The Greater Lewes Community Village, aka the Village, received a $5,000 grant Feb. 28 for its new Transitional Support Program. Many people, when discharged from the hospital, are unaware of the new behaviors they need to adopt to help avoid returning there. The Transitional Support Program, sponsored by Beebe Healthcare, was designed to reduce readmission rates for elderly adults into their local hospital. The TSP utilizes about 70 Village volunteers to provide non-medical support services to the elderly population who are being discharged and need assistance.
“A lot of people who get discharged from the hospital just need a social connection,” said Steve Gruchacz, TSP intake coordinator.
GLCV Executive Director Jackie Sullivan said, “For many of the patients who return to the hospital, Medicare has run out, home healthcare has ended, and patients are without a dependable support network that would help them to fully recover and become self-sufficient. Who do they call? 9-1-1 becomes the first call many older adults make.”
The TSP will initially consist of five patients for a 90-day period. During that time, Village volunteers will assist recently discharged elderly patients with transportation needs, organization, making schedules, discharge plans, picking up prescriptions, and reducing social isolation. “We do daily check-ins and have face-to-face meetings with the clients,” Sullivan said. “A lot of times, these individuals will have family members that are geographically scattered, and they don’t want to be a burden. That’s why they are continually readmitted, because they have no one to turn to. Use us,” Sullivan urged.
“We are there to help them navigate, to listen to them, to see what might interfere with them getting better,” said Gruchacz.
The Village volunteers will be assisting people who are self-sufficient, meaning those who are at least able to get in and out of a car on their own power. The TSP will also exclusively cater to those dealing with congestive heart failure and those coming from medical-surgical units.
High readmission rates are a nationwide issue, and they can cause the hospitals to be penalized in regard to Medicare payments. “The average penalty assessed to hospitals nationwide will be 0.73 percent,” Sullivan said. “Roughly $564 million in payments were projected to be withheld in 2018.”