Landmark Providers: Dr. Matt Zimmerman, psychiatrist, and Katherine Moore, nurse practitioner and nurse care manager
Johnson, 92, is a World War II veteran who served in U.S. Army counterintelligence. He was a stroke victim in 2015 and suffered vision loss, atrial fibillation, depression, anxiety, insomnia, weight loss of 20 pounds and a failure to thrive. Johnson didn't want to go to the doctor because of the physical and mental fatigue involved.
“I feel alive again!” is how Johnson describes his current state of health. After visits and treatments from Landmark providers, Johnson’s dehydration disappeared, his sleep and appetite improved, he gained weight, and felt increasingly better and happier. He is back to gardening in his yard. Johnson continues to see his personal primary care physicians and specialists in tandem with Landmark providers.
Johnson's dehydration was noted by his Landmark provider on her first Urgent Care visit, and a comprehensive health diagnosis indicated need for psychological help. The Landmark provider prescribed specific quantity of water to drink daily, checked medications Johnson was taking, and referred Johnson to a Landmark psychiatrist, who prescribed anti-depressant medication. Johnson improved quickly. Weekly checkups and maintenance visits by providers were made until Johnson stabilized; monthly visits followed, and he is now on a quarterly visit schedule with Landmark.
Citrus Heights, Calif.
Landmark providers: Dr. Thomas Reda and Laura Vogler, physician’s assistant
In December 2018, when White joined Landmark, his primary care physician was moving, and White had not been set up with a new doctor. White had a long list of ailments including congestive heart failure, coronary heart disease, cardiac stenting with stable angina, chronic kidney disease, gout, hypertension, hyperlipidemia, diabetes that is diet controlled with peripheral neuropathy and osteoarthritis of his left shoulder and knees. He was scheduled for total knee replacement in early February and was concerned about recovery and risk infection. He was treated for influenza by a Landmark provider about one week before surgery but was otherwise stable.
After his knee replacement in February, heart issues sent him back to the hospital. During their post-discharge visit from hospital, the Landmark physician and physician’s assistant recognized that White didn’t have a good understanding of his congestive failure symptoms and diet-related issues.
“When I first got the letter from Blue Shield about Landmark, I didn’t believe this service could be real, since it was free, so I waited awhile to sign up. My experience has been better than I expected. I never thought I would be so satisfied,” is how White describes his Landmark experience. White is in better health, understands his congestive heart failure (CHF) triggers and diet restrictions, and exercises moderately. He is planning to go on a cruise with his family at the end of the summer. His goal is to avoid any further hospital stays.
The Landmark physician and physician’s assistant provided ongoing education about diet, fluid and salt restriction, daily weights, daily walks, and use of diuretics. White was seen by a new PCP in March and his diuretics were reduced. On March 14 he called again with symptoms of labored breathing and worsening edema. He was seen by Landmark physician, who ordered lab tests and provided further education. At that time, White was restricting fluids too much, which caused worsening kidney function and CHF symptoms. The Landmark physician helped coordinate follow up with the PCP three days later, and White was able to avoid another ER visit/hospital stay. On April 5, White was seen for another urgent visit related to bronchitis and was successfully treated with antibiotics, again avoiding an urgent care or emergency room visit. The Landmark provider made house calls every few weeks after White's knee surgery to monitor recovery and improvement; she now maintains regular contact with White about his health.
Landmark key providers: Dr. Trevor Hayes, Patrick Alunan, nurse practitioner, and Sharon Huffman, nurse care manager
Gutierrez fell and broke her hip on Feb. 17. A Landmark physician had already visited her twice for general care issues following a visit to the emergency room for heart palpitations and dizziness and some balance issues. Gutierrez really liked him.
After Gutierrez’s hip surgery and rehab in February, Landmark providers visited Gutierrez weekly. They interacted with the rehab facility practitioners and when Gutierrez came home they visited her weekly to address and monitor several post-surgery medical issues and ensure that her recovery was going well.
When multiple medications started affecting Gutierrez’s stomach, with vomiting and the inability to keep food down, Landmark providers recommended stopping most of the medications. They worked with Gutierrez’s primary care provider to confirm this approach. Gutierrez got off all the medications except for a blood thinner and felt better quickly. Her in-home care continues, including physical therapy, and she is on the mend.
“My Landmark team is really good. They’re not just nurses and doctors and social workers; they’re compassionate counselors who have been very responsive to me and my family,” says Juana Gutierrez, 87, a former community activist who lives in Los Angeles County. After surgery for a broken hip and rehabilitation, Juana is on the mend, with ongoing in-home care and physical therapy, and monitoring her overall recovery.
The Landmark providers visited and checked on Gutierrez's progress, including some nighttime confusion she had following the anesthesia from surgery, a negative reaction to post-surgery medications, and caring for a deep tissue injury (DTI) on her left heel that Gutierrez developed at the rehab facility. When the post-surgery multiple medications started affecting Gutierrez's stomach, the nurse care manager was very helpful and had Alunan come the next morning. He recommended changes to her medication. Her in-home care continues, which includes physical therapy and monitoring the healing of her injury.
Landmark providers: Dr. Thomas Reda and Laura Vogler, physician’s assistant
Tomasegovich is a 70-year-old retired engineer who suffered from multiple heart issues, diabetes on insulin, chronic kidney disease, gout, and a recent episode of kidney stone disease. Tomasegovich had difficulty walking and was dizzy. The cause: his potassium was too low.
“I’m sold on Landmark because I can get treatment when I want it. Usually a Landmark provider can get to my house within two hours,” describes the member service that Tomasegovich values about his Landmark participation.
Tomasegovich called his Landmark provider for an Urgent care visit due to dizziness and difficulty walking. The Landmark provider discovered that Tomasegovich’s potassium was too low and sent him to the hospital. When Tomasegovich returned home, the Landmark doctor determined that his problem was a lack of potassium due to an imbalance of potassium pills and diuretic pills prescribed for his cardiovascular issues. Working together, the Landmark doctor and primary care provider adjusted the two prescriptions to deliver the right balance of medications. The potassium prescription was increased, and the diuretic prescription was decreased. The new ratio of medicines has improved Tomasegovich’s health measurably.
Tomasegovich has also worked with a Landmark dietitian to improve his nutrition and he exercises moderately.