Each individual that is in their own home, be it an independent home, seniors apartment building, village setting, or a retirement residence, will have access to an individualized baseline assessment of their current care needs. This initial assessment will inform the development of a specific plan based on each clients’ own needs. With ongoing monitoring and conversation, any time our team becomes aware of a change in client needs, the nurse care management team will adapt the client plan to accommodate those changes.  The nurse care manager will focus on the development of a care plan and can provide acute care to a client on an as needed basis.