One of the key areas where Lutheran Services in America brings together our members—along with strategic national partners in philanthropy, academia, healthcare and more—to advance innovative solutions is in enabling older adults to live with dignity, health, meaning, and independence in a place where they call home.
We recently partnered with our member NYU Langone Family Health Centers (formerly Lutheran Family Health Centers), the University of North Carolina at Chapel Hill (UNC), and The Harry & Jeanette Weinberg Foundation to empower older adults in affordable housing—particularly those transitioning from the hospital or post acute care—to remain living independently in their community.
The work builds on a four-year partnership with UNC and The Harry & Jeanette Weinberg Foundation where we worked with seven members in seven states to successfully transition 875 older adults from post-acute care to home, demonstrating improvement in care transition and quality of life.
The current two-year project will expand UNC’s Connect-Home transition care model to strengthen the capacity of staff to identify affordable housing residents most at risk of hospitalization, address gaps in care that lead to increased isolation and emergency room visits and enable older adults to live independently. Genacross Lutheran Services is providing peer support and expertise based on the extensive work they have done to assess and connect their affordable housing residents to services in the community.
Why is this important? According to CMS, 76 percent of 30-day hospital readmissions are preventable. And we know the transition from hospital to home places older adults at risk. We also know that when we bring together our members with expertise and funding from partners in academia, philanthropy and healthcare that we can tackle tough challenges and make a meaningful difference in the lives of people.
We look forward to sharing with you the learnings and results of the work and partnership in the future.