Primary care at home in Shrewsbury.

In-home primary care in Shrewsbury

Apartment living suits many older adults in Shrewsbury: less upkeep, neighbors nearby, a short drive to stores. It can also mean living alone, with no one to notice that a medication was missed or that swelling in the legs is getting worse. In-home primary care follow-up puts a clinician’s eyes on those things regularly. Gateway arranges the visits with partner clinicians, who review medications and follow chronic conditions, and we coordinate records and messages with the person’s other doctors and family.

For its size, Shrewsbury has a varied mix of housing: brick bungalows and two-story homes, garden apartment complexes and condominiums. Senior living, skilled nursing, rehabilitation and assisted living settings are found in the neighboring communities. Gateway arranges visits from partner clinicians across these settings and follows the patient when the setting changes, for example from a rehabilitation stay back to an apartment. We keep the treating clinician’s orders, the supply requests and the visit schedule tied together through that move.

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 the clinician can look at

Most in-home primary care follow-up centers on long-term conditions such as diabetes, high blood pressure, heart failure, lung disease and kidney disease. At a visit, the treating clinician checks your vital signs, asks what has changed since last time, looks at any readings you keep at home and decides whether the plan needs adjusting.

The same visit can take in a review of your medications, follow-up after a hospital stay, a yearly wellness visit, or orders for tests and specialist appointments. People living with two or more ongoing conditions can also ask about chronic care management, which adds check-ins and care planning between visits. Gateway arranges the visit and keeps track of what the clinician orders afterward.

Who in-home primary care is for

Families are often the first to see that office visits have stopped working. A parent in Shrewsbury cancels appointments because the trip is too much. Refills are handled by phone for a year without an exam. A hospital stay ends and no one follows up. These are common reasons people call Gateway about primary care at home.

The person may be mostly housebound, may be recovering from surgery or a wound, may live in assisted living, or may have no regular clinician at all. A son, daughter, spouse or neighbor can make the call. Our caregiver support page covers what families can ask for.

Why wound care and primary care go together

Healing takes building material. A body that is short on protein, calories or fluids has less to work with, and appetite often drops during illness and recovery. In primary care follow-up, the treating clinician can ask about eating and weight change, look for causes such as dental pain, trouble swallowing, low mood or medication side effects, and order lab tests or a dietitian referral if needed. See nutrition and healing.

What the wound care clinician sees helps here. A wound that stops improving, or weight loss noticed at a wound visit, is shared with the primary care clinician so the question is asked early.

Wound care in Shrewsbury →

Where visits take place

In an assisted living community, a primary care visit involves more people than the resident and the clinician. Staff often manage medications and watch for day-to-day changes, so new orders need to reach the community’s nurse in writing, and staff observations need to reach the clinician. Gateway handles that back-and-forth for residents in Shrewsbury. Read more about primary care in assisted living.

Visits are arranged in private homes, apartments, memory care and skilled nursing as well. Each community has its own rules for outside clinicians, so we check those along with availability.

Keeping your current physician involved

One question clears up a lot of confusion: who do I call for what? When several offices are involved, a refill request or a new symptom can bounce between them. At the start of care, ask the treating clinician’s practice how to reach them between visits and which problems should go to them, to your longtime physician, to a specialist or to the home health nurse. Write the answers down and keep them by the phone. For scheduling, records, supplies and anything that seems stuck, Gateway is the number to call.

How to start

Some people in Shrewsbury 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: St. Louis County, Missouri
• ZIP codes: 63119
• Nearby hospitals: SSM Health St. Mary's Hospital in Richmond Heights; Mercy Hospital South (not affiliated with Gateway)
• Nearby communities: Webster Groves, Maplewood, Affton, South St. Louis
• Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Coverage questions

You can ask Gateway about Medicare, Medicare Advantage, Medicaid and commercial insurance when you call. We cannot tell you over the phone that a visit is a covered benefit, because that depends on three things: the treating practice that would see you, the details of your plan and the care the clinician finds you need. What we can do is tell you which practice would be involved, so you can confirm with your plan before the first visit. The insurance page lists questions worth asking.

Common questions

Related pages

• Shrewsbury
• Primary care
• In-home primary care
• Primary care and wound care together
• Primary care at home
• Primary care at home
• Primary care at home