We are a collaborative group practice of Board Certified Physicians and NP's that specialize in Post Hospitalist Medicine (Internal, Geriatric and Physical Medicine/Rehabilitation). Services are provided exclusively “On-Site” as Attending Physicians, Nurse Practitioners and Medical Directors for patients residing in post-acute and LTC settings. Our practice focus is to provide uncompromising medical support to meet the ever increasing, daily needs and demands of the high-risk, medically complex and chronically ill patient. Services include: - Regularly scheduled daily “On-Site” hours in facilities. - Provide initial first visit and care plan within 24 hrs of hospital discharge. - Visit unstable patients 3-5x per wk. (daily if clinical condition requires). - Stable patients visited 2x per mo. (or more as medically necessary). - Conduct follow-up visits as needed. - Prompt assessments, and reviews of med, lab, therapy and other recommendations. - Prompt orders/development of treatment plans. - Attending to acute and chronic problems/condition changes presented daily. - Collaborate with other providers to deliver the finest continuity of care for patients. - Meet with patients and family's as needed. - Participate in care plan and QI meetings as needed. Our practice was started in 1983, and today, our highly specialized service delivery model is recognized as the leading physician care model for today's geriatric, and chronically ill patient.