“My job is to make sure we have programming available for people no matter where they are in their illness, or their wellness.”

That is how Katelyn Vinklarek, Administrative Director for Post-Acute Services, defines her department’s role serving patients throughout Hill Country Memorial.

Teams work with physicians and health care providers in the area to help identify patients who are needing more support in their homes. And there are a lot of them–at any given time there might be 10 times the number of patients receiving services from Post-Acute Services as there are receiving acute care.

“It can look lots of different ways,” Vinklarek said. “It could be someone has a new diagnosis, and they need to understand what it means to live with that new illness. It could be they’ve had a recent decline in their health so they are not functioning at the same level as before. They could have had a recent hospitalization. Or they could just need more support.”

Vinklarek and her team provide that support with one of the three services:
Home Care
Supportive Care

Home Care

Home Care is about helping patients heal or recover while educating them on their disease processes. Support can begin when a patient is discharged from the hospital or when there is a change in medical condition, or used for chronic conditions which require skilled care, pain management, or even emotional support.

“Generally, they have a desire to live independently, but are in need of extra assistance with daily activities,” Vinklarek said.

Among the tools HCM Home Care can offer:
Nursing Services
Physical Therapy
Occupational Therapy
Speech Therapy
Medical Social Worker
Home Aide

Home Care is about healing and recovery. When illness progresses, Supportive Care comes in.

Supportive Care

Formerly known as Palliative Care, Supportive Care focuses on patients with chronic issues and illnesses, such as cancer, heart failure, or stroke, according to Traci Doerre, Adult and Geriatric Nurse Practitioner.

“They need a bit more care and support at home,” Doerre said. “It is similar to Hospice and Home Care, except those services are limited in duration. With Supportive Care, we can see a patient for any time period, for as long as the patient needs us.”

She noted patients might also utilize both Home Care and Supportive Care at the same time.

Like those other departments, the Supportive Care team offers home visits, providing both medical management and more personal support. As a nurse practitioner, Doerre can prescribe medicines, order lab tests and diagnostic services. For cancer patients, for example, this can be “highly complex” with lots of specialists and treatments involved.

Doerre’s team also has the ability to connect the patient with social workers, chaplains, and people who can help with understanding advanced directives.

“We try to help them make decisions early, when it is easier because they are more stable,” Doerre said. “We are there to help relieve the burden. At some point, we facilitate the transition to Hospice when the time is appropriate.”


“Our focus is on providing comfort and quality of life to people facing terminal conditions,” said Randa Kirchner, Hospice Administrator.

The Hospice team is engaged when the trajectory of a disease appears to be life-ending. This is generally less than six months, although sometimes it extends to one year or even more.

Kirchner emphasizes that her team’s role is not to be curative of any disease process, but rather to be there to treat the symptoms. This can mean taking steps to reduce pain and swelling, keep the patient active, and reduce overall stress on the body.

“We help them feel better, so they can do more.”

One ally she recruits is the patient’s family.

“We really encourage family meetings with our team,” Kirchner said. “We have our piece as far as symptom management, but our goal is not always the same as the family’s goal. They may want to manage symptoms so they can take a trip, or to see a grandbaby born. It’s not about controlling the amount of time left, but working together to improve the quality of the time left.”


Vinklarek emphasizes that a patient is able to start interfacing with any of these three levels of care at any point needed, such as when someone receives a new diagnosis.

Working in these personal, high-need areas such as Hospice takes a special type of caregiver, something Kirchner has given a lot of thought.

“These are situations that go on every day, everywhere,” she said. “It’s an honor to be doing this work.”

Traci Doerre feels an affinity for the age group under her care.

“Even as brand a new nurse, I loved older patients,” Doerre said. “Our team gets to stay in touch longer, so we get to know them at their most vulnerable. Being that person they can reach out to and ask for help is special. At times it can be draining, but to see I made a difference and added to their quality of life–that’s what motivates me to keep going.”

Vinklarek advises everyone not to wait to begin receiving care from HCM’s support services.

“Sometimes families wait until people are in absolute crisis until they get a referral,” Vinklarek said. “If they come to us early, we can help them more. We want people to reach out to us sooner rather than later. I feel sad if someone asks for help too late.”

All are united in their commitment to bring the services of HCM to those who need them when they can do the most good.

“Our role is looking at how we partner with our community to make sure we have programming available for all stages of the disease process,” Vinklarek said. “We are working with you because we want to be part of that journey.”

For more information, you can reach the Hill Country Memorial team at: