For Care Coordinators, Social Workers and Discharge Planners

Somebody is medically cleared and the house is the only thing standing between them and a discharge. You have a date, and the family has no plan.

That is most of what this page is about.

Where Our Referrals Come From

Discharge planners at hospitals in Albuquerque, Santa Fe, Las Cruces and the rural regional centers. Turquoise Care care coordinators at the managed care organizations. Aging and Disability Resource Center options counsellors. Adult Protective Services. Public health nurses. Home health agencies who cannot safely put an aide into a property. Hospice social workers. Tribal social services and community health representatives. Veterans’ service officers. Guardians, conservators and court-appointed fiduciaries.

What Goes In Your File

• Written assessment with photographs, usually within a day or two of the referral
• A fixed written estimate that does not change afterwards
• Room-by-room completion photographs
• Certificates of insurance on request
• Written confirmation that specific safety conditions were met
• A direct line to the crew lead rather than a call center
• Spanish-language communication with the client and family where needed

The Scope Most Referrals Actually Need

Very few of your clients need a spotless house. They need a property that will pass a home safety assessment, and that is a much shorter list.

Clear egress from every sleeping room. A path wide enough for a walker or wheelchair between bed, bathroom and kitchen. Working smoke alarms that can be reached. No standing waste or contamination. Clear stairs and landings. Nothing stacked against a heat source.

We will do exactly that scope and stop there. It often costs a fraction of a full cleanout, and it is frequently the whole difference between a discharge that happens on schedule and one that does not.

The Hantavirus Conversation

Worth raising with any client on a rural property, because it is a genuine occupational issue for your staff as well as a risk to the family.

Deer mice in New Mexico carry hantavirus, and it is transmitted by breathing dust disturbed from droppings and nesting material. That is exactly what happens when a family starts clearing a shed or a back room. Dry-sweeping and vacuuming are the worst possible methods.

If you have a client whose property fits that description, please steer the family away from doing it themselves. We will assess it at no cost. See biohazard cleaning.

Reluctant Clients

We come as workers, not as an inspection. No clipboards at the door, no assessment vocabulary. That single distinction does more for the first hour than anything else we do.

We do not force. If your client halts the job, it halts, and you will hear about it from us honestly rather than through a complaint.

Where APS or a court is involved, we document precisely what was and was not completed.

Tribal Communities

If your client lives on Navajo Nation, at a pueblo, or on Apache land, tell us at the referral. Tribal jurisdictions have their own requirements for outside contractors and we follow the nation’s process rather than assuming state rules apply. We would rather spend a week getting the permissions right than turn up and be turned away.

Timelines

Give us the discharge date or hearing date and we will tell you plainly whether it is reachable. When it is not, we will tell you what can be finished by then, which is more use to you than an optimistic yes.