Transitional Care Support

To those patients or individuals impacted by illnesses and other healthcare emergencies who were recently discharged from the hospital, long-term acute care facilty, and/or skilled nursing facilty.

We are your helping hands as you transition back to the community or adjust to your new optimal health.


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Our Mission

Liminal Health Foundation (LHF) would like to be the "go-to" organization for individuals and patient's transitional urgent needs.

Who Are We

About Us

Liminal Health Foundation provides transitional care support to patients and/or individuals impacted by recent illnesses and other healthcare emergencies who were recently discharged from hospital, long-term acute care facility (LTAC), or skilled nursing facility (SNF).

We focus on social determinants of health such as, access to: discharge home medications, transportation for follow-up clinic visits, food and groceries, medical equipment and supplies, home visiting nurses, SW, CNA, PT/OT, speech therapy services, and housing.

Our Vision

Our program focuses on providing immediate support and remedies to individuals and/or patients with "high-impact "urgent post-acute healthcare needs.

We're Here To Help You

What Are You Looking For?


It is important that patients follow-up with their primary physicians especially after a hospitalization, surgery, or illness. Liminal Health will provide and/or arranged transportation in order for them to be able to follow-up with their primary care physicians,  outpatient rehabilitation centers, etc.


At times, in order for us to avail and optimize our insurance benefits, a small co-pay is needed; this is our cost-sharing responsibility. Unfortunately, not all can afford or are able to meet these co-pay portion. Liminal Health will provide assistance to patients or individuals to meet their copay obligations. In some special cases, Liminal Health will provide support in paying insurance premiums especially for patient’s with complex and catatropic medical conditions.


Food insecurity is real – sometimes temporary. Adequate nutrition is essential to recovery. Liminal Health will provide groceries, high-protein drinks, and other dietary needs to those recently discharged from the hospital, LTACs, and nursing home.


Clothing is important to social determinants of health because it impacts multiple dimensions of an individual’s life, including physical health, mental well-being, social interactions, access to opportunities, and protection from environmental risks. Adequate, culturally appropriate clothing is a fundamental aspect of creating environments that promote health equity and well-being for all individuals.

Medical Equipment

Not all durable medical equipments are covered by our health insurance. Wound vacuum is at times a non-covered equipment amongst some of the HMOs. Oxygen is not covered unless you meet certain insurance quidelines. Liminal Health will assists is obtaining durable medical equipments that will assists patients and or individuals towards recovery.

"Health inequalities and social determinants of health are not a footnote to the determinants of health.
They are the main issue." --- Michael Marmot ---

By addressing social determinants of health, we improve patients’ health outcomes, enhance their quality of life, and reduce healthcare costs