Table 5.

Increased identification of residents in need

Site	Evidence
Mid-Manhattan	• One hundred percent of ED visits by participating residents enrolled in the MyMeds program were reported to the NORC-SSP • Approximately 30% of the (100) enrollees were new to the NORC-SSP
Lower Manhattan	• All enrollees received at least one intervention (e.g. home care referrals, NORC nurse visit, phone reminders, etc.) through the integrated diabetes assessment program, with many receiving multiple interventions
Queens	• Approximately 100 client assessments or reassessments were conducted by NORC-SSP staff (approx. 25 per quarter) using the Hartford Falls Risk Assessment protocol • Approximately 70% of those clients assessed for falls risk were determined to be at risk and in need of intervention
Brooklyn	• Approximately one-quarter of all participating residents reported that their physician or physician office staff asked if they were a client of the Brooklyn-based NORC at the time of an office visit