Care Transitions Community Health
Our nurses collaborate with a primary care provider or hospital to decrease the number of preventable hospitalizations and emergency room visits for the low income chronic disease adults. Nurses make home visits with clients and provide screenings, educational material and answer questions.
Chronic Care Management
Our Chronic Care Management program is in partnership with several St. Louis healthcare providers. Faith Community Nurses administer non face-to-face service to Medicare recipients with two or more chronic conditions. Through this program, patients get the best care possible from everyone that is involved – physicians to clinical staff.
Congregational Faith Community Nurse
Nurses collaborate with the congregational or house of worship community in taking steps towards healthy lifestyles. Nurses conduct health screenings, health education classes, group classes and support and make referrals to health agencies near the place of worship.
Health disparities in the St. Louis area are real and have an impact on regions individual and community health. The faith community nurse provides health screenings, education and social service referrals. Nurses serve in areas with great need in food pantries, at community health fairs and group classes.
Senior Health Community Care
Nurses work towards increasing older adults’ knowledge in disease management and leading a healthy lifestyle, properly administering their medications, and keeping them safely and independently in their homes as long as possible.
Read more about programs that DFCNM can provide: