Counties served: Tioga, Bradford, Susquehanna, Wyoming, Wayne, Pike, Monroe, Carbon, Lackawanna, Luzerne, Sullivan, Lycoming, Clinton, Centre, Clearfield, Union, Snyder, Northumberland, Montour, Columbia, Blair, Fulton, Huntingdon, Franklin, Mifflin, Juniata, Perry, Cumberland, Adams, and York.
Nursing Home Transition is a comprehensive coordination of services and plan development to provide alternatives to institutional living to individuals age 18 and older. Through outreach and service coordination with nursing facilities and residents, the purpose is to relocate from institutions to community living with any needed services in place.
Nursing Home Transition coordinating includes:
- Assessing the appropriateness of the individual for meeting the requirements of an NHT participant
- Acting as a liaison between the facility and the Independent Enrollment Broker for waiver services
- Assist the individual, family, nursing staff and others in the development of an integrated plan that includes services to meet the needs of the individual and ensure a safe discharge
- Assisting in finding and securing housing
- Assess the need for any home adaptions that may be needed
- Coordinate funding through the waiver to obtain household supplies (including furniture), moving expenses and security deposit rental fees
- Provide information to the individual about community resources
- Coordinating the date of discharge and the individual’s move to the community
“I really don’t know what I would have done if not for this agency.” Tkay said that to her, the best part of the whole experience of transitioning from a nursing home back to independent living was, “having the chance to talk to someone (NHT Staff) who seemed to genuinely care”. “She gave me confidence and encouragement when I needed it most and didn’t know I had it in me. It feels like I got my life back!”