In-home primary care in Jefferson County
Getting older in Jefferson County often means getting older a long way from the doctor. People in High Ridge, House Springs, Hillsboro or De Soto may drive half an hour or more to a primary care office, and those who can no longer drive depend on family who may work in St. Louis. In-home primary care follow-up shrinks that distance. A partner clinician visits the home, reviews chronic conditions and medications, and looks for concerns that should be addressed early. Gateway arranges the schedule and shares notes with other providers.
Jefferson County has subdivisions and apartments in Arnold and Imperial, older homes in the river towns, manufactured homes, lake communities, and houses on acreage reached by gravel roads. Skilled nursing, rehabilitation and assisted living facilities are found mainly in the larger towns. Gateway arranges partner clinician visits in private homes and in facilities throughout the county. For homes, we collect directions and access notes. For facilities, we work with the nursing team so that wound orders, supply deliveries and visit days are understood by every shift.
For the full range of services, see primary care in St. Louis, including house calls, annual wellness visits and follow-up after a hospital stay.
What in-home primary care includes
Coming home from a hospital or rehab stay leaves loose ends: new prescriptions, instructions read in a hurry, appointments at several offices. In-home primary care follow-up brings a clinician to you during that stretch. The treating clinician reads the discharge papers with you, sorts out which medications are new, changed or stopped, checks how you are recovering and decides which tests and appointments are still needed. Our page on follow-up care after hospital discharge explains more.
Once things settle, the visits turn to routine care. That means keeping watch on long-term conditions such as diabetes or heart disease, a yearly wellness visit, and referrals to specialists, with Gateway following through on the orders.
Who in-home primary care is for
Recovering from surgery or living with a wound changes what a trip to the doctor involves. A leg that needs to stay elevated, a dressing that should stay dry, pain with sitting, or instructions to keep weight off a foot all make travel harder. For people in Jefferson County in that situation, Gateway can arrange primary care follow-up where they live, so the conditions that affect recovery are not put off until the wound has closed.
The same service helps adults who rarely leave home for other reasons, people in assisted living communities, and people who have no primary care clinician right now.
Why wound care and primary care go together
Swollen legs make wounds slower to heal and skin easier to break. The swelling usually has a cause somewhere else in the body, such as the heart, the kidneys, the veins or a medication. Finding that cause and managing it belongs to primary care and, at times, a specialist. Wrapping the leg and caring for the skin belongs to the wound care team.
The two depend on each other. A wound care clinician who sees a leg at every visit may be the first to notice that swelling is worse or shoes have become tight. Gateway passes that observation to the primary care clinician, who decides whether anything in the medical plan should change.
Where visits take place
Skilled nursing works differently from the other places where Gateway arranges primary care follow-up. Every resident already has an attending physician who is responsible for medical care, and facility nurses carry out the orders. We do not replace that team. In facilities in Jefferson County, we coordinate with the attending and the nursing staff, and we plan follow-up for the day a resident leaves. See primary care follow-up in skilled nursing.
After discharge, a partner clinician can visit at the next address, whether that is a private home, an apartment, assisted living or memory care.
One care team, shared information
Home health and primary care are different jobs that depend on each other. A home health agency sends nurses and therapists, and they work from a clinician’s signed orders. The primary care clinician writes and updates those orders and decides what to do when the nurse reports a change. Without a clinician they can reach, home health staff are left waiting for answers. When Gateway coordinates primary care for someone who has home health, we tell the agency which practice is responsible, where to send reports and whom to call with a concern.
How to start
Here is what follows a call to 314-325-0126. First, we confirm whether a partner clinician is available for your address in Jefferson County and for your type of residence. Next, with your permission, we request records from your doctor’s office or the hospital you were in, so the clinician arrives informed. Then we schedule the visit. After the visit, we follow through on what the clinician ordered, whether that is lab work, equipment or a referral, and keep the people you choose up to date.
- County: Jefferson County, Missouri
- ZIP codes: 63010, 63028, 63019, 63052, 63012, 63050, 63020, 63049, 63051
- Nearby hospitals: Mercy Hospital Jefferson in Festus; Mercy Hospital South; SSM Health St. Clare Hospital in Fenton (not affiliated with Gateway)
- Nearby communities: Arnold, Festus and Crystal City, Imperial, Fenton, Oakville
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
What to ask about your plan
Before a first home visit, a call to the member number on your insurance card can answer most cost questions. Useful things to ask:
- Does this practice participate in my plan?
- Do I need a referral or prior authorization for visits at home?
- What would I owe for a visit?
- Are lab work, imaging and medical equipment handled differently?
Write down the date, the name of the person you spoke with and what they said. Gateway can give you the name of the treating practice to use for that call.
Common questions
Can my spouse and I both be seen during one home visit in Jefferson County?
You can ask for that. Each of you is a separate patient, with your own records, your own coverage questions and your own visit. When one partner practice can see both people, we try to line the visits up back to back so the household has one appointment time. Whether that works depends on clinician availability, so we confirm it when scheduling.
Does Gateway arrange primary care in Jefferson County for people who do not have a wound?
Yes. The company name says wound care, but you can ask about a primary care clinician who visits at home whether or not you have a wound. Long-term conditions, a recent hospital stay or simply being unable to get to an office are all reasons to call. If a wound does develop later, having primary care already in place makes it easier to coordinate both.
Will Medicare or my insurance pay for primary care at home in Jefferson County?
We cannot answer that in general, because it depends on the treating practice, your specific plan and the care you need. When you call, ask which practice would see you. Then call the number on your Medicare or insurance card and ask whether that practice participates in your plan and what you would owe for a visit at home.
How often will a primary care clinician visit me in Jefferson County?
The treating clinician sets the schedule after seeing you, and it changes with your health. Someone just out of the hospital, or with a condition that is not yet stable, is usually seen more often than someone who is steady. Gateway cannot promise a set number of visits or a set interval in advance. Ask at the first visit when the next one should be.
How is in-home primary care in Jefferson County different from home health?
Home health is a service from an agency that sends nurses and therapists, usually for a limited period after an illness, injury or hospital stay, and it runs on a clinician’s orders. Primary care is the clinician who manages your overall health, prescribes medications and writes those orders. Many people have both at once, and the two work better when they share information.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.