Accessing Social Care and Care Management Services Easier
At Kindred, we support and empower people to better navigate the social care network of South Central, VA in order to address various health related social needs (HRSNs). Explore our diverse services today.
Community Health Integration (CHI)
CHI assist community residents by providing transitional assistance for those being discharged from an inpatient stay, back into the community. Members of our clinical support team accomplish this by providing community health navigation services to address patients' needs and ensure they receive the necessary care from providers who can diagnose and treat their medical condition.
Behavioral Health Integration (BHI)
We provide assistance in navigating the community social care network of essential support services for clients with a behavioral health or substance-use disorder diagnosis to ensure they receive the help they need to improve their emotional, social, and mental well-being.
Food and Nutritional Support Services
We offer support to access food resources. Our Nutritionists offer personalize counseling and coaching on diabetes management and healthy living best practices to help people enhance their overall health and well-being. Kindred's nutrition and diabetes education support can be done one-on-one or in a group setting through in-person sessions or telemedicine.
Principle Illness Navigation (PIN)
Our PIN solutions provide navigation and care management services for individuals with serious, high-risk conditions expected to last at least three months that may likely worsen and lead to hospitalization, placement in a nursing facility, and even death.
Principle Illness Navigation/Peer Support (PIN-PS)
For PIN-PS, we provide a trained peer, often someone with personal experience managing similar serious health conditions, to provide personalized support and guidance to patients navigating a high-risk medical situation, particularly focusing on behavioral health conditions, to help them access necessary community resources and to navigate the health care system effectively.
Transitional Care Management (TCM)
As part of our overall care management services, Kindred uses a 90-day TCM model that is based on healthcare best practices. It is designed to prevent health complications and hospital readmissions by providing proactive discharge planning and follow-on community support that begins at admission and continues after discharge.
Transportation Services
We coordinate access to medical and non-medical transportation options to address residents' transportation and security issues. Services includes ambulatory, non-ambulatory, non-emergency, medical, and curb-to-curb transportation.