Family Medicine: Obstetrics to Geriatrics

Hospital Medicine: ER/OR, MedSurg, ICU

Office Medicine & House Calls

Long-Term Care: NF/SNF/ALF/Boarding Homes

Founder and Chairman of Network of7 Assisted Living Homes for low-income elders

Medical Director, Cove's Edge Nursing Home

Founder, Full Circle America

Author, “Alone and Invisible No More”

My Journey

Our Goal is to transform the delivery of healthcare from a hospital-centric, facility-predominant fragmented system to a person-centric, at-home, coordinated support system.

We support elders and those with disabilities with a circle of caring and purposeful living

To help all individuals live independentlyTo provide peace of mind for their families To help each community tap their 'hidden resources' To make chronic care management better and affordable

FULL CIRCLE AMERICA The Best HomeCare Service Program

90% of seniors surveyed want to age in their own homes yet adequate home-based and community-based services are limited in most communities.

53% admitted to a nursing home died in 6 months; the median survival for males was only 3 months!(Journal of American Geriatrics Society 8-24-10)

Among elders needing care: 60% live in their own homes, 31% live with family or close friends, 5% live in nursing homes, and 4% live in assisted living (AARP)

Loneliness among elders increased functional decline by 59% and rate of death by 45%. ( Archives of Internal Medicine June 18, 2012)

60% of all nursing home residents NEVER

have a visitor.

People

Full Circle America Dr. Chip Teel

Empowered members. Doing for others. Circle of Caring.Reconfigured resources.

AttitudeGoals and aspirations. Dignity of Risk. Family, pets, interests.Purposeful living.

TechnologyTools. Easy to use. Affordable. Access. Making connections. Reducing loneliness.

At Home Support with Social Connections

The Dignity of RiskTo experience life fully, you need the opportunity to succeed or fail.

To offer less is to deprive an individual of the ability to grow.

Permission to Live At Home: Less organized, routines vary tremendously or take longer, but potential for a richer quality of life is a risk worth taking. Fosters independence and promotes empowerment.

Goals and Aspirations/ Purpose: Empower each member to live life to the fullest, engaged in family and in community. Awaken dormant personal interests. Encourage new ones. May have been years since they dared to dream that the future held promise for them.

FULL CIRCLE AMERICA: CHRONIC CARE KIT

Talking Scale Medication Reminder Blood Pressure Cuff

Pulse Oximeter Peak Flow Meter Pedometer/ FM Radio

Chronic Care/ Telemedicine Visits

High quality real time video conversation with your health care professionals from the convenience of your own home Easy to use interface for patient exam, prescriptions, and referrals Works with HL7 compliant and CCHIT compliant EMRs Encrypted data, secure connections, and HIPPA compliance of all patient data Daily vital sign collection supported by phone calls and video Simple medical devices for you and your physician to manage your chronic care Medication reminders by phone or programmed pillbox Caregiver app for instant communication between FCA and your family & care team Web-based secure personal health record (PHR) and 'Circle of Caring' logbook with alerts and data displays

LIVING LONGER. WHO PAYS?Senior Actuarial Table (Fidelity Investments)

The Elder Cost Cascade30MM annual US ER visits are people over 65Average Cost of these ED visits is $2168Half of >65 year-olds in ED admitted to HospitalAverage Length of Stay in Hospital for >65 is 5.4 days at $2100/day

40% of >85yo and 30% of all hospitalized Medicare patients go to SNFAverage Stay in SNF is 29 days at $423/day

NH admissions at $83400/yr: 1/3 from hospital, 1/3 from SNFs/ ALFs, and 1/3 from home

Congressional Medical Advisory Group estimates 60% of ED visits and 25% admissions unnecessary if more home-based services available.

FCA Program total healthcare systems savings estimated at 40%.

Private DutyCare

Nursing HomeCare

Assisted Living FCA

$15,000

$6,000

$10,000

$6,000

$10,000

FCA Package Includes$350- FCA Tech Support$800- Rent Mortgage$750- Personal Care$200-Food$250- Utilities$160-Nursing

$2510

Monthly Costs

BETTER CARE TRANSITIONS = FEWER READMISSIONS

20% MEDICARE PATIENTS READMITTED <30 DAYS = 2.6M COSTING $28B/ YEAR• HOSPITALS W/ HIGH READMISSIONS RECEIVE REDUCED OVERALL MEDICARE PAYMENTS

• READMISSIONS HIGHEST W/ FRAGILE SUPPORT SYSTEMS,– ISSUES W/ HOUSING– NO TRANSPORTATION FOR FOLLOW-UP CARE– LIMITED SUPPORT– LOW HEALTH IQ– CHRONIC MEDICAL AND MENTAL HEALTH CONDITIONS – POOR CARE TRANSITIONS.

• EFFECTIVE CARE TRANSITION ELEMENTS: PATIENT-CENTERED CARE PLAN; INCREASED PATIENT INVOLVEMENT IN SELF-CARE, ENGAGING FAMILY IN TRANSITION, AVAILABILITY OF MEDICAL AND SOCIAL SERVICES, COMMUNICATION BETWEEN PROVIDERS, MED RECONCILIATION, DELIVERY OF DME, TRANSPORTATION ENSURED FOR MEDICAL FOLLOW UP

Full Circle America

Building the “Stay at Home Network” around You

We help you age at home with a High Tech, High Touch approach to elder care. Using available community resources, including family, friends and technology, we build a network of support around our members.

Social NetworkingPeer-2-Peer CallingCommunity OutingsCompanion VisitsVideo Calling

Chronic Disease ManagementBP/ Weight/ O2 Sat / Peak FlowDiet/ Exercise

Remote MonitoringVirtual Check Ins24/7 Family Access

Call ButtonQuick Call to FCA24/7 On Call

Physical and Mental HealthExerciseEntertainmentEducationCompanionship

Support ServicesShopping/Errands/TransportationHome Modification/RepairsMeals/Housekeeping Adaptive Devices

Medical SupportHome Health PersonnelVirtual House CallsHospital At-HomePCPs/PCMH/Hospital/SNF

Full Circle America MEMBER

© Full Circle America 2014