New Intermountain Castell Health House Call Service Helps Homebound Patients Improve Their Health

Gail Stahle is 88 years old, and he and his wife Carol retired just four months ago to St. George, Utah. After getting COVID and ending up staying in the hospital, he went home but was very weak, on oxygen and continued to struggle with chronic lung, kidney and balance issues and became partially bed bound, so he qualified for Intermountain Health’s Castell House Calls service.

Gail has worked in the newspaper business since he was 10 years old. He’s been the owner or publisher of 30-40 newspapers during his career, including the St. George Spectrum newspaper.

Angie Mayer, APRN is an internal medicine nurse practitioner who visits Gail and makes house calls in St. George with Castell Health, the population health subsidiary of Intermountain Health.

“The Castell House Calls program is a temporary service from Intermountain Health that assists vulnerable patients who are homebound and have mobility or transportation challenges along with chronic health conditions. We can bring healthcare to them in their home and help them navigate the healthcare system to give them better medical care and improved quality of life,” said Mayer.

Patients are referred to Castell House Calls through people in the medical community such as, their primary care or emergency room provider, hospital staff or a case manager with their insurance company. Intermountain Health’s insurance company, Select Health, helped create the house calls program.

“The Castell team has taken care of me on every hand. I had physical therapists come into my home and help me work toward being more mobile again,” said Gail Stahle.

“What helped me the most was keeping track of exactly how my medications were working or not working by ordering blood tests. Angie was absolutely wonderful, she is very knowledgeable and on top of everything, I didn’t have to worry with her there,” he added.

The Castell House Calls service was first piloted in the St. George area in December 2019. The service has been expanded to serve patients in parts of seven Utah counties from Brigham City to St. George.

“We work as a team of providers, nurse managers and case managers to address the social determinants of health that affect the ability of our patients to get care such as mobility, transportation, access to healthy food, their housing situation and social support, and whether they have heat or air conditioning, and are they taking their medications as directed,” said Mayer.

The goal of Castell House Calls is to help patients improve their health and decrease the number of their emergency room visits and the time they spend in the hospital as a patient. And when those goals are met, it can help reduce health care costs,” said Mayer.

Intermountain recognizes that a portion of the population is not able to access medical care. Castell House Calls bridges the gap to get medical care to the part of the population that needs this.

“You learn so much more about a patient in their home environment. It’s less formal. You get to know your patients very well. You develop a trust level with them. I meet amazing people and every day is different. When we can visit patients in their home, it helps reduces their anxiety, about getting out of their house to appointments or the hospital,” said Mayer.

“Having Gail receive care in our home allowed me to stay with him rather than having him go to a facility,” said Gail’s wife, Carol Stahle.

According to Mayer, the house calls program has helped decrease emergency room utilization by about 8-12%, which is significant. The Castell House calls program has reduced overall medical expenses by 13% for 2022.

In addition to the nurse practitioners, there are case managers, care guides/medical assistants, pharmacists, pharmacy assistants and doctors that help with all the challenges our homebound patients face.

About 1000 patients in Utah have been served by Castell House calls to date. Currently, there are more than 400 patients in Utah receiving Castell House Calls. Mayer cares for up to 7 patients a day from Cedar City to Enoch. Some patients are seen weekly, some monthly. About 70 percent of them are 65 or older.

“Our goal is to get the patient able to go back to see their primary care provider,” said Mayer.

“For these homebound patients, we’re going back to old school holistic house calls. I’m able to see their whole life. Being in the home they tell you more things. The patients trust you more when you’re in their home. This is the way medicine should be. I really care for them and I get attached,” she added.

Gail is off of oxygen now and back to walking every day around the neighborhood. He’s taking fewer medications. He and his wife Carol can get out to restaurants.

“Gail is still passionate about the news, he loves keeping up on world events and reads 10 newspapers every week. He writes a family newsletter for his seven children, 30 grandchildren and 39 great grandchildren. He also recently dictated his life story and had it printed,” said Carol Stahle.

For more information about the various types of homecare available visit Intermountain at Home.

About Intermountain Health

Headquartered in Utah with locations in seven states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.