home visit general physician

In-Home Primary Care Services

Say goodbye to crowded waiting rooms and long commutes. In-home primary care brings the doctor’s office to you! Experience personalized medical care in the comfort and safety of your own home. Perfect for those with chronic conditions or limited mobility, our expert team is here to make your healthcare journey as convenient and stress-free as possible.

What is Home-Based Primary Care?

Home-based primary care offers specialized medical services like physical exams, medication management, and wound care in the comfort of patients’ homes. This type of care is designed for patients who have difficulty traveling to a traditional doctor’s office due to limited mobility, chronic illness, or other factors. This approach to healthcare allows for a more personalized and patient-centered approach, improving patient outcomes and overall quality of life.

Our In-Home Primary Care Team

Our primary care providers deliver a wide range of medical services ensuring your well-being and convenience. We understand the importance of continuity and personalized attention, which is why our providers take the time to develop strong relationships with our patients, fostering trust and open communication.

Our in-home primary care physicians offer personalized medical care with a compassionate approach. They bring expertise, attentive listening, and a holistic perspective to ensure comprehensive and quality medical attention in the comfort of your home.

Intake Coordinators

Our intake coordinators are the caring first point of contact, guiding you through the process of initiating in-home primary care services. With empathy and efficiency, they gather essential information, listen to your needs, and ensure a smooth transition.

Care Coordinator

Our in-home primary care coordinators provide medication support, schedule medical appointments, offer patient education, and ensure seamless communication with medical professionals and family members.

Social Workers

Our in-home primary care social workers play a vital role as empathetic allies, offering emotional support and practical assistance to you and your family during challenging times. They provide a nurturing presence, understanding your unique circumstances, and connecting you with community resources.

Registered Nurse

Our registered nurse plays a vital role in in-home primary care, providing skilled medical assistance, administering medications, monitoring health conditions, coordinating care plans, and offering valuable education and support to patients and their families.

Scheduling Coordinators

Our scheduling coordinators are meticulously organizing appointments and ensuring that you receive timely and attentive medical attention in the convenience of your home.

Our In-Home Primary Care Services

Ennoble Care is committed to providing high-quality primary care services in the comfort of your own home. From house calls to chronic care management, we are committed to delivering compassionate and exceptional healthcare for you and your loved ones. Learn more about our in-home primary care services.

Our housecall services bring comprehensive healthcare directly to your doorstep, ensuring well-being and convenience in the comfort of your home.

Chronic Care Management

Our in-home chronic care services prioritize personalized healthcare, monitoring conditions, crafting care plans, and engaging patients for optimal health outcomes.

Behavioral Health Services

Our in-home behavioral health services address the interplay of mental, emotional, and behavioral well-being, promoting optimal mental health and overall wellness.

Remote Patient Monitoring

Through remote patient monitoring, we collect and analyze vital health data at home, enabling timely interventions and personalized care for improved outcomes.

Primary Care Medication Management

Our comprehensive primary care medication management optimizes health through reconciliation, monitoring, education, and empowerment for improved adherence and well-being.

Telemedicine Visits

Revolutionizing primary healthcare through our secure virtual consultations and personalized treatment plans to provide easy access to medical expertise

Common Conditions We Treat

Our in-home primary care addresses a wide range of common conditions, ensuring personalized medical attention for our patients. From managing chronic illnesses to providing support for pain management, our dedicated team of healthcare professionals ensures comprehensive and personalized care to enhance your well-being at home.

Treating diabetes through comprehensive support, personalized management, and valuable education

Enhancing mobility and quality of life for individuals with arthritis through our comprehensive care approach

Hypertension

Promoting optimal health and well-being through specialized care and management strategies for hypertension

COPD and Asthma

Improving quality of life for COPD and asthma patients through personalized care and effective treatment

Alzheimer’s / Dementia

Providing tailored strategies to mitigate health risks and improve overall well-being for individuals impacted by obesity

Cardiovascular Disease

Treating cardiovascular disease through comprehensive care, interventions, and lifestyle modifications

Chronic Kidney Disease

Offering comprehensive support and management strategies to improve quality of life for individuals with CKD

Our In-Home Primary Care Providers

With a focus on personalized attention, our primary care providers deliver a wide range of medical services, from routine check-ups and preventive care to chronic disease management, ensuring your well-being and convenience. We understand the importance of continuity and personalized attention, which is why our providers take the time to develop strong relationships with our patients, fostering trust and open communication.

Our In-Home Primary Care Service Areas

We believe in accessible high-quality healthcare for all, regardless of location. Our dedicated teams serve multiple communities, familiar with their unique needs, ensuring personalized and compassionate in-home primary care services. We are committed to continuing our mission of comprehensive care for those in need.

Primary Care Patient Testimonials

Discover heartwarming stories in our testimonial section. Hear from satisfied patients and families who share their experiences of compassionate care and the positive impact our services have had on their lives.

“ Your professionalism, your subject knowledge, and your commitment to doing things the right way is so refreshing. I couldn’t let the day pass without giving you a short note. Thanks so much for being our healthcare professional. We have had the best experience with Ennoble Care.”

“ I wanted to let you know how much I appreciate your agency’s work. From the staff’s patience in helping in scheduling appointments to quickly processing any essentials regarding my mom. Every phone call was handled in a pleasant and supportive manner. It was obvious it wasn’t just a job to my mom’s provider but how she invested in my mom’s welfare. Simply you just need to know how wonderful our provider is. Her soft caring voice and engaging demeanor always put my mom at ease.”

“ My parents moved into the Memory Care section of an Assisted Living Facility after leaving their home of 55 years. Dad declined from having dementia and after a bout with pneumonia this summer, returned to their AL Facility with the FABULOUS care of ENNOBLE! We as a family are so very grateful for the top-quality care given to our Dad! The staff is simply AMAZING and we are so impressed with their care and compassion.”

Benefits of Primary Care at Home

• Personalized attention and tailored care
• Convenient and comfortable, eliminating the need for travel
• Continuity of care and long-term patient-provider relationships
• Enhanced communication and patient-centered approach
• Comprehensive services for holistic healthcare
• Improved quality of life, independence, and emotional well-being

Primary Home Care FAQs

Our FAQs can address any questions you may have about our in-home primary care services. We are committed to providing you with the information you need to make informed decisions about your healthcare journey.

At Ennoble Care, we provide in-home primary care services to patients who have difficulty traveling to a doctor’s office or who prefer to receive care in the comfort of their own homes. Our services are available to patients of all ages who have chronic conditions, disabilities, or mobility issues that make it difficult to receive care in a traditional setting. Contact us today to learn more about our eligibility criteria and to schedule an appointment.

Ennoble Care accepts Medicare and most commercial insurances. As part of our patient enrollment, our awesome intake team will review your insurance policy and confirm whether Ennoble Care accepts your policy. Contact us today to begin patient enrollment and to schedule an appointment.

Our physicians and nurse practitioners approach each patient with the unique care that they deserve. Through regular home visits and a proactive approach to coordination of care, we can monitor and maintain the health and well-being of our patients, keeping them healthy at home.

We offer a wide range of complementary programs as part of our primary care services, including chronic care management (CCM), remote patient monitoring (RPM), behavioral health support (BHI), and more.

Get Started with Primary Care at Home

Ready to experience the Ennoble Care difference? Contact us today to learn more about our home-based primary care services. Our experienced team is here to answer any questions you may have and help you take the first step toward receiving the high-quality care you deserve.

Don’t wait – let us show you how we can support your health and well-being today!

Look out for your health

A UnitedHealthcare® HouseCalls visit is a no-cost, yearly health check-in that can make a big difference. 

Call 1-866-799-5895 ,

TTY 711,  to schedule your visit.

HouseCalls brings yearly check-in care

To you at home.

Connect for up to a full hour of 1-on-1 time with a licensed health care practitioner. Every visit includes a physical, tailored recommendations on health care screenings and plenty of time to ask questions that matter to you.

After your visit, HouseCalls connects with your primary care provider (PCP) to help keep them informed about your health. It's a great way to feel confident knowing an extra set of eyes is looking out for you between regular PCP visits.

What is a HouseCalls visit? 

[Text On Screen – SAY HELLO TO HOUSE CALLS]

Say hello to HouseCalls.

[Text On Screen- PAID ACTOR PORTRAYAL.]

HouseCalls is our way of looking out for your health, so you can focus on your future. Here’s what it’s all about.

[Text On Screen – HERE’S WHAT IT’S ALL ABOUT]

Once a year, a licensed health care practitioner can come to your home to spend up to an hour with you on your health and wellness.

[Text On Screen- EASY, CONVENIENT, INFORMATIVE]

It's designed to be easy, convenient and informative.

[Text On Screen- HEAD-TO-TOE EXAM]

[Text On Screen- IMPORTANT HEALTH SCREENINGS]

[Text On Screen- HEALTH GOALS DISCUSSION]

You'll get a head-to-toe exam, important health screenings and plenty of time to talk about your health goals.

We'll also provide guidance on managing your health and if you need it, give you referrals for other health plan resources and services.

HouseCalls is a great way to stay on top of your health between regular doctor's visits.

At the end of your visit, you'll get a personalized checklist so you can feel more confident in what to discuss with your regular doctor.

[Text On Screen- COST? NO EXTRA COST TO YOU]

[Text On Screen- INCLUDED IN YOUR HEALTH PLAN]

If you're wondering how much all of this is going to cost, the best part is, there is no extra cost to you. It's included in your health plan.

[Text On Screen- HOUSECALLS VIDEO VISITS ARE NOT AVAILABLE WITH ALL PLANS.]

A HouseCalls visit takes place in the comfort of your own home or by video if you prefer.

So, say hello to HouseCalls and invite us in for a visit today.

[Text On Screen – SAY HELLO TO HOUSE CALLS TODAY]

Access one of the most popular UnitedHealthcare offerings, at no cost to you

Schedule your visit

Call 1-866-799-5895 , TTY 711

Monday–Friday, 8 a.m.–8:30 p.m. ET

Your in-home health check-in

• Up to a full hour with a licensed health care practitioner
• Ask the questions that matter to you and get valuable health tips
• No cost — it's included in your health plan

Get rewarded

Meet your friendly housecalls medical staff.

Just like the professionals you see in your regular doctor’s office, our licensed health care practitioners may be nurse practitioners, physician assistants or medical doctors. They’re state licensed and maintain national certification.

We perform background checks on these professionals to provide additional peace of mind for our members. Your loved ones, caregivers or friends are welcome to be present during the visit — it’s up to you.

Ready to open the door to better health?

Getting ready for your housecalls appointment, tips to help you prepare:  .

• Wear shoes that are easily removed to have your feet checked
• Make a list of upcoming appointments with your PCP and specialists
• Make sure all of your medications, both prescription and over-the-counter vitamins and supplements, are in their original bottles for our review
• If you record blood pressure readings, please have your results available for review
• If you have diabetes, please have your blood glucose meter handy
• Make a list of questions and concerns you’d like to discuss

During your appointment

• You'll have up to a full hour of 1-on-1 time with your health care practitioner for a physical, select lab tests, health screenings and more
• A HouseCalls visit can be completed while sitting at your kitchen table or in the living room, and you can use the time to ask any health-related questions
• The visit is tailored to your individual needs, so screenings and conversation topics can vary

After your appointment

Less travel time. more face time..

Think of HouseCalls as an extra layer of care — valuable 1-on-1 time you don't always get in the doctor's office. And it's tailored to your individual needs.

Schedule today

To secure your spot, call us at  1-866-799-5895 , TTY 711

Have a question?

Find answers to frequently asked questions.  

If you have a specific question about your upcoming appointment or need to reschedule, call us at 1-866-799-5895, TTY 711 , Monday–Friday, 8 a.m.–8:30 p.m. ET

We're here to help.  

There was a time when doctors treated patients in their own home. This old-fashioned care matched with new medical technology is here again. At HouseCall Primary Care, we serve homebound patients wherever home may be...a patient's house, a nursing home, or assisted living. Our team of providers stay with our patients wherever they go.

HouseCall Primary Care offers these general areas of specialty. Select one of the services below to learn more.

House Call Doctor Visits Make Life Easier for Seniors and Caregivers

Important: This is an informational article to explain how house call doctor visits can benefit seniors. DailyCaring isn’t a medical organization, we aren’t medical professionals, and we aren’t affiliated with any healthcare organizations. We aren’t qualified to respond to any medical questions.

House call doctor visits benefit older adults and caregivers

Getting your older adult to the doctor’s office for an appointment can be difficult or sometimes impossible.

Whether they’re frail, can’t walk on their own, or have Alzheimer’s or dementia , getting out of the house is hard on both of you. Going to a doctor’s office can also expose seniors to germs or harsh weather.

We explain what a house call doctor is, what type of insurance they accept, how to find one, and what to look for in terms of services.

What is a house call doctor?

Today, many doctors are bringing back the old practice of visiting patients in their homes. With house calls, older adults don’t have to go through the stress and difficulty of getting to the doctor’s office. And neither do you.

Another bonus is that these doctors usually spend more time with patients. You won’t have to fit all your questions into a 15 minute visit.

Do they accept Medicare?

Yes, many house call doctors accept Medicare , private insurance, and sometimes Medicaid . It usually costs the same as a regular office visit.

But every house call doctor is different, so make sure you understand their fees and accepted insurance plans before making an appointment.

How to find a house call doctor

Some large health care systems like Kaiser Permanente or the VA have programs that include home visits by doctors and nurses. For example, Kaiser’s home-based palliative care program includes house calls.

Even your older adult isn’t part of a large health network, it’s worthwhile to ask your older adult’s doctor if they have home doctor visit programs.

The American Academy of Home Care Medicine’s provider directory is another way to locate a house call doctor in your area.

You can also use Google to search for “house call doctor” + your city or county or “home doctor visit” + your city or county (don’t include the quotation marks).

What to look for in a house call doctor

Before booking an appointment, make sure you understand the doctor’s services, fees, and billing.

Questions to ask:

• Do you specialize in treating seniors, people with Alzheimer’s or dementia , or those with  multiple chronic conditions ?
• Do you accept Medicare , Medicaid , or my older adult’s private insurance plan?
• If we want, can we also keep my older adult’s primary care doctor?
• Will you communicate with my older adult’s existing doctors and specialists so their care is coordinated?

Examples of house call doctor private practices

We want to be clear that we’re not recommending any specific home doctor services or companies and aren’t affiliated with any of these businesses. These are examples to give you an idea of what a house call doctor looks like and the type of services that are typically offered.

Examples of what a house call doctor looks like:

• Visiting Physicians Association (VPA)
• Bay Area House Call Physicians
• Kindred House Calls

Recommended for you:

• 4 Expert Tips for Managing Multiple Chronic Health Conditions in Seniors
• 7 Tips for Helping Seniors at the Doctor: Being a Health Advocate
• Should Seniors See a Geriatrician?

By DailyCaring Editorial Team Image: Now It Counts

This article wasn’t sponsored and doesn’t contain affiliate links. For more information, see How We Make Money .

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18 comments, tony carrancho.

My parent s lives in [redacted for privacy]. How do i get started locating a house call doctor. I am pretty sure there insurance covers this. Thank you. TONY

DailyCaring

We hope the tips and suggestions in the article above will help you find a house call doctor in your parents’ local area.

Susan Quercio

My 95 year old father has a deep cough and he is disoriented. Temp 99 degrees.

Please contact your father’s doctor immediately or the local hospital to find out how to safely get him examined by a doctor (to reduce risk of exposure to Covid-19).

DailyCaring isn’t a medical organization, we aren’t medical professionals, and we aren’t affiliated with any healthcare organizations.

Ruby m VanNostern

I live in [redacted for privacy] and need a doctor visit in home.

This article includes suggestions for how you can find house call doctor services in your area. At DailyCaring, we aren’t doctors and don’t provide any medical services. We hope you’re able to find a great house call doctor in your area.

Stewart Goldman

need Doctor for a home visit Andrews N.C.

Joseph Artusa

I need a doctor

Linda Williams

I was released from the hospital on Thursday after 5 days.I am not able to go to Dr office but most definitely need to be checked.Still having breaking problems and am very week.I have severe asthma and blood pressure was running very high from so much steroids.Could I possibly get help.Thanks so much.

I’m so sorry to hear that you’re not feeling well. Since you’re noticing some issues with your recovery, it’s essential to call your primary doctor immediately. Since they’re the ones who have been treating you and are familiar with your recent hospitalization, they’re the best people to advise you on what you need. If you need help getting to your doctor’s office, you may want to contact your local Area Agency on Aging or a ride sharing service. Or, use the tips in this article to search for a doctor in your area who makes house calls.

Here are some articles that may be helpful: — 8 Ridesharing Services for Seniors https://dailycaring.com/8-ridesharing-services-for-seniors/ — 6 Affordable Senior Transportation Options https://dailycaring.com/6-affordable-senior-transportation-options/ — Local Community Resources for Seniors and Caregivers: Area Agency on Aging (to connect you with local organizations that may be able to help) https://dailycaring.com/local-community-resources-for-seniors-and-caregivers-area-agency-on-aging/ — 4 Ways to Know If Seniors Need to Return to the Hospital https://dailycaring.com/4-ways-to-know-if-seniors-need-to-return-to-the-hospital/

(DailyCaring doesn’t provide any services and isn’t affiliated with any medical providers.)

What areas do you service?

This article explains that house call doctor services are available and could help senior and caregivers. We also share suggestions for finding one in your area, but we do not provide any services ourselves. I hope you’re able to find a great local house call doctor!

What areas do you service

This article includes suggestions for finding house call doctor services in your area. We at DailyCaring aren’t doctors and don’t provide any medical services. I hope you’re able to find a great house call doctor in your area.

need a home care doctor

I hope the information above helps you find a great home care doctor in your area.

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• ALL MOSCOW TOURS
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Healthcare in Moscow – Personal and Family Medicine

Emergency : 112 or 103

Obstetric & gynecologic : +7 495 620-41-70

About medical services in Moscow

Moscow polyclinic

Emergency medical care is provided free to all foreign nationals in case of life-threatening conditions that require immediate medical treatment. You will be given first aid and emergency surgery when necessary in all public health care facilities. Any further treatment will be free only to people with a Compulsory Medical Insurance, or you will need to pay for medical services. Public health care is provided in federal and local care facilities. These include 1. Urban polyclinics with specialists in different areas that offer general medical care. 2. Ambulatory and hospitals that provide a full range of services, including emergency care. 3. Emergency stations opened 24 hours a day, can be visited in a case of a non-life-threatening injury. It is often hard to find English-speaking staff in state facilities, except the largest city hospitals, so you will need a Russian-speaking interpreter to accompany your visit to a free doctor or hospital. If medical assistance is required, the insurance company should be contacted before visiting a medical facility for treatment, except emergency cases. Make sure that you have enough money to pay any necessary fees that may be charged.

Insurance in Russia

Travelers need to arrange private travel insurance before the journey. You would need the insurance when applying for the Russian visa. If you arrange the insurance outside Russia, it is important to make sure the insurer is licensed in Russia. Only licensed companies may be accepted under Russian law. Holders of a temporary residence permit or permanent residence permit (valid for three and five years respectively) should apply for «Compulsory Medical Policy». It covers state healthcare only. An employer usually deals with this. The issued health card is shown whenever medical attention is required. Compulsory Medical Policyholders can get basic health care, such as emergencies, consultations with doctors, necessary scans and tests free. For more complex healthcare every person (both Russian and foreign nationals) must pay extra, or take out additional medical insurance. Clearly, you will have to be prepared to wait in a queue to see a specialist in a public health care facility (Compulsory Medical Policyholders can set an appointment using EMIAS site or ATM). In case you are a UK citizen, free, limited medical treatment in state hospitals will be provided as a part of a reciprocal agreement between Russia and UK.

Some of the major Russian insurance companies are:

Ingosstrakh , Allianz , Reso , Sogaz , AlfaStrakhovanie . We recommend to avoid  Rosgosstrakh company due to high volume of denials.

Moscow pharmacies

A.v.e pharmacy in Moscow

Pharmacies can be found in many places around the city, many of them work 24 hours a day. Pharmaceutical kiosks operate in almost every big supermarket. However, only few have English-speaking staff, so it is advised that you know the generic (chemical) name of the medicines you think you are going to need. Many medications can be purchased here over the counter that would only be available by prescription in your home country.

Dental care in Moscow

Dentamix clinic in Moscow

Dental care is usually paid separately by both Russian and expatriate patients, and fees are often quite high. Dentists are well trained and educated. In most places, dental care is available 24 hours a day.

Moscow clinics

«OAO Medicina» clinic

It is standard practice for expats to visit private clinics and hospitals for check-ups, routine health care, and dental care, and only use public services in case of an emergency. Insurance companies can usually provide details of clinics and hospitals in the area speak English (or the language required) and would be the best to use. Investigate whether there are any emergency services or numbers, or any requirements to register with them. Providing copies of medical records is also advised.

Moscow hosts some Western medical clinics that can look after all of your family’s health needs. While most Russian state hospitals are not up to Western standards, Russian doctors are very good.

Some of the main Moscow private medical clinics are:

American Medical Center, European Medical Center , Intermed Center American Clinic ,  Medsi , Atlas Medical Center , OAO Medicina .

Several Russian hospitals in Moscow have special arrangements with GlavUPDK (foreign diplomatic corps administration in Moscow) and accept foreigners for checkups and treatments at more moderate prices that the Western medical clinics.

Medical emergency in Moscow

Moscow ambulance vehicle

In a case of a medical emergency, dial 112 and ask for the ambulance service (skoraya pomoshch). Staff on these lines most certainly will speak English, still it is always better to ask a Russian speaker to explain the problem and the exact location.

Ambulances come with a doctor and, depending on the case, immediate first aid treatment may be provided. If necessary, the patient is taken to the nearest emergency room or hospital, or to a private hospital if the holder’s insurance policy requires it.

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Moscow metro & stalin skyscrapers private tour, moscow art & design private tour, soviet moscow historical & heritage private tour, gastronomic moscow private tour, «day two» moscow private tour, layover in moscow tailor-made private tour, whole day in moscow private tour, all-in-one moscow essential private tour, tour guide jobs →.

Every year we host more and more private tours in English, Russian and other languages for travelers from all over the world. They need best service, amazing stories and deep history knowledge. If you want to become our guide, please write us.

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In Home Medical Senior Care Services | Landmark Health

• Patient or Caregiver
• Community Provider

Are you a new Landmark patient?

Burn-out is real. landmark is different..

Living with chronic health conditions? We can help.

Our providers and care teams come to you, bringing care through house call visits. This in-home medical care is designed around understanding your health needs and goals. We work with you and your regular doctors to help you stay well and stay home.

House calls and video visits in 37 states.

Landmark partners with health plans to bring medical, behavioral health, and palliative care, along with social services, to patients in communities across the U.S. Our mobile providers visit patients in their homes through in-person house calls and telemedicine visits over video and phone.

We are the future of health care.

Landmark is one of the nation’s largest healthcare companies focused on in-home care of complex, chronic patients. Our physician-led provider groups support collaborative ties between community-based organizations, primary care providers, specialists and patients and their families.

patients nationally for which Landmark bears risk

reduction in hospital admissions

reduction in mortality

Discover the benefits.

• For Patients + Caregivers
• For Community Providers
• For Partners

Health care in your home

Old-fashioned house calls by medical doctors, nurse practitioners and physician assistants bring modern medicine to you. Feel better and stay well at home.

Covered by your health plan

The Landmark program works with health plans to improve access to care for patients with multiple chronic conditions. Landmark’s team-based care is available often at no cost to you.

Keep your current doctors

Landmark coordinates its care with your primary care provider, specialists and other community resources. Landmark provides added support to those who need it most.

Available 24 / 7

Our provider-staffed call center answers any time of the day or night. We also provide urgent visits to help you avoid unnecessary trips to the emergency room.

No waiting room

With Landmark house calls, you won’t need transportation to clinics and hospitals, and you avoid waiting rooms and exposure to germs.

Reduced stress

Patients and caregivers enjoy peace of mind with Landmark support. Landmark cares for the whole patient.

Landmark house calls put patients at the center of health care.

Collaborative care for complex patients.

Landmark’s community-based mobile providers bring coordinated care to patients with multiple chronic health conditions. We augment your care in the patient’s home.

Covered by health plans

The Landmark program is included in eligible patients’ health plans to improve care coordination and healthcare access for home-limited patients.

You remain the primary care provider

Landmark care is coordinated directly with you. Our providers reinforce your care plan in the home through physician-led interdisciplinary care teams.

Access our interdisciplinary team

Landmark’s interdisciplinary care team is available to you and your patients, including behavioral health specialists, social workers, palliative care specialists, nurse care managers and pharmacists.

Reduce administrative burden

We can help your highest acuity patients by managing post-acute care, home health orders, face-to-face encounters, and more.

24 / 7 availability

You can reach us any time, including weekends and holidays. We do urgent home visits to intervene if your patient experiences a chronic disease exacerbation.

Landmark supports your patients with complex health and social needs.

Chronic care management.

We’re one of the nations’ leading risk-bearing medical groups. We focus on giving your most complex members care when they need it, right in their home.

Over 250,000 patients across the country

We bear risk for over 250,000 complex, chronic patients, spanning Medicare Advantage, Medicaid, Dual, and Commercial, populations.

Behavioral, social and palliative care

Our team of multidisciplinary clinicians may include behavioral health specialists, palliative care practitioners, social workers, nurse care managers, dietitians and pharmacists.

Urgent in-home visits

One in four of our home visits is urgent. We bring medical care to your members when they need it, to avoid unnecessary emergency room trips and hospitalizations.

Built-for-purpose infrastructure

Our technology platform is designed specifically to support the medically vulnerable, clinically complex population.

Meaningful outcomes

Landmark commonly helps health plans achieve 4- and 5-star performance on Medicare STARS clinical quality of care, while caring for the most complex patients.

Landmark provides care for complex, chronic patients to positively impact access, satisfaction, outcomes and cost.

The doctor and nurses show they care about you and your health they are really there for you when you need them I love that they come to your house we did a zoom meeting with the nurse practitioner and she gave suggestions I really appreciate them

It was a pleasure to talk and see the doctor, she was very knowledgeable of all my conditions and gave me great advice to improve my health.

Joan was very helpful. It was nice getting to know her. How Landmark can help me

Practice health care the way you always wanted — with those who need it most.

Expert insights.

Prioritizing Mental Health as a Universal Human Right

By: Neltada Charlemagne, DNP, APRN, PMHNP-BC, PHN, BHC

Outsmart Unplanned Medical Costs: 10 Steps for Managing the Unexpected

Older adults can safeguard themselves from the physical, mental and emotional toll of unexpected medical costs.

Optum Care Network – Monarch and Landmark Health bring care to you at home.

Optum Care Network – Monarch has teamed up with Landmark to deliver in-home medical care to members with multiple chronic conditions.

Have questions about Landmark? We’d love to hear from you.

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At UI Health, our foundation in academic excellence leads to new possibilities in healthcare. We take pride in serving Chicago and are committed to keeping your family healthy.

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Physician Home Visits

Family & community medicine, family medicine services, appointments, student health, our providers, locations and hours, our home visits team.

Gina Choi, MD Family Medicine

Yvette Kimble, DNP, APRN-FPA, FNP-C Family Medicine

Julie Loza, MD Family Medicine

L. Amanda Perry, MD Family Medicine

Advanced Care in the Comfort of your Home

The UI Health Physician Home Visits Program, staffed by the excellent physicians from the Family Medicine Clinic , brings compassionate, comprehensive medical care to the homes of patients of all ages, enabling them to

• Remain at home
• Avoid costly hospitalizations and emergency room visits
• Stay healthy before a condition or situation gets worse

You may need a Physician Home Visit if you

• Were recently discharged from the hospital, Emergency Room, or Critical Decision Unit
• Are home bound due to a medical condition
• Have a difficult time getting to physician office visits
• Had a major surgery and need post-surgical care at home
• Are seeking palliative care or end of life care services

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• Physician home visits
• Assisted living home visits
• Wound care, including decubitus ulcer care and debridement
• Blood testing
• Coordination of care with home health and social service agencies
• Other physician services that can be provided in your home

Making an Appointment An initial house call can be scheduled by contacting our office at 312-996-1119 .

New patients must complete registration and have a brief eligibility screening by phone. The physician home visit will be scheduled within a week of contacting our office.

Follow-up Visits Follow-up visits will be scheduled during each home visit as needed. If a problem develops before the next scheduled visit, the patient or caregiver can contact our office and schedule an earlier appointment.

Refills Medications are refilled during regular office hours by calling our office at 312.996.2901 . Leave a message for the nurse if necessary and she will call you back within 24 hours. Please allow 48 hours for all refill requests.

Billing and Insurance The UI Health Home Visits Program accept Medicare, Medicaid, and most major insurance providers.

Home Visit Physicians' Hours Visits are scheduled as needed, and will usually occur between 7 am and 5 pm. Some home visits may occur on Saturday. To schedule a house call, please call 312-996-1119 .

How to Contact us after Business Hours Although our family doctors do not make late evening or night visits, we provide a 24-hour answering service to reach a physician for a consultation or to determine if urgent or emergency care is needed. Call our office at 312.996.2901 , and a physician will return your call, usually within one hour.

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GENERAL INFORMATION 866.600.CARE

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University of Illinois Hospital 1740 West Taylor Street Chicago, IL 60612

BRIAN K. UNWIN, MAJ, MC, USA, AND ANTHONY F. JERANT, M.D.

Am Fam Physician. 1999;60(5):1481-1488

See editorial on page 1337 .

With the advent of effective home health programs, an increasing proportion of medical care is being delivered in patients' homes. Since the time before World War II, direct physician involvement in home health care has been minimal. However, patient preferences and key changes in the health care system are now creating an increased need for physician-conducted home visits. To conduct home visits effectively, physicians must acquire fundamental and well-defined attitudes, knowledge and skills in addition to an inexpensive set of portable equipment. “INHOMESSS” (standing for: i mmobility, n utrition, h ousing, o thers, m edication, e xamination, s afety, s pirituality, s ervices) is an easily remembered mnemonic that provides a framework for the evaluation of a patient's functional status and home environment. Expanded use of the telephone and telemedicine technology may allow busy physicians to conduct time-efficient “virtual” house calls that complement and sometimes replace in-person visits.

In 1990, the American Medical Association (AMA) reported that approximately one half of primary care physicians polled in a national survey indicated that they performed home visits. 1 Although most of the physicians surveyed perceived home visits to be an important service, the majority performed only a few such visits per year. 1 Consistent with these self-reported behaviors are data indicating that only 0.88 percent of Medicare patients receive home visits from physicians. 2 In addition, the Health Care Financing Administration reported charges for only 1.6 million home visits in 1996, an extremely small percentage of the total number of annual physician-patient contacts in the United States. 3 These statistics stand in sharp contrast to medical practice before World War II, at which time about 40 percent of patient-physician encounters were in the home. 4

The low frequency of home visits by physicians is the result of many coincident factors, including deficits in physician compensation for these visits, time constraints, perceived limitations of technologic support, concerns about the risk of litigation, lack of physician training and exposure, and corporate and individual attitudinal biases. Physicians most likely to perform home visits are older generalists in solo practices. Health care providers who have long-established relationships with their patients are also more likely to utilize house calls. Rural practice setting, older patient age and need for terminal care correlate with an increased frequency of home visits. 5

Rationale for Home Visits

Studies suggest that home visits can lead to improved medical care through the discovery of unmet health care needs. 6 – 8 One study found that home assessment of elderly patients with relatively good health status and function resulted in the detection of an average of four new medical problems and up to eight new intervention recommendations per patient. 8 Major problems detected included impotence, gait and balance problems, immunization deficits and hypertension. Significantly, these problems had not been expected based on information obtained from outpatient clinic encounters. Other investigators have demonstrated the effectiveness of home visits in assessing unexpected problems in patient compliance with therapeutic regimens. 9 Finally, specific home-based interventions, such as adjusting the elderly patient's home environment to prevent falls, have also yielded health benefits. 10

Beyond the potential benefit of improved patient care, family physicians who conduct home visits report a higher level of practice satisfaction than those who do not offer this service. 5 Physicians with more positive attitudes about home visits are more likely to have conducted house calls during training. 11 Faculty mentorship and longitudinal exposure in training appear to be important for the development of positive attitudes toward home visits. 5 However, in 1994, only 66 of 123 medical schools offered specific instruction in the role and conduct of home visits. 12 Although 83 percent of the medical schools offered students the opportunity to participate in home visits, only three of the 123 schools required students to make five or more such visits. 12

Home Health Care Industry

Physician home visits have largely been supplanted by the extensive use of home health care services, a $22.3 billion industry that augments a medical system largely comprising facility-based health care providers. 13 The mean annual frequency of home health referrals was 43 per provider in a study published in 1992. 14

Family physicians have authorization and supervision responsibilities for a broad spectrum of skilled services that can be offered in the home. Such services include home health nursing, assistance from home health aides, and physical, occupational and speech therapy. Other health care support services are provided by medical supply companies, respiratory therapists, nutritionists, intravenous therapy services, hospice organizations, respite care services, Meals-on-Wheels volunteers and bereavement support staff. Family physicians also work extensively with social workers, who provide invaluable assistance in coordinating these services.

Thus, effective use of home care services has become a core competency for family physicians. In 1998, the AMA published the second edition of Medical Management of the Home Care Patient: Guidelines for Physicians . 15 The basic physician home care responsibilities outlined in that document are listed in Table 1 . 15

Recent data suggest that many physicians do not have the necessary knowledge and skills to perform these tasks effectively. For example, a survey found that 64 percent of physicians who had signed claims for care plans that were later disallowed had relied on a home health agency to prepare the plan of care, and 60 percent were not aware of the homebound requirement for home services. 16 Thus, increased physician education about home visits seems necessary if the responsibilities and obligations created by the expansion of home health care industry are to be fulfilled.

Types of Home Visits

The four major types of home visits are illness visits, visits to dying patients, home assessment visits and follow-up visits after hospitalization ( Table 2 ) . 17 , 18 The illness home visit involves an assessment of the patient and the provision of care in the setting of acute or chronic illness, often in coordination with one or more home health agencies. Emergency illness visits are infrequent and impractical for the typical office-based physician.

The dying patient home visit is made to provide care to the home-bound patient who has a terminal disease, usually in coordination with a hospice agency. The family physician can provide valuable medical and emotional support to family members before, during and after the death of a patient in the home environment. Family assistance involves evaluating the coping behaviors of survivors and assessing the medical, psychosocial, environmental and financial resources of the remaining family members.

The assessment home visit can also be described as an investigational visit during which the physician evaluates the role of the home environment in the patient's health status. An assessment visit is often made when a patient is suspected of poor compliance or has been making excessive use of health care resources. Medication use can be evaluated in the patient who is taking many drugs (polypharmacy) because of multiple medical problems. Evaluation of the home environment of the “at-risk” patient can reveal evidence of abuse, neglect or social isolation. Patients and family members who are trying to cope with chronic problems such as cognitive impairment or incontinence may particularly benefit from this evaluation. A joint assessment home visit facilitates coordination of the efforts of home health agencies and the physician. Finally, an assessment home visit is invaluable in assessing the need for nursing home placement of a frail elderly patient with uncertain social support.

The hospitalization follow-up home visit is useful when significant life changes have occurred. For example, a home visit after the birth of a new baby provides an excellent opportunity to discuss wellness and prevention issues and to address parental concerns. A home visit after a major illness or surgery can be useful in evaluating the coping behaviors of the patient and family members, as well as the effectiveness of the home health care plan.

Many aspects of physician home care have not been evaluated in the literature. However, it seems likely that properly focused and conducted home visits can enhance home health care delivery, improve patient satisfaction and strengthen the doctor-patient relationship.

Conducting the Home Visit

Equipment and planning.

Most equipment for a home visit can still be carried in the family physician's “black bag” ( Table 3 ) . Some additional items may be acquired from the patient's home.

One of the keys to conducting a successful home visit is to clarify the reason for the visit and carefully plan the agenda. Preplanning allows the physician to gather the necessary equipment and patient education materials before departure. The physician should have a map, the patient's telephone number and directions to the patient's home. The physician, patient and home care team should set a formal appointment time for the visit. Coordinating the house call to allow for the presence of key family members or significant others can enhance communication and satisfaction with care. Finally, confirming the appointment time with all involved parties before departure from the office is a common courtesy to the family as well as a wise time-management strategy.

HOME VISIT CHECKLIST: “INHOMESSS”

The INHOME mnemonic was devised to help family physicians remember the items to be assessed during the home visit directed at a patient's functional status and living environment. 19 This mnemonic can be expanded to “INHOMESSS,” which incorporates investigations of safety issues, spiritual health and home health agencies ( Table 4 ) . 19

Immobility . Evaluation of the patient's functional activities includes assessment of the activities of daily living (bathing, transfer, dressing, toileting, feeding, continence) and the instrumental activities of daily living (using the telephone, administering medications, paying bills, shopping for food, preparing meals, doing housework). The physician can ask the patient to demonstrate elements of the daily routine, such as getting out of bed, performing personal hygiene and leisure activities, and getting in and out of a car. Corrective interventions can be directed at any deficiencies noted. For example, modified pill-bottle caps can be obtained for the patient who has trouble opening medication containers because of a condition such as arthritis.

Nutrition . The physician should assess the patient's current state of nutrition, eating behaviors and food preferences. Permission to look in the refrigerator or cupboard can be obtained by asking open-ended but directed questions. For example, the physician might say, “We have been working hard on your diet to control your diabetes. Would you mind if I look in your refrigerator to see the types of foods you eat?” Improvements in product labeling allow the physician to assess serving sizes and the nutritional value of foods with relative ease. Healthy food preparation techniques can also be reviewed with the patient.

Home Environment . The patient's home environment should allow for privacy, social interaction and both spiritual and emotional comfort and safety. A safe neighborhood with close proximity to services is important for many older patients. The home may reflect pride in the patient's family and past accomplishments and reveal the patient's interests and hobbies. The physician should not make assumptions about social class or material wealth based on the patient's physical environment.

Other People . Having the patient's social support system present at the home visit clarifies the roles and concerns of family members. During routine visits, the physician can assess the availability of emergency help for the patient from family members and friends and can clarify specific issues, such as who is to serve as surrogate for the patient in the event of incapacitation. Discussion of a durable power of attorney and a living will may be more comfortably performed during the home visit than in the usual clinic visit. Evaluation of the caregiver's needs and risk of burnout is critically important.

Medications . To remedy or avoid polypharmacy, the physician must evaluate the type, amount and frequency of medications, and the organization and methods of medication delivery. An inventory of the patient's medicine cabinet can provide clues to previously unidentified drug-drug or drug-food interactions. A home medication review can also allow a direct estimate of patient compliance, uncover evidence of “doctor shopping” and identify the use or abuse of over-the-counter medications and herbal remedies.

Examination . The home visit should include a directed physical examination based on the needs of the patient and the physician's agenda. Practical, function-related examination techniques may include having the patient demonstrate getting on and off the toilet or in and out of the bathtub. The physician can have the patient demonstrate proper technique for the self-monitoring of blood glucose levels. In addition, the physician can weigh the patient and obtain a blood pressure measurement. In-person correlation of home and office measures provides useful information for future telephone and clinic contacts.

Safety . Common home safety issues are listed in Table 5 . The goal of the home safety assessment is to determine whether the patient's environment is comfortable and safe (no unreasonable risk of injury). To raise the subject, the physician should simply state the intention to identify and help modify potential safety hazards. For example, furniture placement or throw rugs may create problems for an elderly patient with gait instability, or the tap water may be so hot that the patient is at risk for scald injury. 20

Spiritual Health . If the home contains religious objects or reading materials, the physician can ask about the influence of spiritual beliefs on the patient's sense of physical and emotional health. This information may provide the impetus, as desired by the patient, for a discussion of spirituality as a coping and healing strategy.

Services . Having members of cooperating home health agencies present for the house call can enhance communication and cooperation among the physician, patient and agencies. Existing orders can be clarified, priorities for future care can be established and other perspectives on the care plan can be solicited. The patient's relationship with home health agency providers can also be assessed.

Elements of the INHOMESSS mnemonic may be used independently, based on the needs of the patient and the physician's agenda. For example, the physician may wish to focus on polypharmacy and safety in a patient with a recent fall, or to assess mobility and the extent of social support in a patient with newly diagnosed Alzheimer's disease. Figure 1 presents the major elements of the home visit in a checklist format that facilitates comprehensive assessment.

INTEGRATING HOME VISITS INTO CLINICAL PRACTICE

Lack of reimbursement and the busy pace of office practice are the reasons commonly cited for not conducting house calls. Poorly organized, sporadic home visits may indeed interfere with clinical practice. Therefore, it is important to develop a systematic approach for planning home visits. 21

Most practices will benefit from using home visits with patients who have difficulty accessing outpatient facilities because of sensory impairment, immobility or transportation problems. Removing such logistically difficult appointments from the clinic schedule and performing them in the home setting may actually enhance clinic functioning. Clustering home visits by geographic location and within defined blocks of time may also improve efficiency. Finally, nurse practitioners and physician assistants can conduct visits as part of a home health care delivery team.

The 1999 Current Procedural Terminology codes and corresponding Medicare reimbursement rates for common types of home visits are listed in Table 6 . 22

Telephone Calls and Telemedicine

Proactive telephone calls are an underutilized method of conducting highly focused and time-efficient “virtual” home visits. 23 Provider-initiated telephone calls can be used to reassure family members after a patient has had an acute illness or has been hospitalized. 23 These calls can also be helpful in reinforcing patient compliance with new medications, following patients with chronic diseases and reducing inappropriate use of primary care clinic or office services. 24

Telemedicine is the use of communication technologies, such as two-way video-conferencing, to provide patient care across distances. A variety of institutions are exploring these technologies as methods of delivering health care in the home. 25 , 26

Final Comment

As fewer patients are admitted to hospitals and hospital stays become ever briefer, the medical complexity of home care will increase, as will the demand for both in-person and “virtual” physician home visits. Physicians interested in obtaining additional information about home care provision can contact the American Academy of Home Care Physicians (P.O. Box 1037, Edgewood, MD 21040; Web address: http://www.aahcp.org/ ).

Shut in, but not shut out [Editorial]. Am Med News. 1996;39:47.

Meyer GS, Gibbons RV. House calls to the elderly: a vanishing practice among physicians. N Engl J Med. 1997;337:1815-20.

Boling PA. House calls [Letter]. N Engl J Med. 1998;338:1466.

Starr P. The social transformation of American medicine. New York: Basic Books, 1982:359.

Adelman AM, Fredman L, Knight AL. House call practices: a comparison by specialty. J Fam Pract. 1994;39:39-44.

Arcand M, Williamson J. An evaluation of home visiting of patients by physicians in geriatric medicine. Br Med J. 1981;283:718-20.

Fabacher D, Josephson K, Pietruszka F, Linderborn K, Morley JE, Rubenstein LZ. An in-home preventive assessment program for independent older adults: a randomized controlled trial. J Am Geriatr Soc. 1994;42:630-8.

Ramsdell SW, Swart J, Jackson JE, Renvall M. The yield of a home visit in the assessment of geriatric patients. J Am Geriatr Soc. 1989;37:17-24.

Bernardini J, Piraino B. Compliance in CAPD and CCPD patients as measured by supply inventories during home visits. Am J Kidney Dis. 1998;31:101-7.

Tideiksaar R. Environmental adaptation to preserve balance and prevent falls. Top Geriatr Rehabil. 1990;5:178-84.

Knight AL, Adelman AM, Sobal J. The house call in residency training and its relationship to future practice. Fam Med. 1991;23:57-9.

Steel RK, Musliner M, Boling PA. Medical schools and home care. N Engl J Med. 1994;331:1098-9.

Goldberg AI. Home healthcare: the role of the primary care physician. Compr Ther. 1995;21:633-8.

Boling PA, Keenan JM, Schwartzberg JG, Retchin SM, Olson L, Schneiderman M. Home health agency referrals by internists and family physicians. Am Geriatr Soc. 1992;40:1241-9.

American Medical Association. Medical management of the home care patient: guidelines for physicians. 2d ed. Chicago: The Association, 1998:1–60.

Klein S. Guidance for home care physicians. Am Med News. 1998;41:5-6.

Cauthen DB. The house call in current medical practice. J Fam Pract. 1981;13:209-13.

Scanameo AM, Fillit H. House calls: a practical guide to seeing the patient at home. Geriatrics. 1995;50:33-9.

Knight AL, Adelman AM. The family physician and home care. Am Fam Physician. 1991;44:1733-7.

Huyer DW, Corkum SH. Reducing the incidence of tap-water scalds: strategies for physicians. Can Med Assoc J. 1997;156:841-4.

American Academy of Home Care Physicians. Making house calls a part of your practice. Edgewood, Md.: American Academy of Home Care Physicians, 19981;1–35.

Kirschner CG, ed. Current procedural terminology: CPT. Standard ed. Chicago: American Medical Association, 1999:26–8.

Studdiford JS, Panitch KN, Snyderman DA, Pharr ME. The telephone in primary care. Prim Care. 1996;23:83-102.

Wasson J, Gaudette C, Whaley F, Sauvigne A, Baribeau P, Welch HG. Telephone care as a substitute for routine clinic follow-up. JAMA. 1992;267:1788-93.

Jerant AF, Schlachta L, Epperly TD, Barnes-Camp J. Back to the future: the telemedicine house call. Fam Pract Management. 1998;5:18-22.

Johnson B, Wheeler L, Deuser J. Kaiser Permanente Medical Center's pilot tele-home health project. Telemed Today. 1997;5:16-8.

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To book your appointment with a specialist of Home Visits in lahore, call at 042-32591427 or 0311-1222398. There are no extra charges for booking appointment through Marham.

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The fee for specialists of Home Visits in lahore varies from PKR 500-3000 depending upon doctor's experience and qualification.

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• Dr. Mehmood Ul Haque
• Dr. Omer Iqbal
• Dr. Muhammad Umair Arif
• Dr. Waqas Akhtar

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A Growing Trend: Home Nurse Practitioner Visits

Nurse and Nurse Practitioners don’t just work in hospitals anymore. They’re starting their own in-home care practices that benefit everyone seeking medical care.

Benefits of a Home Visit From a Nurse Practitioner

The most obvious benefit of a house call is that patients don’t have to leave their homes. Some patients have difficulty moving due to illness, injury, or age. Being forced to go to a doctor can increase their levels of stress and pain. Having the care provider come to them instead of going to the hospital or emergency room also means lower risk of infection from hospital-borne illness.

According to the American Associations of Nurse Practitioners (AANP), nurse practitioners can arrive at the home quickly and at any hour, and are able to treat their patients more efficiently than if they had to schedule an appointment. Typically, the same nurse practitioner cares for the same patient, so the nurse practitioner becomes familiar with the patient’s needs. There are also no scheduled appointments, so an in-home nurse can stay with a patient as long as needed. Medpage Today claims the cost of an in-home nurse practitioner is about 20 percent less per visit compared to the emergency room, not including ambulance fees.

While home care has many benefits to patients, it’s not as easy for nurse practitioners. They often earn less money due to the cost of running a home-care practice, and they have less access to expensive but helpful technology used in hospitals.

The History of In-Home Care

House calls were fairly common for physicians up to and through the 1960s, but they steadily began to disappear until the practice was almost non-existent in the 1980s. The primary reason for the decline in in-home care was increased physician specialization. Typically, doctors who make house calls are general physicians, so they know how to treat the variety of illnesses they may come across when they make a home visit. Today, very few doctors are general practitioners (under 1 percent).

Nurse Practitioners, however, do have a working general knowledge of medicine suitable for in-home care. Training for nurses gives them all the knowledge they need to treat a variety of health conditions. Nurse Practitioners are also known for getting to know their patients better than physicians, which can lead to better treatment.

How Home Care Might Change In the Future

Communications technology is advancing rapidly, allowing care providers to see patients while connected to a smartphone or a computer with a webcam. According to Hedgeweek, this field of telemedicine could be the future of the house calls, allowing a nurse or doctor to diagnose and treat conditions without ever physically being present.

The market for health care is growing, with millions of new patients insured due to health care reform. Nurse practitioners are leading the way in terms of how to treat this influx of patients with house calls.  The Gulf Coast Gerontological Advanced Practice Nurses Association (GCGAPNA) claim nurse practitioners are a great solution to make up for the lack of primary care doctors. They will have new opportunities to really get to know their patients and work with them in their homes, providing the quality of care that everyone deserves.

If you’re interested in advancing in your nursing career and taking advantage of the increasing need for nurse practitioners, check out the  online DNP degree  at Maryville University.

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King Charles Holds Hands With Cancer Patients in First Public Outing Since His Own Diagnosis

K ing Charles III officially returned to public duties on Tuesday, following a months-long period of recuperation since being diagnosed with an undisclosed type of cancer in February. 

The 75-year-old monarch opted for a cause close to home to mark his return to work. King Charles and Queen Camilla visited a cancer treatment center in London, where he greeted doctors, held hands with patients, and gave out gifts to children. They were also joined by Baroness Neuberger, chairman of University London College Hospitals, and David Probert, its chief executive.

The visit marked the King’s first official public visit since his cancer diagnosis since cutting back his duties while undergoing cancer treatment. It aimed to emphasize the significance of early cancer diagnosis and highlight the lifesaving research conducted at the University College Hospital Macmillan Cancer Centre. 

The royal couple met the team responsible for TRACERx, the single biggest investment in lung cancer research by Cancer Research UK. The King will also take over from his mother, the late Queen Elizabeth II, as the patron of the cancer charity. 

“His Majesty’s treatment programme will continue, but doctors are sufficiently pleased with the progress made so far that the King is now able to resume a number of public-facing duties,” Buckingham Palace said ahead of Tuesday’s visit.

It is understood that the King will have a fuller schedule throughout May, which will also see Prince Harry return to London for an event. Their overlapping schedules have led to observers speculating about a father and son reunion.

The King is not the only royal battling cancer. In March, Kate Middleton revealed that she had been diagnosed with cancer following planned abdominal surgery earlier in the year. The 42-year-old made her health condition public after months of intense speculation —and far fetched conspiracy theories—about her whereabouts. 

The Duke of Sussex will travel from his California home to London for a ceremony to mark the 10 year anniversary of the Invictus Games, a sporting event for wounded veterans. The “service of thanksgiving” will take place on March 8 at St Paul’s Cathedral.

While the King will be in London during Harry’s visit, it is understood that his schedule that week will be packed, the Telegraph reported . According to the British newspaper, Charles and Harry are still likely to meet if their schedules allow it. 

On the day of Harry’s engagement, King Charles will attend his weekly meeting with the U.K. Prime Minister Rishi Sunak and—if he is well enough—attend a garden party at Buckingham Palace. The monarch will also have various other commitments throughout the week.

The King is also expected to host a state visit for the Emperor and Empress of Japan in late June. However, his plans for fixed calendar royal events, such as Trooping the Colour and D-Day commemorations, remain uncertain.

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FTC Announces Rule Banning Noncompetes

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Today, the Federal Trade Commission issued a final rule to promote competition by banning noncompetes nationwide, protecting the fundamental freedom of workers to change jobs, increasing innovation, and fostering new business formation.

“Noncompete clauses keep wages low, suppress new ideas, and rob the American economy of dynamism, including from the more than 8,500 new startups that would be created a year once noncompetes are banned,” said FTC Chair Lina M. Khan. “The FTC’s final rule to ban noncompetes will ensure Americans have the freedom to pursue a new job, start a new business, or bring a new idea to market.”

The FTC estimates that the final rule banning noncompetes will lead to new business formation growing by 2.7% per year, resulting in more than 8,500 additional new businesses created each year. The final rule is expected to result in higher earnings for workers, with estimated earnings increasing for the average worker by an additional $524 per year, and it is expected to lower health care costs by up to $194 billion over the next decade. In addition, the final rule is expected to help drive innovation, leading to an estimated average increase of 17,000 to 29,000 more patents each year for the next 10 years under the final rule.

Noncompetes are a widespread and often exploitative practice imposing contractual conditions that prevent workers from taking a new job or starting a new business. Noncompetes often force workers to either stay in a job they want to leave or bear other significant harms and costs, such as being forced to switch to a lower-paying field, being forced to relocate, being forced to leave the workforce altogether, or being forced to defend against expensive litigation. An estimated 30 million workers—nearly one in five Americans—are subject to a noncompete.

Under the FTC’s new rule, existing noncompetes for the vast majority of workers will no longer be enforceable after the rule’s effective date. Existing noncompetes for senior executives - who represent less than 0.75% of workers - can remain in force under the FTC’s final rule, but employers are banned from entering into or attempting to enforce any new noncompetes, even if they involve senior executives. Employers will be required to provide notice to workers other than senior executives who are bound by an existing noncompete that they will not be enforcing any noncompetes against them.

In January 2023, the FTC issued a  proposed rule which was subject to a 90-day public comment period. The FTC received more than 26,000 comments on the proposed rule, with over 25,000 comments in support of the FTC’s proposed ban on noncompetes. The comments informed the FTC’s final rulemaking process, with the FTC carefully reviewing each comment and making changes to the proposed rule in response to the public’s feedback.

In the final rule, the Commission has determined that it is an unfair method of competition, and therefore a violation of Section 5 of the FTC Act, for employers to enter into noncompetes with workers and to enforce certain noncompetes.

The Commission found that noncompetes tend to negatively affect competitive conditions in labor markets by inhibiting efficient matching between workers and employers. The Commission also found that noncompetes tend to negatively affect competitive conditions in product and service markets, inhibiting new business formation and innovation. There is also evidence that noncompetes lead to increased market concentration and higher prices for consumers.

Alternatives to Noncompetes

The Commission found that employers have several alternatives to noncompetes that still enable firms to protect their investments without having to enforce a noncompete.

Trade secret laws and non-disclosure agreements (NDAs) both provide employers with well-established means to protect proprietary and other sensitive information. Researchers estimate that over 95% of workers with a noncompete already have an NDA.

The Commission also finds that instead of using noncompetes to lock in workers, employers that wish to retain employees can compete on the merits for the worker’s labor services by improving wages and working conditions.

Changes from the NPRM

Under the final rule, existing noncompetes for senior executives can remain in force. Employers, however, are prohibited from entering into or enforcing new noncompetes with senior executives. The final rule defines senior executives as workers earning more than $151,164 annually and who are in policy-making positions.

Additionally, the Commission has eliminated a provision in the proposed rule that would have required employers to legally modify existing noncompetes by formally rescinding them. That change will help to streamline compliance.

Instead, under the final rule, employers will simply have to provide notice to workers bound to an existing noncompete that the noncompete agreement will not be enforced against them in the future. To aid employers’ compliance with this requirement, the Commission has included model language in the final rule that employers can use to communicate to workers. 

The Commission vote to approve the issuance of the final rule was 3-2 with Commissioners Melissa Holyoak and Andrew N. Ferguson voting no. Commissioners Rebecca Kelly Slaughter , Alvaro Bedoya , Melissa Holyoak and Andrew N. Ferguson each issued separate statements. Chair Lina M. Khan will issue a separate statement.

The final rule will become effective 120 days after publication in the Federal Register.

Once the rule is effective, market participants can report information about a suspected violation of the rule to the Bureau of Competition by emailing  [email protected] . 

The Federal Trade Commission develops policy initiatives on issues that affect competition, consumers, and the U.S. economy. The FTC will never demand money, make threats, tell you to transfer money, or promise you a prize. Follow the  FTC on social media , read  consumer alerts  and the  business blog , and  sign up to get the latest FTC news and alerts .

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New mother says JBS gave her filthy room to pump milk, fired her for doctor visits

A former Iowa slaughterhouse worker who'd already lost one child says she was penalized and fired by her employer for pumping milk and going to medical appointments to protect her next one.

Plaintiff Star Rice sued multinational pork producer JBS in Wapello County in January, accusing the company of pregnancy and gender discrimination and violations of the federal Family Medical Leave Act and Fair Labor Standards Act. JBS has since moved the case to federal court, and in court filings has denied wrongdoing. An attorney for JBS did not respond to messages seeking comment.

Attorney Jacquelyn Judickas, representing Rice, said in a statement that pregnant women and nursing mothers are entitled to "dignity and respect" from their employers.

“That means not penalizing individuals for going to pregnancy-related doctor appointments and providing a safe space to pump breast milk," Judickas said. "Women cannot be required to make decisions at the expense of their child’s health in order to keep their jobs. Ms. Rice is committed to both caring for her children and being a working member of society.”

Pregnant worker penalized for approved absences

According to her complaint, Star began working on the production lines at JBS' Ottumwa pork plant in early 2020, and later that year learned she was pregnant.

Related: As Tyson Foods closes Perry plant, are other Iowa facilities headed to the chopping block?

Rice's pregnancy was deemed high-risk by doctors, leading to numerous medical appointments. Her suit says she sought, and obtained, approval from JBS for those work absences, only to learn later they were still being counted against her in a "points" system the company used to track worker absences.

Rice gave birth in June 2021 and returned to work the following month, but continued to have medical appointments related to her newborn. At one point, she alleges, JBS attempted to fire her because she had accrued too many absence points, even though the absences were approved for legitimate medical needs.

Rice says that when she protested her firing, JBS reinstated her but did not remove the absence points from her attendance records.

New mother says she pumped milk in filthy room

Rice says she returned to work with a doctor's note seeking accommodations to pump breast milk while at work. According to the U.S. Department of Labor , "Most nursing employees have the right to reasonable break time and a place, other than a bathroom, that is shielded from view to express breast milk while at work" for up to one year after giving birth.

Instead, Rice claims in her suit, she was offered the use of "an old room that smelled of rotten meat, with dirty cement floors, tacky traps for insects, and a semi-functional sink." The room also was not private, she says, with other employees coming and going and, on one occasion, pulling aside the shower curtain that was supposed to shield her from view.

Similar: Female doctors allege they were paid less than men, hounded into leaving Des Moines lab

She also got pushback for the amount of time she was taking to pump, she alleges. Supervisor Victor Rodriquez, who is named as a defendant, allegedly sought to obtain a copy of her medical file from the company's human resources office and tried to get her to limit her pumping breaks to 15 minutes instead of 30, the suit says. It notes that Rice was required to wear several layers of protective equipment to work on the production line, adding considerably to the time it took to disrobe herself to pump. Nonetheless, she says, she was written up for taking too long to pump in March 2022.

Rice claims she made multiple complaints to human resources about the condition of the lactation space and the harassment she was getting from peers and managers, but that the company took no steps to correct the issues.

'Can't you just feed your baby when you get home?'

Another supervisor named in the lawsuit, Erika Kemp, allegedly both ignored and participated in the harassment against Rice. At one point, Rice says in her suit, Kemp told her “you can either put up with it or you can leave.” Kemp also repeatedly made comments to the effect of "can’t you just feed your baby when you get home?" Rice claims.

More: Walmart settles Ottumwa worker's gender discrimination complaint for $60,000

In fact, Rice says, she had even more cause than most parents to do everything she could to pump milk to ensure her child was healthy.

"Defendants knew that Ms. Rice's first child had died from Sudden Infant Death Syndrome and that Ms. Rice was desperately trying to do everything she could to help ensure good health for her newborn child, including feeding her child with breastmilk," she says in the complaint.

Finally, in April 2022, Rice was told upon arriving at work that she was being terminated, again due to having accrued too many attendance points, the suit says. These points again included her approved time off for medical appointments, Rice says.

This article has been edited to correct the spelling of Jacquelyn Judickas' name.

William Morris covers courts for the Des Moines Register. He can be contacted at  [email protected]  or 715-573-8166 .