Program Support Assistant


Community Nursing Home (CNH) Program –
(401)273-7100 x 3151/3218

Program Manager: Meghan Farrelly, LICSW

The CNH Program is designed to assist eligible Veterans and their families in making the transition from an episode of hospital or domiciliary care to the community, or to provide indefinite nursing home placement for Veterans who require 24-hour medical care and/or supervision. The primary goals of the CNH Program are to meet the Veteran’s health care needs, provide rehabilitation services with a goal of returning home, and promote the maximum wellbeing of the Veteran.

CNH oversight is provided by an interdisciplinary team, which includes a social worker and a registered nurse. The CNH team provides direct care and advocacy to Veterans and their families, administrative oversight of the CNH facility, conducts annual reviews of contracted facilities, reviews medical records, and visits with the Veteran at the CNH every month. The CNH team also serves as a liaison between VA and State Veterans Home.

Institutional Respite –
(401)273-7100 x 3151/3218

Program Manager: Meghan Farrelly, LICSW

Institutional Respite program offer 24-hour care in community nursing home to family and other caregivers of disabled or ill Veterans who are cared for in their homes.

Outpatient respite programs provide care for Veterans in an outpatient setting, which can include Adult Day Health Care or paying for attendants in the Veteran’s home, so the caregiver can safely attend to other duties or respite outside of the home.


Community Adult Day Health Care (C-ADHC) –
(401)273-7100 x 3151/3218

Program Manager: Meghan Farrelly, LICSW

C-ADHC programs enable elderly and disabled Veterans to reside in supportive home environments rather than in nursing homes and improve the Veteran's quality of life by supporting their caregivers and maintaining the Veteran’s highest level of functioning possible. The program is for Veterans who need skilled services, case management and help with activities of daily living. Providence VAMC provides this service through contracts with local private centers (C-ADHC).

The C-ADHC social worker provides advocacy to Veterans and their families and provides oversight of the care provided at C-ADHC facilities by means of annual inspections, medical record reviews, and contact with Veterans.


Home Based Primary Care (HBPC) –
(401)273-7100 x 6700

Program Manager: Sara Koslosky, BSN, RN, MPH

HBPC delivers intensive primary care in the home for homebound Veterans with a history of or at risk for frequent hospitalization due to ambulatory care sensitive conditions. This service provides Veterans with intensive clinical oversight, individual care coordination and chronic disease care management to help keep Veterans safe at home, decrease hospitalization, and the need for institutionalization.

  • Disease & medication management by a nurse practitioner
  • Care management by a registered nurse
  • Coordination of services and resources by a social worker
  • Rehabilitation services by PT and OT
  • Mental health services by clinical psychologists
  • Nutrition counseling by a registered dietician

Homemaker/Home Health Aide Program
(401)273-7100 x 6792

Program Manager: Danielle Domingoes, LICSW

The goal of H/HHA Program is to provide family caregivers and other informal social support systems assistance with the demands of daily care, thereby decreasing caregiver burden and supporting the Veteran’s desire to delay or prevent nursing home placement. A Homemaker or Home Health Aide is a trained person who comes to a Veteran's home and help the Veteran with their daily activities. This program is for Veterans who need skilled services, case management and help with activities of daily living.


Home Respite –
(401)273-7100 x 6792

Program Manager: Danielle Domingoes, LICSW

The Respite Program is designed to give caregivers of Veterans a break from day-to-day care giving responsibilities. The program is for Veterans who need skilled services, case management and help with activities of daily living. The goal is to improve the quality of life for both the Veteran and caregiver, by providing relief and support to caregiver who are at risk for caregiver burnout.

 

Hospital in Home (HIH) –
(401)273-7100 x 6108

Program Manager: Amy Putnam, MSN APRN-BC CNP

HIH is a VHA program which provides short term acute care to Veterans in their homes. The intent of the program is to avoid hospital admission, shorten hospital length of stay and prevent readmission to the hospital. The HIH team is interdisciplinary with physician, nurse practitioner, registered nurses, social work and pharmacist. Care is individualized based on patient diagnosis and treatment plan and can range from 10 days to several weeks.

  • Initial assessment within 24 hours of discharge from hospital
  • Daily oversight of all home visits
  • Access to HIH team 24/7
  • Access to laboratory tests, EKG, IV medications in the home
  • Complex wound care
  • Comprehensive cardiopulmonary assessment and teaching
  • Collaboration with other VA clinics and departments to provide Veteran-centered care

Hospice/Palliative Care –
(401)273-7100 x 2000/1468

Palliative Care Coordinator: Kristin Hogan, Nurse Practitioner
Palliative Care Social Work Coordinator: Susan Cesaro, LICSW, ACHP-SW

The Hospice and Palliative Care team provides supportive care for Veterans and their families with advanced illnesses and the terminally ill. The focus of care is a collaborative approach by providing education and support to address quality of life including symptom management/comfort and goals of care conversations.

The team works closely with physicians, nurses, care-coordinators, social workers and chaplains to implement a treatment plan that addresses the physical, emotional, social and spiritual needs of the patient and their families. The team currently provides care to Veterans on both, inpatient and outpatient basis, and making referrals to community agencies as needed.




Contact Info

Location

  • PVAMC Campus - Trailer 34

Contact Number(s)

  • 401-273-7100 Ext. 6129

Hours of Operation

  • 8 a.m. - 4 p.m.