House call primary care in Monroe and Clinton counties
In Monroe and Clinton counties, a routine primary care visit can mean a drive past miles of fields, and for some Monroe County residents, a trip over the river into Missouri. Older adults who have spent their lives in these towns often want to stay in their own homes, even after driving is no longer safe. Gateway arranges in-home primary care follow-up with partner clinicians so conditions such as diabetes, heart failure and high blood pressure are reviewed regularly. The treating clinician directs the care. We coordinate the records, orders and follow-up.
Homes in Monroe and Clinton counties include farmhouses, houses on small-town streets, newer subdivisions around Columbia and Waterloo, and apartments for older adults. Assisted living and skilled nursing care are available in several of the towns and serve the countryside around them. Gateway arranges visits with partner clinicians in both. For a farmhouse or a home outside town, we ask who will be there to let the clinician in and what time of day suits the household. For facilities, we speak with the nursing staff about visit timing, the resident’s chart and the treating clinician’s orders.
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
Primary care at home is not only for times when something is wrong. A yearly wellness visit looks ahead. It is a planning visit more than a physical exam: a review of your health risks, questions about memory, mood and falls, and a schedule for the vaccines and screenings that fit your age and health. Some people also use it to talk through the care they would want during a serious illness. See annual wellness visits for what to expect.
Between wellness visits, follow-up covers the everyday work of primary care: managing long-term conditions, reviewing medications, checking in after a hospital stay, and ordering lab tests or specialist visits when the treating clinician decides they are needed.
Who it helps
Getting to a doctor’s office is the hard part for many people in Monroe and Clinton counties. Stairs, a wheelchair, an oxygen tank, no longer driving, or needing a second person just to reach the car can turn a short appointment into a full day. In-home primary care is arranged for adults in that position, whether or not they think of themselves as homebound. Our page on primary care for homebound adults goes into detail.
It also suits people recovering from surgery or living with a wound, residents of assisted living, and anyone whose longtime doctor has retired or moved and who has gone without primary care since.
Why wound care and primary care go together
A wound on the leg or foot needs blood flow to heal, and checking circulation is partly a primary care job. The primary care clinician asks about leg pain with walking, checks the pulses in your feet, reviews risks such as smoking, diabetes and high cholesterol, and decides whether a circulation test or a vascular specialist is needed. The page on circulation and vascular health explains the basics.
Those results matter to the wound care clinician, because poor arterial flow changes which treatments are safe, including compression. Gateway sends test results and specialist notes to both clinicians, so each one is working from the same facts.
Homes, assisted living and skilled nursing
For someone living with dementia, a trip to a clinic can mean a strange room, a long wait and a hard day afterward. Seeing the clinician in a familiar place is usually calmer. In memory care communities in Monroe and Clinton counties, the visiting clinician can talk with the staff who know the resident’s normal routine, and a family member or legal decision-maker can join in person or by phone.
Gateway also arranges primary care follow-up in houses, apartments, assisted living and skilled nursing facilities. Availability depends on the location and the type of setting, and we confirm it before a visit is booked.
Working with your existing doctors
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.
Getting started in Monroe and Clinton counties
Some people in Monroe and Clinton counties come to primary care through another door. If Gateway already coordinates wound care for you, tell your coordinator that you would like primary care follow-up too. We already have your address and contact details. If you are in a hospital or rehab center, the discharge planner can make a referral before you leave. Facility nurses and physician offices can do the same by phone at 314-325-0126 or by fax at 314-786-7966. Whoever starts the request, we confirm availability before anything is scheduled.
- County: Monroe and Clinton counties, Illinois
- ZIP codes: 62236, 62298, 62230, 62231
- Nearby hospitals: HSHS St. Joseph's Hospital in Breese; Memorial Hospital Belleville; Mercy Hospital South (not affiliated with Gateway)
- Nearby communities: Belleville, Illinois, St. Clair County, Illinois, Metro East, Oakville
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Coverage questions
The visit itself is not the only thing to ask about. Lab tests, imaging, medical equipment and supplies are usually billed by whoever provides them, under their own rules. Programs that add support between visits, such as chronic care management or remote monitoring, are billed separately from visits and may carry their own cost share, so ask about that before you enroll. Gateway does not quote prices. The treating practice and your health plan are the sources for what you would owe.
Common questions
What should I do if I get sick between home visits in Monroe and Clinton counties?
For chest pain, trouble breathing, signs of a stroke, heavy bleeding, fainting or sudden confusion, call 911. In-home primary care is planned care, and Gateway is not an emergency service. For a problem that is worrying but not an emergency, such as a fever or a new cough, call the treating clinician’s practice. Ask at your first visit which number to use.
What if my parent in Monroe and Clinton counties has dementia and cannot answer the clinician’s questions?
That is common, and the visit can still be useful. A family member, caregiver or facility staff member who knows the person can give the history and describe recent changes. If someone holds legal authority for health decisions, tell us when you call so the right person is included. Read more about memory concerns and primary care.
Does someone have to be homebound to get a house call in Monroe and Clinton counties?
You do not have to meet a formal definition to ask. Homebound is a word that certain programs, such as home health under Medicare, use with specific rules. Just describe what makes leaving home difficult. The treating practice and your plan decide what applies to you. Our guide to what homebound means explains the term.
Will the clinician fill out forms for a patient in Monroe and Clinton counties, such as facility or equipment paperwork?
Often, but it is the clinician’s call. Forms for assisted living admission, medical equipment, a disabled parking placard or a caregiver’s leave from work usually require that the clinician has examined the patient and knows the history. Mention forms when you first call and have them ready at the visit. Gateway tracks the paperwork and helps get signed copies where they need to go.
Can blood pressure or blood sugar be tracked between home visits in Monroe and Clinton counties?
Sometimes. If the treating clinician decides it would help, a program called remote patient monitoring uses devices such as a blood pressure cuff or a scale that send readings from your home to the practice. Whether it is offered depends on the practice, your plan and your condition. A written log you keep yourself is also worth showing at each visit. See remote patient monitoring.
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.