Level 2 · Patient worklist
Every patient on census with outreach, appointment status and the next action. Click a box to filter the list.
210 records match the current filters
| Patient | Tier / Owner | Setting & facility | Case mgmt | Admit / Discharge | Outreach | Appointment | Window | Status / Next action |
|---|---|---|---|---|---|---|---|---|
Eleanor Baptiste M473562 · 65y · Foxfield Primary (258) 360-7587 | Critical Nurse | ED Northside Medical ED | No case No plan | Aug 4 Aug 4 | Not started — · 0 attempts | Not scheduled — | 23d past | No outreach yet |
Marcus Sorensen M492265 · 60y · Foxfield Primary (210) 341-466560d readmit | Critical Nurse | Inpatient Valley Baptist | Case open Proj. DC Aug 8 | Jul 28 Aug 7 | Contacted Nurse case manager · 3 attempts | Not scheduled — | 20d past | Window missed |
Willie Baptiste M434405 · 89y · Millbrook Clinic (208) 854-920060d readmitReturned | Serious Nurse | SNF Golden Oaks Rehab | Case open Proj. DC Jul 27 | Jul 16 Jul 27 | Contacted Care coordinator · 1 attempt | Not scheduled — | 31d past | Readmit — no appointment |
Callum Guillory M494130 · 68y · Millbrook Clinic (308) 763-1587Returned | Critical Nurse | Inpatient Valley Baptist | Case open Proj. DC Nov 15 | Nov 8 Nov 14 | Contacted Nurse case manager · 1 attempt | Cancelled Nov 20 · 1 miss | 286d past | No-show recovery |
Rosa Guillory M440512 · 79y · Stonebridge Health (410) 709-9309 | Critical Nurse | Observation Mercy General | Case open Proj. DC Aug 4 | Aug 1 Aug 4 | Contacted Nurse case manager · 1 attempt | Cancelled Aug 9 · 1 miss | 23d past | No-show recovery |
Frank Baptiste M478918 · 68y · Stonebridge Health (425) 579-3563 | Critical Nurse | SNF Willowbrook SNF | Case open Proj. DC Jul 7 | Jun 25 Jul 7 | Contacted Nurse case manager · 2 attempts | Cancelled Jul 13 · 1 miss | 51d past | No-show recovery |
Bernard Guillory M440532 · 78y · Foxfield Primary (490) 332-911360d readmitReturned | Critical Nurse | ED St. Aldon Regional ED | Case open Proj. DC Dec 26 | Dec 26 Dec 26 | Contacted Nurse case manager · 3 attempts | Completed Dec 29 · 3d · 1 miss | Met | Readmit — visit completed |
Xiomara Marsden M473384 · 74y · Millbrook Clinic (621) 232-282460d readmitReturned | Good Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Sep 15 | Sep 6 Sep 15 | Unable to reach Care coordinator · 3 attempts | Not scheduled — | 346d past | Readmit — no appointment |
Frank Kowalski M451862 · 64y · Foxfield Primary (272) 320-5894Returned | Serious Nurse | Observation St. Aldon Regional | No case No plan | Jan 13 Jan 21 | Not started — · 0 attempts | Not scheduled — | 218d past | Readmit — no appointment |
Callum Marsden M449225 · 78y · Foxfield Primary (467) 381-8806 | Serious Nurse | Inpatient St. Aldon Regional | Case open Proj. DC Jun 18 | Jun 15 Jun 18 | Contacted Nurse case manager · 1 attempt | Cancelled Jun 21 · 1 miss | 70d past | No-show recovery |
Priya Salazar M443666 · 59y · Millbrook Clinic (227) 612-2238Returned | Serious Nurse | Inpatient Mercy General | Case open Proj. DC Jan 8 | Jan 5 Jan 9 | Contacted Nurse case manager · 1 attempt | Cancelled Jan 12 · 1 miss | 230d past | No-show recovery |
Rafael Ionescu M499365 · 85y · Foxfield Primary (345) 514-627060d readmit | Critical Nurse | Inpatient St. Aldon Regional | Case open Proj. DC Aug 4 | Jul 27 Aug 4 | Contacted Nurse case manager · 3 attempts | Completed Aug 13 · 9d | 23d past | On track |
Marcus Nguyen M457358 · 74y · Stonebridge Health (219) 274-145860d readmit | Critical Nurse | Inpatient Northside Medical Center | Case open Proj. DC Jan 20 | Jan 12 Jan 20 | Contacted Nurse case manager · 2 attempts | Completed Jan 31 · 11d | 219d past | On track |
Frank Mbeki M484927 · 87y · Millbrook Clinic (310) 899-9634Returned | Serious Nurse | Inpatient Northside Medical Center | Case open Proj. DC Mar 6 | Mar 1 Mar 5 | Contacted Nurse case manager · 2 attempts | Cancelled Mar 8 · 1 miss | 175d past | No-show recovery |
Rosa Lindstrom M484818 · 83y · Foxfield Primary (317) 791-9755 | Critical Nurse | ED Northside Medical ED | No case No plan | Aug 26 Aug 26 | Attempted Nurse case manager · 1 attempt | Not scheduled — | 1d past | Window missed |
Amir Chandler M494496 · 60y · Foxfield Primary (216) 869-3750Returned | Critical Nurse | Inpatient St. Aldon Regional | Case open Proj. DC May 30 | May 23 May 30 | Contacted Nurse case manager · 1 attempt | Completed Jun 2 · 3d · 1 miss | Met | Readmit — visit completed |
Nadia Nguyen M411224 · 64y · Foxfield Primary (348) 462-240060d readmit | Good Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Dec 2 | Nov 21 Dec 1 | Contacted Care coordinator · 2 attempts | No-show Dec 7 · 1 miss | 269d past | No-show recovery |
Frank Sorensen M455347 · 78y · Millbrook Clinic (273) 697-974560d readmit | Good Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Jun 13 | Jun 6 Jun 13 | Contacted Front desk · 2 attempts | No-show Jun 17 · 1 miss | 75d past | No-show recovery |
Beatrice Baptiste M421503 · 73y · Millbrook Clinic (280) 508-351260d readmit | Good Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Nov 5 | Oct 31 Nov 6 | Contacted Care coordinator · 1 attempt | No-show Nov 12 · 1 miss | 294d past | No-show recovery |
Terrance Salazar M478994 · 68y · Millbrook Clinic (585) 820-793960d readmit | Good Care coordinator | Inpatient Mercy General | Case open Proj. DC Jun 9 | Jun 3 Jun 9 | Contacted Care coordinator · 1 attempt | No-show Jun 15 · 1 miss | 79d past | No-show recovery |
Hattie Baptiste M492368 · 84y · Millbrook Clinic (461) 393-7636 | Good Care coordinator | Inpatient Valley Baptist | No case No plan | Aug 15 Aug 25 | Not started — · 0 attempts | Not scheduled — | 2d past | No outreach yet |
Lena Petrov M452234 · 86y · Stonebridge Health (274) 715-300560d readmitReturned | Fair Care coordinator | Inpatient Valley Baptist | No case No plan | Oct 3 Oct 11 | Not started — · 0 attempts | Not scheduled — | 320d past | Readmit — no appointment |
Otis Abernathy M420085 · 88y · Stonebridge Health (434) 413-201360d readmit | Critical Nurse | Observation Mercy General | No case No plan | Oct 30 Nov 3 | Unable to reach Nurse case manager · 3 attempts | Not scheduled — | 297d past | On track |
Ruth Haddad M413601 · 85y · Stonebridge Health (243) 340-955260d readmit | Critical Nurse | SNF Golden Oaks Rehab | Case open Proj. DC Dec 27 | Dec 11 Dec 27 | Contacted Nurse case manager · 3 attempts | Completed Jan 2 · 6d | Met | On track |
Yuki Salazar M411025 · 80y · Millbrook Clinic (491) 842-992860d readmit | Critical Nurse | Observation Northside Medical Center | Case open Proj. DC Sep 5 | Aug 28 LOS 6d | Contacted Nurse case manager · 1 attempt | Not scheduled — | In facility | On track |
Imani Whitmore M438055 · 91y · Foxfield Primary (694) 582-7847 | Serious Nurse | Home Health Comfort Care at Home | Case open Proj. DC Jun 5 | May 14 Jun 5 | Contacted Nurse case manager · 1 attempt | Cancelled Jun 10 · 1 miss | 83d past | No-show recovery |
Callum Delgado M420267 · 70y · Foxfield Primary (668) 789-666260d readmit | Critical Nurse | Observation St. Aldon Regional | Case open Proj. DC Aug 31 | Aug 20 Aug 30 | Contacted Nurse case manager · 1 attempt | Scheduled Sep 9 | 3d left | On track |
Ruth Ionescu M493013 · 61y · Millbrook Clinic (277) 749-4305Returned | Good Care coordinator | Inpatient Northside Medical Center | Case open Proj. DC Aug 13 | Aug 6 Aug 13 | Attempted Care coordinator · 2 attempts | Not scheduled — | 14d past | Readmit — no appointment |
Willie Kowalski M408165 · 72y · Millbrook Clinic (245) 851-4256 | Good Care coordinator | ED Mercy General ED | No case No plan | Aug 14 Aug 14 | Not started — · 0 attempts | Not scheduled — | 13d past | No outreach yet |
Beatrice Lindstrom M419219 · 65y · Stonebridge Health (413) 221-255360d readmit | Fair Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Oct 31 | Oct 22 Oct 30 | Contacted Care coordinator · 1 attempt | No-show Nov 5 · 1 miss | 301d past | No-show recovery |
Callum Nguyen M461172 · 80y · Foxfield Primary (307) 307-332860d readmit | Fair Care coordinator | Inpatient Mercy General | Case open Proj. DC Apr 7 | Mar 30 Apr 6 | Contacted PCP office · 1 attempt | Cancelled Apr 10 · 1 miss | 143d past | No-show recovery |
Simone Salazar M467144 · 65y · Stonebridge Health (415) 244-3561 | Critical Nurse | Inpatient Mercy General | Case open Proj. DC Nov 8 | Oct 29 Nov 8 | Contacted Nurse case manager · 2 attempts | Completed Nov 12 · 4d | Met | On track |
Willie Haddad M448677 · 78y · Foxfield Primary (576) 632-8259 | Critical Nurse | Inpatient Mercy General | Case open Proj. DC Jan 15 | Jan 12 Jan 16 | Contacted Nurse case manager · 2 attempts | Completed Jan 22 · 6d | Met | On track |
Xiomara Kowalski M458773 · 74y · Millbrook Clinic (565) 398-7891 | Critical Nurse | Inpatient Mercy General | No case No plan | Jan 27 Feb 3 | Attempted Nurse case manager · 1 attempt | Not scheduled — | 205d past | On track |
Delia Marsden M420661 · 71y · Stonebridge Health (533) 699-238660d readmit | Serious Nurse | Inpatient Mercy General | Case open Proj. DC Sep 16 | Sep 11 Sep 17 | Contacted Nurse case manager · 1 attempt | Rescheduled Sep 22 · 1 miss | 344d past | On track |
Rafael Mbeki M444201 · 86y · Foxfield Primary (295) 348-4589Returned | Good Care coordinator | SNF Riverstone Post-Acute | No case No plan | Sep 16 Oct 4 | Attempted PCP office · 1 attempt | Not scheduled — | 327d past | Readmit — no appointment |
Terrance Haddad M409708 · 83y · Millbrook Clinic (640) 336-5057Returned | Good Care coordinator | ED Northside Medical ED | Case open Proj. DC Jul 2 | Jul 2 Jul 2 | Contacted Care coordinator · 2 attempts | Not scheduled — | 56d past | Readmit — no appointment |
Alma Ferreira M409318 · 66y · Stonebridge Health (493) 536-3301Returned | Good Care coordinator | Home Health BrightPath Home Health | Case open Proj. DC Apr 6 | Mar 8 Apr 6 | Unable to reach Front desk · 5 attempts | Not scheduled — | 143d past | Readmit — no appointment |
Yuki Okafor M463182 · 65y · Millbrook Clinic (560) 778-7155Returned | Good Care coordinator | Observation St. Aldon Regional | Case open Proj. DC Feb 21 | Feb 16 Feb 21 | Contacted Care coordinator · 2 attempts | Not scheduled — | 187d past | Readmit — no appointment |
Delia Nguyen M439818 · 79y · Millbrook Clinic (333) 768-3170Returned | Good Care coordinator | SNF Riverstone Post-Acute | Case open Proj. DC Dec 21 | Dec 11 Dec 21 | Unable to reach Care coordinator · 5 attempts | Not scheduled — | 249d past | Readmit — no appointment |
Harold Sorensen M476673 · 81y · Millbrook Clinic (558) 866-3136Returned | Good Care coordinator | SNF Willowbrook SNF | No case No plan | Jan 10 Jan 24 | Not started — · 0 attempts | Not scheduled — | 215d past | Readmit — no appointment |
Alma Haddad M494049 · 73y · Foxfield Primary (318) 483-6346Returned | Good Care coordinator | SNF Golden Oaks Rehab | Case open Proj. DC Nov 18 | Oct 25 Nov 19 | Not started — · 0 attempts | Not scheduled — | 281d past | Readmit — no appointment |
Marcus Mbeki M449960 · 81y · Stonebridge Health (586) 279-579260d readmit | Fair Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Sep 1 | Aug 29 Sep 2 | Contacted Front desk · 3 attempts | Not scheduled — | 6d left | Contacted, no appointment |
Eleanor Petrov M492006 · 68y · Millbrook Clinic (306) 592-4491 | Good Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Jul 16 | Jul 8 Jul 17 | Contacted PCP office · 3 attempts | No-show Jul 21 · 1 miss | 41d past | No-show recovery |
Callum Marsden M464786 · 64y · Foxfield Primary (681) 294-107660d readmit | Fair Care coordinator | Inpatient Mercy General | No case No plan | Aug 30 Sep 2 | Attempted Care coordinator · 2 attempts | Not scheduled — | 6d left | Contacted, no appointment |
Eleanor Delgado M423578 · 79y · Foxfield Primary (436) 601-2881 | Good Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Oct 26 | Oct 18 Oct 26 | Contacted PCP office · 1 attempt | No-show Oct 28 · 1 miss | 305d past | No-show recovery |
Lena Marsden M491956 · 87y · Stonebridge Health (636) 407-8852Returned | Serious Nurse | Inpatient Mercy General | No case No plan | May 31 Jun 9 | Contacted Nurse case manager · 1 attempt | Completed Jun 15 · 6d · 1 miss | Met | Readmit — visit completed |
Ingrid Sorensen M435962 · 89y · Foxfield Primary (689) 457-629260d readmit | Fair Care coordinator | SNF Golden Oaks Rehab | Case open Proj. DC Mar 10 | Feb 14 Mar 10 | Contacted Care coordinator · 2 attempts | Cancelled Mar 18 · 1 miss | 170d past | No-show recovery |
Cora Baptiste M407734 · 86y · Stonebridge Health (575) 397-816860d readmit | Fair Care coordinator | ED Valley Baptist ED | Case open Proj. DC May 24 | May 24 May 24 | Contacted Front desk · 1 attempt | No-show Jun 4 · 1 miss | 95d past | No-show recovery |
Delia Baptiste M427738 · 78y · Foxfield Primary (666) 889-1014Returned | Fair Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Jul 28 | Jul 21 Jul 29 | Contacted Front desk · 2 attempts | Not scheduled — | 29d past | Readmit — no appointment |
Cora Whitmore M413822 · 76y · Foxfield Primary (597) 818-9641 | Fair Care coordinator | Observation Mercy General | No case No plan | Aug 11 Aug 14 | Not started — · 0 attempts | Not scheduled — | 13d past | No outreach yet |
Jonas Baptiste M448649 · 70y · Foxfield Primary (287) 646-536060d readmit | Serious Nurse | SNF Willowbrook SNF | Case open Proj. DC Feb 26 | Feb 6 Feb 25 | Contacted Nurse case manager · 3 attempts | Completed Mar 1 · 4d | Met | On track |
Rafael Kowalski M472343 · 64y · Foxfield Primary (669) 458-2843 | Critical Nurse | SNF Golden Oaks Rehab | Case open Proj. DC Jan 2 | Dec 12 Jan 3 | Contacted Nurse case manager · 3 attempts | Completed Jan 7 · 4d | Met | On track |
Priya Chandler M460209 · 71y · Foxfield Primary (646) 474-6044 | Critical Nurse | Observation Mercy General | Case open Proj. DC May 12 | May 7 May 12 | Contacted Care coordinator · 3 attempts | Completed May 16 · 4d | Met | On track |
Lena Okafor M454109 · 82y · Millbrook Clinic (693) 744-6043 | Critical Nurse | Home Health Comfort Care at Home | Case open Proj. DC Nov 11 | Oct 22 Nov 11 | Contacted Nurse case manager · 1 attempt | Completed Nov 14 · 3d | Met | On track |
Bernard Chandler M437362 · 88y · Stonebridge Health (648) 676-7170Returned | Critical Nurse | Observation Northside Medical Center | No case No plan | Apr 24 Apr 29 | Contacted Nurse case manager · 2 attempts | Rescheduled May 5 · 1 miss | 120d past | On track |
Ruth Kowalski M468043 · 65y · Foxfield Primary (624) 675-4347 | Critical Nurse | Observation Northside Medical Center | Case open Proj. DC Oct 5 | Sep 30 Oct 5 | Attempted Nurse case manager · 2 attempts | Not scheduled — | 326d past | On track |
Alma Sorensen M448193 · 77y · Stonebridge Health (396) 810-359260d readmit | Serious Nurse | ED Mercy General ED | Case open Proj. DC Nov 24 | Nov 24 Nov 24 | Contacted Nurse case manager · 3 attempts | Completed Nov 28 · 4d | Met | On track |
Xiomara Sorensen M408477 · 73y · Millbrook Clinic (421) 835-1954Returned | Critical Nurse | ED Mercy General ED | No case No plan | Sep 26 Sep 26 | Contacted Nurse case manager · 3 attempts | Rescheduled Sep 29 · 1 miss | 335d past | On track |
Lena Kowalski M482014 · 58y · Stonebridge Health (301) 572-2967 | Critical Nurse | Observation Northside Medical Center | No case No plan | Mar 6 Mar 10 | Contacted Nurse case manager · 3 attempts | Completed Mar 14 · 4d · 1 miss | Met | On track |
Jonas Kowalski M460715 · 78y · Stonebridge Health (393) 350-6710 | Good Care coordinator | Home Health BrightPath Home Health | No case No plan | Aug 26 LOS 8d | Not started — · 0 attempts | Not scheduled — | In facility | No case management |
Otis Sorensen M425804 · 79y · Stonebridge Health (468) 580-8701 | Critical Nurse | Home Health BrightPath Home Health | Case open Proj. DC Aug 3 | Jul 5 Aug 3 | Contacted Nurse case manager · 2 attempts | Rescheduled Aug 8 · 1 miss | 24d past | On track |
Yuki Whitmore M493443 · 81y · Millbrook Clinic (341) 771-322060d readmit | Serious Nurse | Observation St. Aldon Regional | Case open Proj. DC Oct 17 | Oct 12 Oct 17 | Contacted Nurse case manager · 3 attempts | Completed Nov 2 · 16d | 314d past | On track |
Priya Whitmore M402739 · 89y · Millbrook Clinic (468) 874-2766Returned | Critical Nurse | SNF Ridgeway LTAC | Case open Proj. DC Aug 19 | Aug 1 Aug 18 | Contacted Nurse case manager · 3 attempts | Completed Aug 31 · 13d · 1 miss | 9d past | On track |
Ingrid Salazar M418414 · 90y · Millbrook Clinic (210) 636-4806 | Critical Nurse | ED St. Aldon Regional ED | No case No plan | Dec 25 Dec 25 | Contacted Nurse case manager · 1 attempt | Completed Dec 27 · 2d | Met | On track |
Willie Chandler M419057 · 75y · Millbrook Clinic (570) 269-749760d readmit | Serious Nurse | ED Valley Baptist ED | No case No plan | May 29 May 29 | Contacted Nurse case manager · 1 attempt | Completed May 31 · 2d | Met | On track |
Terrance Rios M451038 · 63y · Millbrook Clinic (443) 270-9759 | Critical Nurse | SNF Willowbrook SNF | Case open Proj. DC Nov 20 | Nov 6 Nov 21 | Contacted Nurse case manager · 1 attempt | Completed Nov 26 · 5d | Met | On track |
Yuki Lindstrom M479264 · 68y · Millbrook Clinic (614) 224-1003 | Good Care coordinator | ED Northside Medical ED | Case open Proj. DC Jul 3 | Jul 3 Jul 3 | Contacted Front desk · 3 attempts | No-show Jul 8 · 1 miss | 55d past | No-show recovery |
Harold Salazar M406030 · 73y · Stonebridge Health (526) 501-4265Returned | Serious Nurse | SNF Ridgeway LTAC | Case open Proj. DC Nov 2 | Oct 23 Nov 3 | Contacted Nurse case manager · 3 attempts | Completed Nov 7 · 4d · 1 miss | Met | Readmit — visit completed |
Xiomara Nguyen M412182 · 69y · Millbrook Clinic (347) 276-7718 | Fair Care coordinator | SNF Golden Oaks Rehab | Case open Proj. DC Aug 29 | Aug 13 Aug 29 | Contacted PCP office · 3 attempts | Not scheduled — | 2d left | Window closing |
Terrance Delgado M453896 · 64y · Millbrook Clinic (596) 584-5841Returned | Fair Care coordinator | ED St. Aldon Regional ED | Case open Proj. DC Jun 4 | Jun 4 Jun 4 | Not started — · 0 attempts | Not scheduled — | 84d past | Readmit — no appointment |
Priya Rios M479311 · 76y · Stonebridge Health (669) 445-9928 | Fair Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Jun 30 | Jun 26 Jun 29 | Contacted Care coordinator · 2 attempts | No-show Jul 2 · 1 miss | 59d past | No-show recovery |
Eleanor Guillory M483514 · 68y · Foxfield Primary (406) 740-3574 | Good Care coordinator | Inpatient Mercy General | Case open Proj. DC Aug 17 | Aug 11 Aug 17 | Unable to reach PCP office · 3 attempts | Not scheduled — | 10d past | Window missed |
Bernard Baptiste M400899 · 91y · Foxfield Primary (269) 577-1961 | Good Care coordinator | Observation Northside Medical Center | Case open Proj. DC Aug 29 | Aug 23 Aug 30 | Attempted Front desk · 2 attempts | Not scheduled — | 3d left | Contacted, no appointment |
Priya Baptiste M438352 · 79y · Stonebridge Health (448) 719-5539 | Serious Nurse | Inpatient Valley Baptist | Case open Proj. DC Sep 12 | Sep 5 Sep 13 | Contacted Nurse case manager · 3 attempts | Completed Sep 23 · 10d | 348d past | On track |
Harold Abernathy M442333 · 71y · Stonebridge Health (542) 847-2003 | Serious Nurse | Inpatient Northside Medical Center | No case No plan | May 4 May 8 | Contacted Nurse case manager · 3 attempts | Completed May 10 · 2d | Met | On track |
Otis Ionescu M419495 · 59y · Millbrook Clinic (259) 887-3941 | Serious Nurse | Inpatient Northside Medical Center | No case No plan | Oct 24 Nov 3 | Contacted Nurse case manager · 2 attempts | Completed Nov 12 · 9d | 297d past | On track |
Xiomara Chandler M400721 · 59y · Stonebridge Health (378) 657-8493 | Serious Nurse | Inpatient St. Aldon Regional | Case open Proj. DC Sep 25 | Sep 18 Sep 26 | Contacted Care coordinator · 2 attempts | Not scheduled — | 335d past | On track |
Cora Abernathy M471465 · 77y · Stonebridge Health (591) 238-3992 | Serious Nurse | Inpatient Northside Medical Center | Case open Proj. DC Oct 24 | Oct 15 Oct 23 | Contacted Nurse case manager · 1 attempt | Completed Oct 29 · 6d | Met | On track |
Cora Rios M451484 · 64y · Foxfield Primary (548) 702-9805 | Serious Nurse | Inpatient Valley Baptist | Case open Proj. DC May 15 | May 11 May 15 | Contacted Care coordinator · 3 attempts | Not scheduled — | 104d past | On track |
Otis Ferreira M461727 · 60y · Foxfield Primary (270) 384-3896 | Serious Nurse | Inpatient Mercy General | No case No plan | May 14 May 24 | Unable to reach Nurse case manager · 3 attempts | Not scheduled — | 95d past | On track |
Ruth Whitmore M407671 · 75y · Foxfield Primary (609) 669-3052Returned | Serious Nurse | Inpatient Mercy General | No case No plan | Aug 23 Aug 29 | Contacted Nurse case manager · 1 attempt | Scheduled Sep 4 | 2d left | On track |
Xiomara Lindstrom M471569 · 64y · Stonebridge Health (211) 696-4465 | Serious Nurse | Inpatient Mercy General | Case open Proj. DC Aug 21 | Aug 13 Aug 22 | Contacted Nurse case manager · 2 attempts | Completed Aug 28 · 6d | Met | On track |
Milton Lindstrom M454880 · 74y · Stonebridge Health (563) 651-5101 | Serious Nurse | Inpatient Northside Medical Center | Case open Proj. DC Sep 6 | Aug 26 LOS 8d | Contacted Nurse case manager · 1 attempt | Not scheduled — | In facility | On track |
Rosa Ferreira M481520 · 91y · Stonebridge Health (408) 506-8458 | Serious Nurse | Inpatient St. Aldon Regional | Case open Proj. DC Feb 8 | Feb 4 Feb 7 | Contacted Nurse case manager · 2 attempts | Completed Feb 9 · 2d | Met | On track |
Willie Marsden M469607 · 71y · Millbrook Clinic (619) 648-6964 | Serious Nurse | Inpatient Valley Baptist | Case open Proj. DC Aug 9 | Aug 2 Aug 10 | Contacted Nurse case manager · 3 attempts | Completed Aug 14 · 4d | Met | On track |
Rosa Whitmore M436412 · 79y · Millbrook Clinic (373) 853-9389 | Serious Nurse | Inpatient Valley Baptist | Case open Proj. DC Apr 25 | Apr 21 Apr 25 | Attempted Care coordinator · 1 attempt | Not scheduled — | 124d past | On track |
Alma Haddad M487397 · 60y · Foxfield Primary (284) 209-9199 | Serious Nurse | Inpatient Northside Medical Center | Case open Proj. DC Sep 2 | Aug 29 Sep 2 | Contacted Nurse case manager · 2 attempts | Scheduled Sep 7 | 6d left | On track |
Delia Ionescu M455958 · 88y · Millbrook Clinic (478) 531-7053 | Serious Nurse | Inpatient St. Aldon Regional | Case open Proj. DC Dec 27 | Dec 23 Dec 27 | Contacted Nurse case manager · 1 attempt | Completed Dec 30 · 3d · 1 miss | Met | On track |
Ingrid Abernathy M446499 · 83y · Foxfield Primary (701) 429-6050 | Serious Nurse | Inpatient Valley Baptist | Case open Proj. DC Jan 6 | Jan 4 Jan 7 | Contacted Care coordinator · 1 attempt | Rescheduled Jan 11 · 1 miss | 232d past | On track |
Simone Delgado M468798 · 90y · Foxfield Primary (361) 859-7021 | Serious Nurse | Inpatient Valley Baptist | Case open Proj. DC Jul 24 | Jul 19 Jul 24 | Contacted Nurse case manager · 3 attempts | Completed Aug 2 · 9d · 1 miss | 34d past | On track |
Imani Haddad M454853 · 82y · Foxfield Primary (419) 785-9019 | Serious Nurse | Inpatient St. Aldon Regional | Case open Proj. DC Aug 13 | Aug 4 Aug 13 | Contacted Nurse case manager · 2 attempts | Completed Aug 19 · 6d | Met | On track |
Alma Mbeki M444975 · 69y · Millbrook Clinic (637) 878-319660d readmit | Good Care coordinator | Inpatient Mercy General | Case open Proj. DC Sep 5 | Sep 1 LOS 2d | Not started — · 0 attempts | Not scheduled — | In facility | On track |
Xiomara Ferreira M417066 · 79y · Millbrook Clinic (309) 479-281560d readmit | Good Care coordinator | Inpatient Valley Baptist | No case No plan | Aug 15 Aug 25 | Contacted Care coordinator · 1 attempt | Completed Aug 28 · 3d | Met | On track |
Hattie Guillory M495006 · 76y · Millbrook Clinic (527) 620-891960d readmit | Good Care coordinator | Inpatient St. Aldon Regional | No case No plan | Aug 12 Aug 20 | Contacted PCP office · 3 attempts | Completed Aug 25 · 5d | Met | On track |
Beatrice Mbeki M434823 · 90y · Stonebridge Health (228) 427-236960d readmit | Good Care coordinator | Inpatient St. Aldon Regional | No case No plan | Jul 22 Jul 26 | Attempted Front desk · 1 attempt | Not scheduled — | 32d past | On track |
Simone Kowalski M449738 · 91y · Millbrook Clinic (600) 294-7524 | Fair Care coordinator | Home Health Anchor Home Services | Case open Proj. DC Aug 22 | Jul 21 Aug 22 | Contacted PCP office · 2 attempts | No-show Aug 24 · 1 miss | 5d past | No-show recovery |
Alma Lindstrom M419936 · 82y · Foxfield Primary (609) 559-6691Returned | Fair Care coordinator | SNF Golden Oaks Rehab | Case open Proj. DC Jun 29 | Jun 21 Jun 30 | Contacted Front desk · 2 attempts | No-show Jul 9 · 1 miss | 58d past | No-show recovery |
Hattie Haddad M446230 · 62y · Stonebridge Health (338) 852-6865 | Good Care coordinator | SNF Golden Oaks Rehab | No case No plan | Aug 16 Aug 26 | Attempted Care coordinator · 1 attempt | Not scheduled — | 1d past | Window missed |
Callum Kowalski M439546 · 66y · Foxfield Primary (625) 610-7306Returned | Fair Care coordinator | Home Health Anchor Home Services | Case open Proj. DC Aug 20 | Jul 19 Aug 21 | Contacted Front desk · 1 attempt | No-show Aug 26 · 1 miss | 6d past | No-show recovery |
Ingrid Petrov M452997 · 58y · Foxfield Primary (230) 887-3473 | Serious Nurse | SNF Golden Oaks Rehab | Case open Proj. DC Feb 13 | Jan 19 Feb 12 | Contacted Nurse case manager · 1 attempt | Completed Feb 14 · 2d | Met | On track |
Bernard Ionescu M457017 · 89y · Millbrook Clinic (225) 786-5435 | Serious Nurse | SNF Riverstone Post-Acute | Case open Proj. DC Mar 25 | Mar 3 Mar 24 | Contacted Nurse case manager · 1 attempt | Completed Mar 28 · 4d | Met | On track |
Simone Ionescu M410757 · 83y · Stonebridge Health (462) 300-9506 | Serious Nurse | SNF Riverstone Post-Acute | Case open Proj. DC Feb 11 | Jan 25 Feb 12 | Contacted Nurse case manager · 1 attempt | Rescheduled Feb 18 · 1 miss | 196d past | On track |
Bernard Sorensen M484557 · 70y · Foxfield Primary (667) 479-7958 | Serious Nurse | Home Health Comfort Care at Home | Case open Proj. DC Nov 22 | Oct 26 Nov 22 | Contacted Nurse case manager · 3 attempts | Rescheduled Dec 4 · 1 miss | 278d past | On track |
Xiomara Petrov M402904 · 66y · Foxfield Primary (275) 478-1079 | Serious Nurse | SNF Riverstone Post-Acute | Case open Proj. DC Dec 15 | Dec 4 Dec 14 | Contacted Nurse case manager · 2 attempts | Completed Dec 26 · 12d | 256d past | On track |
Ingrid Delgado M408132 · 81y · Stonebridge Health (268) 330-7405 | Serious Nurse | SNF Golden Oaks Rehab | Case open Proj. DC Apr 5 | Mar 23 Apr 6 | Contacted Nurse case manager · 1 attempt | Completed Apr 17 · 11d · 1 miss | 143d past | On track |
Eleanor Lindstrom M458535 · 91y · Millbrook Clinic (453) 844-8773Returned | Serious Nurse | SNF Golden Oaks Rehab | Case open Proj. DC Dec 11 | Dec 1 Dec 11 | Contacted Nurse case manager · 2 attempts | Completed Dec 23 · 12d | 259d past | On track |
Bernard Mbeki M491498 · 68y · Foxfield Primary (694) 696-2103 | Serious Nurse | SNF Riverstone Post-Acute | Case open Proj. DC Apr 12 | Mar 30 Apr 12 | Contacted Nurse case manager · 2 attempts | Completed Apr 15 · 3d | Met | On track |
Jonas Marsden M486157 · 78y · Stonebridge Health (533) 499-3134 | Serious Nurse | ED Valley Baptist ED | Case open Proj. DC Nov 8 | Nov 8 Nov 8 | Contacted Nurse case manager · 3 attempts | Completed Nov 23 · 15d | 292d past | On track |
Otis Petrov M462178 · 63y · Stonebridge Health (217) 540-6661 | Serious Nurse | SNF Willowbrook SNF | Case open Proj. DC Apr 17 | Mar 27 Apr 17 | Contacted Nurse case manager · 2 attempts | Completed Apr 29 · 12d · 1 miss | 132d past | On track |
Ingrid Delgado M469501 · 73y · Stonebridge Health (328) 273-3337 | Serious Nurse | ED Mercy General ED | No case No plan | Mar 9 Mar 9 | Contacted Nurse case manager · 1 attempt | Rescheduled Mar 11 · 1 miss | 171d past | On track |
Delia Nguyen M498022 · 80y · Stonebridge Health (312) 747-6669 | Serious Nurse | SNF Willowbrook SNF | No case No plan | Jul 12 Jul 27 | Contacted Nurse case manager · 1 attempt | Not scheduled — | 31d past | On track |
Lena Ionescu M480291 · 83y · Millbrook Clinic (571) 855-6300 | Serious Nurse | Observation St. Aldon Regional | No case No plan | May 13 May 21 | Contacted Nurse case manager · 2 attempts | Completed May 23 · 2d | Met | On track |
Yuki Abernathy M486441 · 89y · Foxfield Primary (405) 652-2802 | Serious Nurse | ED Mercy General ED | No case No plan | Dec 21 Dec 21 | Contacted Nurse case manager · 3 attempts | Completed Dec 25 · 4d · 1 miss | Met | On track |
Marcus Haddad M403381 · 82y · Millbrook Clinic (296) 347-5477 | Serious Nurse | ED Mercy General ED | No case No plan | Nov 23 Nov 23 | Attempted Nurse case manager · 1 attempt | Not scheduled — | 277d past | On track |
Harold Marsden M439182 · 82y · Millbrook Clinic (211) 679-6088 | Serious Nurse | ED Northside Medical ED | Case open Proj. DC Nov 15 | Nov 15 Nov 15 | Contacted Nurse case manager · 2 attempts | Rescheduled Nov 20 · 1 miss | 285d past | On track |
Marcus Tanaka M448932 · 80y · Stonebridge Health (335) 543-8169 | Serious Nurse | Observation St. Aldon Regional | Case open Proj. DC Dec 22 | Dec 15 Dec 21 | Attempted Care coordinator · 1 attempt | Not scheduled — | 249d past | On track |
Nadia Ferreira M431439 · 79y · Millbrook Clinic (348) 237-6743 | Serious Nurse | SNF Golden Oaks Rehab | Case open Proj. DC Aug 23 | Aug 10 Aug 22 | Contacted Nurse case manager · 3 attempts | Completed Aug 27 · 5d | Met | On track |
Terrance Delgado M428885 · 59y · Millbrook Clinic (533) 872-3427 | Serious Nurse | Observation Mercy General | Case open Proj. DC Jan 28 | Jan 26 Jan 29 | Contacted Nurse case manager · 1 attempt | Completed Feb 4 · 6d | Met | On track |
Alma Petrov M422495 · 69y · Millbrook Clinic (574) 494-9295 | Serious Nurse | Home Health Anchor Home Services | Case open Proj. DC Aug 31 | Jul 31 Sep 1 | Contacted Nurse case manager · 2 attempts | Completed Sep 3 · 2d | Met | On track |
Lena Ionescu M480345 · 59y · Foxfield Primary (578) 356-5559 | Serious Nurse | ED Northside Medical ED | No case No plan | May 19 May 19 | Unable to reach Nurse case manager · 4 attempts | Not scheduled — | 100d past | On track |
Delia Salazar M475725 · 71y · Stonebridge Health (424) 549-6414 | Serious Nurse | SNF Ridgeway LTAC | Case open Proj. DC Oct 24 | Oct 11 Oct 25 | Contacted Nurse case manager · 1 attempt | Not scheduled — | 306d past | On track |
Alma Kowalski M495996 · 74y · Millbrook Clinic (408) 320-9372 | Fair Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Aug 11 | Aug 8 Aug 12 | Unable to reach Care coordinator · 4 attempts | Not scheduled — | 15d past | Window missed |
Rafael Marsden M412110 · 59y · Foxfield Primary (212) 829-224660d readmit | Good Care coordinator | ED Mercy General ED | No case No plan | May 27 May 27 | Not started — · 0 attempts | Not scheduled — | 92d past | On track |
Rafael Rios M483578 · 70y · Stonebridge Health (553) 783-433060d readmit | Good Care coordinator | ED Mercy General ED | Case open Proj. DC May 17 | May 17 May 17 | Attempted Care coordinator · 2 attempts | Not scheduled — | 102d past | On track |
Yuki Okafor M447397 · 91y · Millbrook Clinic (645) 206-813160d readmit | Good Care coordinator | ED St. Aldon Regional ED | No case No plan | Mar 20 Mar 20 | Not started — · 0 attempts | Not scheduled — | 160d past | On track |
Otis Rios M440364 · 74y · Foxfield Primary (555) 479-272560d readmit | Good Care coordinator | SNF Golden Oaks Rehab | No case No plan | Mar 4 Mar 29 | Contacted Care coordinator · 2 attempts | Completed Apr 1 · 3d | Met | On track |
Xiomara Lindstrom M486026 · 69y · Millbrook Clinic (401) 643-779360d readmit | Good Care coordinator | ED Valley Baptist ED | No case No plan | Jan 29 Jan 29 | Not started — · 0 attempts | Not scheduled — | 210d past | On track |
Ruth Kowalski M439611 · 59y · Stonebridge Health (353) 746-680660d readmit | Good Care coordinator | ED Mercy General ED | No case No plan | Jul 9 Jul 9 | Contacted Care coordinator · 3 attempts | Not scheduled — | 49d past | On track |
Yuki Okafor M416855 · 76y · Millbrook Clinic (423) 455-478460d readmit | Good Care coordinator | Observation Mercy General | No case No plan | Nov 2 Nov 7 | Not started — · 0 attempts | Not scheduled — | 293d past | On track |
Ruth Abernathy M451246 · 85y · Stonebridge Health (622) 242-383460d readmit | Fair Care coordinator | Inpatient Mercy General | Case open Proj. DC Jun 22 | Jun 15 Jun 22 | Contacted PCP office · 1 attempt | Rescheduled Jun 26 · 1 miss | 66d past | On track |
Beatrice Baptiste M412542 · 62y · Foxfield Primary (656) 330-421760d readmit | Fair Care coordinator | Inpatient Northside Medical Center | Case open Proj. DC Jun 23 | Jun 16 Jun 22 | Contacted Care coordinator · 3 attempts | Completed Jul 5 · 13d | 66d past | On track |
Jonas Rios M443142 · 71y · Millbrook Clinic (285) 376-6135 | Good Care coordinator | Inpatient Northside Medical Center | Case open Proj. DC Dec 10 | Dec 4 Dec 10 | Contacted Care coordinator · 2 attempts | Not scheduled — | 260d past | On track |
Nadia Baptiste M476963 · 77y · Stonebridge Health (343) 884-7096 | Good Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Dec 20 | Dec 10 Dec 20 | Unable to reach Care coordinator · 3 attempts | Not scheduled — | 250d past | On track |
Hattie Tanaka M479482 · 89y · Stonebridge Health (228) 440-3298 | Good Care coordinator | Inpatient Valley Baptist | No case No plan | Jan 8 Jan 15 | Contacted Care coordinator · 2 attempts | Completed Jan 31 · 16d | 224d past | On track |
Dwight Marsden M455129 · 85y · Millbrook Clinic (474) 278-5186 | Good Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Jul 28 | Jul 21 Jul 28 | Contacted Care coordinator · 2 attempts | Completed Jul 30 · 2d | Met | On track |
Harold Abernathy M420955 · 81y · Millbrook Clinic (627) 449-3890 | Good Care coordinator | Inpatient Mercy General | No case No plan | Jul 23 Jul 28 | Contacted Care coordinator · 1 attempt | Completed Aug 1 · 4d | Met | On track |
Marcus Marsden M479564 · 80y · Foxfield Primary (275) 334-6158 | Good Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Sep 5 | Aug 30 LOS 4d | Not started — · 0 attempts | Not scheduled — | In facility | On track |
Jonas Tanaka M465868 · 61y · Stonebridge Health (305) 541-9060 | Good Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Jun 24 | Jun 13 Jun 23 | Contacted PCP office · 2 attempts | Not scheduled — | 65d past | On track |
Callum Haddad M421532 · 91y · Stonebridge Health (262) 482-3627 | Good Care coordinator | Inpatient Mercy General | Case open Proj. DC Jun 2 | May 30 Jun 3 | Unable to reach Care coordinator · 3 attempts | Not scheduled — | 85d past | On track |
Bernard Guillory M441819 · 81y · Millbrook Clinic (637) 249-8837 | Good Care coordinator | Inpatient Northside Medical Center | Case open Proj. DC Jul 23 | Jul 18 Jul 23 | Contacted Care coordinator · 1 attempt | Completed Jul 25 · 2d | Met | On track |
Jonas Rios M477382 · 58y · Stonebridge Health (659) 712-6534 | Good Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Mar 7 | Mar 3 Mar 7 | Unable to reach PCP office · 5 attempts | Not scheduled — | 173d past | On track |
Rafael Sorensen M447445 · 67y · Foxfield Primary (586) 846-8074 | Good Care coordinator | Inpatient Valley Baptist | Case open Proj. DC May 30 | May 27 May 31 | Attempted Front desk · 2 attempts | Not scheduled — | 88d past | On track |
Bernard Guillory M455701 · 71y · Foxfield Primary (399) 543-7938 | Good Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Feb 13 | Feb 10 Feb 13 | Unable to reach Front desk · 5 attempts | Not scheduled — | 195d past | On track |
Hattie Chandler M469412 · 60y · Millbrook Clinic (576) 874-3291 | Good Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Dec 15 | Dec 8 Dec 16 | Contacted PCP office · 3 attempts | Completed Dec 26 · 10d | 254d past | On track |
Rafael Mbeki M450159 · 59y · Millbrook Clinic (648) 515-3322 | Good Care coordinator | Inpatient Northside Medical Center | Case open Proj. DC Nov 18 | Nov 16 Nov 19 | Contacted PCP office · 3 attempts | Completed Nov 24 · 5d | Met | On track |
Bernard Salazar M468602 · 88y · Millbrook Clinic (567) 309-9875 | Good Care coordinator | Inpatient Mercy General | Case open Proj. DC Aug 9 | Aug 5 Aug 8 | Contacted PCP office · 2 attempts | Completed Aug 12 · 4d | Met | On track |
Marcus Lindstrom M429110 · 61y · Stonebridge Health (658) 216-378660d readmit | Fair Care coordinator | ED Northside Medical ED | Case open Proj. DC Aug 8 | Aug 8 Aug 8 | Contacted Care coordinator · 1 attempt | Completed Aug 13 · 5d | Met | On track |
Willie Delgado M425293 · 83y · Millbrook Clinic (302) 351-498260d readmit | Fair Care coordinator | SNF Golden Oaks Rehab | Case open Proj. DC Jan 9 | Dec 21 Jan 9 | Attempted Care coordinator · 1 attempt | Not scheduled — | 230d past | On track |
Dwight Sorensen M455646 · 77y · Foxfield Primary (347) 614-170460d readmit | Fair Care coordinator | SNF Ridgeway LTAC | Case open Proj. DC Apr 21 | Apr 2 Apr 20 | Contacted Care coordinator · 3 attempts | Completed Apr 26 · 6d | Met | On track |
Milton Delgado M481022 · 86y · Foxfield Primary (492) 817-187160d readmit | Fair Care coordinator | SNF Willowbrook SNF | Case open Proj. DC Apr 4 | Mar 15 Apr 3 | Attempted Care coordinator · 2 attempts | Not scheduled — | 146d past | On track |
Callum Nguyen M432468 · 60y · Foxfield Primary (231) 433-800660d readmit | Fair Care coordinator | SNF Ridgeway LTAC | Case open Proj. DC Jul 22 | Jul 8 Jul 23 | Contacted PCP office · 2 attempts | Completed Jul 27 · 4d | Met | On track |
Terrance Nguyen M479648 · 84y · Stonebridge Health (467) 539-1458 | Good Care coordinator | SNF Ridgeway LTAC | Case open Proj. DC Dec 14 | Dec 2 Dec 15 | Attempted PCP office · 1 attempt | Not scheduled — | 255d past | On track |
Hattie Guillory M482258 · 80y · Stonebridge Health (554) 386-7207 | Good Care coordinator | Observation Mercy General | Case open Proj. DC Aug 14 | Aug 11 Aug 14 | Contacted Care coordinator · 2 attempts | Completed Aug 20 · 6d | Met | On track |
Hattie Lindstrom M487088 · 59y · Stonebridge Health (248) 875-7611 | Good Care coordinator | ED Mercy General ED | No case No plan | Feb 6 Feb 6 | Contacted Front desk · 2 attempts | Completed Feb 10 · 4d | Met | On track |
Milton Marsden M470917 · 69y · Foxfield Primary (346) 631-2479 | Good Care coordinator | SNF Willowbrook SNF | Case open Proj. DC May 8 | Apr 22 May 7 | Contacted Front desk · 3 attempts | Rescheduled May 13 · 1 miss | 112d past | On track |
Rafael Abernathy M469414 · 84y · Stonebridge Health (222) 444-6772 | Good Care coordinator | ED St. Aldon Regional ED | No case No plan | Jul 27 Jul 27 | Contacted Front desk · 2 attempts | Not scheduled — | 31d past | On track |
Alma Sorensen M436239 · 79y · Stonebridge Health (686) 587-2517 | Good Care coordinator | ED Northside Medical ED | No case No plan | Jul 12 Jul 12 | Contacted Care coordinator · 3 attempts | Rescheduled Jul 17 · 1 miss | 46d past | On track |
Xiomara Mbeki M424052 · 91y · Stonebridge Health (678) 878-5654 | Good Care coordinator | Home Health Comfort Care at Home | Case open Proj. DC Feb 11 | Jan 23 Feb 12 | Attempted Care coordinator · 1 attempt | Not scheduled — | 196d past | On track |
Terrance Whitmore M458069 · 61y · Stonebridge Health (615) 349-9493 | Good Care coordinator | Observation Northside Medical Center | Case open Proj. DC Dec 5 | Nov 28 Dec 6 | Contacted Care coordinator · 3 attempts | Rescheduled Dec 8 · 1 miss | 264d past | On track |
Cora Petrov M472886 · 62y · Foxfield Primary (694) 337-7737 | Good Care coordinator | Observation Northside Medical Center | Case open Proj. DC Oct 23 | Oct 18 Oct 23 | Contacted Front desk · 1 attempt | Completed Nov 2 · 10d | 308d past | On track |
Xiomara Haddad M488397 · 78y · Foxfield Primary (410) 353-8683 | Good Care coordinator | ED Valley Baptist ED | No case No plan | Apr 15 Apr 15 | Contacted PCP office · 3 attempts | Completed Apr 21 · 6d · 1 miss | Met | On track |
Priya Chandler M488781 · 66y · Stonebridge Health (445) 231-3016 | Good Care coordinator | SNF Ridgeway LTAC | Case open Proj. DC Jun 16 | Jun 5 Jun 16 | Not started — · 0 attempts | Not scheduled — | 72d past | On track |
Xiomara Tanaka M467375 · 83y · Millbrook Clinic (222) 623-1990 | Good Care coordinator | Home Health BrightPath Home Health | Case open Proj. DC Apr 4 | Mar 15 Apr 3 | Contacted Care coordinator · 1 attempt | Completed Apr 6 · 3d | Met | On track |
Eleanor Ferreira M450311 · 87y · Millbrook Clinic (430) 301-5022 | Good Care coordinator | SNF Riverstone Post-Acute | Case open Proj. DC Jun 28 | Jun 4 Jun 28 | Contacted Front desk · 2 attempts | Not scheduled — | 60d past | On track |
Rafael Nguyen M466216 · 65y · Millbrook Clinic (403) 301-6326 | Good Care coordinator | Home Health Anchor Home Services | Case open Proj. DC Apr 18 | Mar 23 Apr 19 | Unable to reach Care coordinator · 3 attempts | Not scheduled — | 130d past | On track |
Gerald Marsden M420255 · 85y · Foxfield Primary (536) 352-8561 | Good Care coordinator | SNF Willowbrook SNF | Case open Proj. DC Apr 16 | Mar 27 Apr 16 | Contacted Front desk · 1 attempt | Completed Apr 19 · 3d | Met | On track |
Cora Abernathy M475278 · 88y · Stonebridge Health (264) 214-9757 | Good Care coordinator | SNF Ridgeway LTAC | Case open Proj. DC Nov 29 | Nov 11 Nov 28 | Contacted Care coordinator · 1 attempt | Completed Dec 4 · 6d · 1 miss | Met | On track |
Priya Sorensen M470423 · 73y · Millbrook Clinic (267) 826-6059 | Good Care coordinator | ED Northside Medical ED | No case No plan | Mar 11 Mar 11 | Not started — · 0 attempts | Not scheduled — | 169d past | On track |
Rafael Salazar M476879 · 63y · Millbrook Clinic (633) 662-4562 | Good Care coordinator | SNF Ridgeway LTAC | Case open Proj. DC Mar 30 | Mar 23 Mar 31 | Contacted Care coordinator · 2 attempts | Completed Apr 2 · 2d | Met | On track |
Callum Guillory M449545 · 76y · Millbrook Clinic (212) 201-7025 | Good Care coordinator | SNF Ridgeway LTAC | Case open Proj. DC Aug 20 | Aug 1 Aug 20 | Contacted Care coordinator · 2 attempts | Completed Aug 22 · 2d | Met | On track |
Dwight Ionescu M475660 · 78y · Millbrook Clinic (288) 731-8167 | Good Care coordinator | ED St. Aldon Regional ED | Case open Proj. DC Oct 29 | Oct 29 Oct 29 | Contacted Care coordinator · 2 attempts | Completed Oct 31 · 2d | Met | On track |
Lena Marsden M460060 · 61y · Stonebridge Health (540) 234-6863 | Good Care coordinator | Home Health Comfort Care at Home | Case open Proj. DC Nov 25 | Oct 25 Nov 26 | Attempted PCP office · 1 attempt | Not scheduled — | 274d past | On track |
Rafael Marsden M406246 · 83y · Stonebridge Health (699) 631-1027 | Fair Care coordinator | Inpatient Northside Medical Center | Case open Proj. DC Feb 4 | Jan 31 Feb 4 | Contacted Front desk · 3 attempts | Rescheduled Feb 8 · 1 miss | 204d past | On track |
Cora Rios M415218 · 70y · Stonebridge Health (364) 548-7586 | Fair Care coordinator | Inpatient Mercy General | Case open Proj. DC Feb 27 | Feb 21 Feb 26 | Attempted PCP office · 2 attempts | Not scheduled — | 182d past | On track |
Rosa Lindstrom M479235 · 91y · Stonebridge Health (606) 227-5086 | Fair Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Aug 29 | Aug 26 Aug 30 | Contacted Care coordinator · 2 attempts | Scheduled Sep 14 | 3d left | On track |
Xiomara Lindstrom M459894 · 85y · Stonebridge Health (311) 860-7546 | Fair Care coordinator | Inpatient Mercy General | Case open Proj. DC Aug 6 | Aug 2 Aug 6 | Contacted PCP office · 1 attempt | Completed Aug 15 · 9d | 21d past | On track |
Ruth Rios M402426 · 85y · Stonebridge Health (275) 794-2967 | Fair Care coordinator | Inpatient Northside Medical Center | Case open Proj. DC Feb 23 | Feb 12 Feb 22 | Contacted Care coordinator · 2 attempts | Completed Feb 28 · 6d | Met | On track |
Simone Abernathy M442298 · 88y · Millbrook Clinic (597) 605-9695 | Fair Care coordinator | Inpatient St. Aldon Regional | No case No plan | May 18 May 24 | Attempted Care coordinator · 2 attempts | Not scheduled — | 95d past | On track |
Imani Haddad M419803 · 63y · Foxfield Primary (531) 215-2583 | Fair Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Mar 11 | Mar 8 Mar 11 | Unable to reach PCP office · 5 attempts | Not scheduled — | 169d past | On track |
Xiomara Ferreira M409602 · 85y · Millbrook Clinic (390) 369-8022 | Fair Care coordinator | Inpatient Valley Baptist | No case No plan | Apr 7 Apr 17 | Not started — · 0 attempts | Not scheduled — | 132d past | On track |
Jonas Guillory M460066 · 65y · Foxfield Primary (531) 255-4583 | Fair Care coordinator | Inpatient Valley Baptist | Case open Proj. DC May 5 | Apr 26 May 4 | Contacted Care coordinator · 1 attempt | Not scheduled — | 115d past | On track |
Priya Nguyen M450195 · 85y · Millbrook Clinic (262) 213-3871 | Fair Care coordinator | Inpatient Northside Medical Center | Case open Proj. DC Sep 3 | Aug 31 Sep 3 | Contacted Care coordinator · 3 attempts | Scheduled Sep 9 | 7d left | On track |
Xiomara Nguyen M413936 · 69y · Foxfield Primary (322) 459-3264 | Fair Care coordinator | Inpatient Northside Medical Center | No case No plan | Jan 7 Jan 14 | Unable to reach Front desk · 3 attempts | Not scheduled — | 225d past | On track |
Willie Mbeki M440899 · 64y · Millbrook Clinic (365) 225-1528 | Fair Care coordinator | Inpatient Mercy General | Case open Proj. DC Aug 26 | Aug 17 Aug 25 | Contacted Care coordinator · 2 attempts | Completed Aug 29 · 4d · 1 miss | Met | On track |
Rosa Tanaka M423742 · 68y · Millbrook Clinic (621) 384-3046 | Fair Care coordinator | Inpatient Mercy General | Case open Proj. DC Apr 20 | Apr 14 Apr 19 | Contacted PCP office · 3 attempts | Rescheduled Apr 25 · 1 miss | 130d past | On track |
Delia Okafor M440359 · 63y · Millbrook Clinic (249) 764-4887 | Fair Care coordinator | Inpatient Valley Baptist | Case open Proj. DC Apr 26 | Apr 20 Apr 25 | Contacted Care coordinator · 1 attempt | Completed May 9 · 14d | 124d past | On track |
Cora Guillory M496095 · 58y · Foxfield Primary (679) 254-1861 | Fair Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Sep 3 | Aug 28 LOS 6d | Not started — · 0 attempts | Not scheduled — | In facility | On track |
Dwight Okafor M437879 · 75y · Foxfield Primary (698) 662-5728 | Fair Care coordinator | Inpatient Mercy General | Case open Proj. DC May 4 | Apr 29 May 5 | Contacted Care coordinator · 2 attempts | Rescheduled May 9 · 1 miss | 114d past | On track |
Terrance Ferreira M411304 · 80y · Millbrook Clinic (341) 751-8390 | Fair Care coordinator | Inpatient St. Aldon Regional | Case open Proj. DC Oct 19 | Oct 15 Oct 18 | Contacted Care coordinator · 1 attempt | Rescheduled Oct 21 · 1 miss | 313d past | On track |
Bernard Tanaka M406144 · 67y · Stonebridge Health (344) 654-5452 | Fair Care coordinator | ED Mercy General ED | No case No plan | May 1 May 1 | Not started — · 0 attempts | Not scheduled — | 118d past | On track |
Simone Kowalski M456477 · 78y · Stonebridge Health (691) 375-5700 | Fair Care coordinator | ED Northside Medical ED | No case No plan | Feb 20 Feb 20 | Contacted Front desk · 1 attempt | Not scheduled — | 188d past | On track |
Amir Marsden M423003 · 67y · Foxfield Primary (341) 487-3961 | Fair Care coordinator | SNF Golden Oaks Rehab | Case open Proj. DC Sep 11 | Aug 19 LOS 15d | Not started — · 0 attempts | Not scheduled — | In facility | On track |
Milton Nguyen M460065 · 88y · Stonebridge Health (361) 354-1393 | Fair Care coordinator | Home Health BrightPath Home Health | Case open Proj. DC Feb 1 | Jan 1 Feb 2 | Attempted Care coordinator · 2 attempts | Not scheduled — | 206d past | On track |
Rosa Chandler M435433 · 84y · Foxfield Primary (355) 461-4878 | Fair Care coordinator | SNF Riverstone Post-Acute | Case open Proj. DC Oct 22 | Oct 9 Oct 21 | Contacted Care coordinator · 3 attempts | Completed Nov 1 · 11d · 1 miss | 310d past | On track |
Bernard Sorensen M473750 · 60y · Foxfield Primary (612) 204-6350 | Fair Care coordinator | Observation Mercy General | No case No plan | Oct 8 Oct 11 | Contacted Care coordinator · 3 attempts | Not scheduled — | 320d past | On track |
Imani Delgado M408489 · 82y · Foxfield Primary (493) 204-4533 | Fair Care coordinator | SNF Golden Oaks Rehab | No case No plan | Mar 23 Apr 5 | Contacted Care coordinator · 2 attempts | Completed Apr 11 · 6d | Met | On track |
Harold Abernathy M450818 · 88y · Foxfield Primary (206) 703-8379 | Fair Care coordinator | SNF Ridgeway LTAC | No case No plan | May 18 Jun 12 | Contacted PCP office · 2 attempts | Rescheduled Jun 22 · 1 miss | 76d past | On track |
Simone Salazar M447929 · 90y · Millbrook Clinic (283) 404-5757 | Fair Care coordinator | ED Northside Medical ED | Case open Proj. DC Nov 24 | Nov 24 Nov 24 | Contacted Front desk · 3 attempts | Completed Dec 8 · 14d · 1 miss | 276d past | On track |
Frank Baptiste M434513 · 87y · Foxfield Primary (525) 890-3693 | Fair Care coordinator | Home Health Comfort Care at Home | Case open Proj. DC Jul 16 | Jun 20 Jul 15 | Contacted PCP office · 3 attempts | Completed Jul 17 · 2d | Met | On track |
Showing the top 200 by priority — narrow the filters or export for the full list.