Why: A follow up within 5-7 days has shown to decrease complications and provide better outcomes for patients by providing a safe transition to the home setting.

When: The Tele-visit will be conducted within the first 5-7 days after discharge to home. A secondary visit can be arranged if clinically necessary. Pioneer will provide care for patients as a bridge to their primary care provider.

How: By collaborating with our valued Home Health partners, Pioneer seamlessly combines efforts to ensure patients’ safe transition back to their home setting.

• Ensure patient’s understanding of medications
• Make any necessary medication adjustments
• Review labs and orders
• Answer any patient questions
• Educate the patient on when to call the nurse or call 911