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We are a consultation and service provider whose focus is to help you understand the maze of healthcare today. Our mission is to identify gaps in care that are not covered by traditional insurances with the goal of helping you stay in your chosen home for as long as possible.


We can provide peace of mind that your loved one is being cared for by the most reliable cost effective provider, even assisting referrals to VNA, or other healthcare services that ARE covered by traditional insurance.
Sarah was able to assist a family member in filing an insurance appeal resulting in the return of over $5000 for services that should have been covered by that insurance.


Just call your nurse case manager, Sarah Ireland, at 508-494-1782 for your free 30 minute telephone consultation. If a more comprehensive in person consultation and evaluation of service needs is necessary a follow up appointment will be made.


This will be an in home nurse case management evaluation, including a home safety and risk assessment, which initiates a determination of needed services to help you remain in your home safely for as long as possible.


Frequently we will meet only one time for an educational session or explanation of benefits regarding your insurance coverage. Many people are daunted and confused by what Medicare and other insurances do or do not cover, and why. We can explain and answer your questions.


Rita and Sarah have 60 years of experience navigating and providing healthcare services to those in need, and do so in a reliable, intelligent, confidential, caring and professional way. We love the Outer Cape and have identified the gaps in care that make it difficult for you to thrive and succeed in your home. Our goal is to assist you and your chosen family in remaining successfully in your residence of choice.


Please refer to the fee schedule in this website.

LINKS nursinghomecompare

Sarah Ireland and I worked together for four years at Whittier Rehabilitation Hospital in WestBorough, Massachusetts,  she as a nurse case manager and I as a social worker.  we shared many cases, I knew that patients and their families were in good hands when Sarah was their case manager.  she provided patient focused case management services in a collaborative, efficient, and thorough way.  She forms empathetic, professional relationships with patients and their families.  Sarah communicates difficult information clearly and provides researched choices for patients and families to consider for continuing care options.  She is a strong advocate for patient and I have often been in awe  of her firm care options.  She is a strong advocate for patients.  Sarah has established many collegial relationships and consults with other medical professionals.  She is very respected in the community.  Sarah is able to negotiate a very complex medical system for patients with significant and often life changing medical issues.  She is, in sum, dedicated to the work she does and she enjoys what she does.  It was a pleasure to work with Sarah 

Deborah P. Lebeaux LICSW

Know with great truth, that you were very instrumental in pulling me off of the ledge in the most dark time I have ever experienced...

Your kindness, and good nature "humanized" me, and made things that needed to happen, happen...

It's been a long road, & I've still got miles ahead of me in my recovery, but I will get there... Hope & faith are key, but good people like yourself are so key, at the most crucial, vulnerable & raw moments of crisis.

I'm a blessed man to have met you, and I'll remember this always...

Thank you sweet Sarah Ireland ...

Big hug to you, until I see you again in person...


Christopher D

I worked with Sarah at Whittier Rehabilitation Hospital where she served as a Case Manager for my patients.  There she helped many patients and families in a stressful environment.  Rehabilitation is often the transition from acute hospital care ( including direct ICU transfers) to home or SNF.  This transition can be overwhelming considering where they came from and possible where patients may be going next.  It is essential to have someone advocating, educating, supporting and comforting these patients and families.  Sarah Ireland was that person and I was happy to have her by my side.

Sarah is an intelligent and motivated individual.  She is someone who cares about her patients and their outcomes.  She always took the time to follow up with questions and concerns, but more importantly, Sarah was proactive in seeking out those questions patients and families needed answered.  Sarah is someone who is approachable and easy to talk to.  She is very resourceful and knows the healthcare system well.  She is reliable in her interactions with ancillary providers, medical staff and insurance companies.

Jennifer Louloudes, PA-C

Jennifer Louloudes - MS PA-C



outer cape cod senior in home care services


Sarah Ireland

I am a bachelor’s degree prepared Registered Nurse case manager with 44 years experience in health care. I have spent the last 17 years working as a case manager in the insurance, skilled nursing, acute rehabilitation hospital and outpatient physician practice arenas. I started my healthcare experience working for 15 years as a nurse's aide in a variety of venues. As a result of this experience I pursued a career in nursing, graduating from both Quinsigamond Community College and then Framingham State University. I have been a member of the nursing honor society, Sigma Theta Tau International, and I am listed in “Who’s Who amongst American Junior Colleges”. I have worked as a hospital nurse, a nurse manager in long term care, as well as in in-patient psychiatric and substance abuse settings. I have been the director of admissions for a sub acute facility, and most recently the Director of Care Coordination for an outer cape physician practice with an affiliation to Beth Israel Deaconess Care organization. I have 25 years working education with private insurances, Medicare regulations, levels of care criteria, and the billing, payment and appeals processes. I maintain both my nurse licensure with the State of Massachusetts, as well as national certification in case management per the Commission for Case Management Certification. I am a member, and past board member, of the Case Management Society of America, New England Chapter.

I am an organized, disciplined, motivated and experienced
healthcare practitioner with the ability to coordinate care within every healthcare venue.

Rather, ten times, die in the surf, heralding the way to a new world, than stand idly on the shore" - Florence Nightingale

outer cape cod senior in home care services

Social Services Director, MSW, LCSW

Rita Paradise

"You are never too old to set another goal or to dream a new dream" - C.S. Lewis

I received my bachelor’s degree in social work from Anna Maria College and my Masters degree in social work from Springfield College. I am currently licensed through the state of Massachusetts as a licensed certified social worker (LCSW). My 20 plus years experience is in providing case management, advocacy and counseling to seniors, young adults, children, individuals and families. I will use a strategic and multidisciplinary approach tailored to your needs. My wish is to combine my knowledge and experience to deliver the best care management possible. My role is to facilitate strength-based therapy that will improve one's life journey to become more proficient at using the systems that confront us everyday. I have a long history of bringing complex caseloads to a successful conclusion to the satisfaction of all. I'm a year round resident of North Truro who is strongly committed to bringing my knowledge, compassion and support to my Outer Cape community. After volunteering, socializing and
working in our community, I recognize a great need in connecting folks to other valuable services as well as providing counseling services in your home, my office in North Truro, or on the beach anytime from sunrise to sunset.

Rather, ten times, die in the surf, heralding the way to a new world, than stand idly on the shore" - Florence Nightingale


Team Member Professionals


Free initial 30 minute phone consultation


Initial nurse case manager consultation $195/hr


Follow-up Certified Nurse Case Manager services $100/hr


MSW/LCSW hourly in your home $75


Counseling service package, in your home, 5 sessions $300


Nursing services $100/hr

(billable in 15 minute increments)


Concierge services $35/hr


Occupational Therapy home evaluation $225


Notary Public service done in your home $25

(No fee if included with other in-home services)

PCA, CNA $28/hr. Companion $22/hr

Transportation and assist to medical appointments

(as far as Hyannis)

$28 hourly plus .50 per mile door to door

RN medical transportation assist (as far as Hyannis) $100 flat fee plus $50 hourly

additional mileage rates apply.


All other transportation trips negotiable


Free 30 Minute Phone Consultation


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The Initial Consultation

The purpose of the initial consultation is to allow us the privilege not only to meet you and your chosen family/caregivers, but also to allow Healthcare Solutions to start the assessment process. The initial consultation usually takes 1-2 hours to complete. This will allow us, together, to determine your exact needs and initiate a coordinated plan.
We also understand the consultation may be the only visit you need, as the challenges of navigating tumultuous healthcare systems today can, at times, be easily met.
The Initial Consultation, if performed in your home, will include a comprehensive home safety evaluation.

outer cape cod senior in home care services


Patient Advocacy

Outer Cape Healthcare Solutions will become your primary advocate, assisting you in maximizing every aspect of your care. Healthcare education is most likely the entryway to our role in advocating for your benefit and on your behalf, with you and your collateral service providers. We pledge to help you and your care givers understand your current health status and how to optimize your maximum health potential in the most cost effective and appropriate way.

outer cape cod senior in home care services


Professional  Nurse Case Management

“Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation,  and advocacy for options and services to meet an individual's and family's comprehensive health needs through           communication and available resources to promote quality, cost-effective outcomes.”                                                       ( definition))

What does this really mean? We want you and your loved ones to experience the healthiest outcomes. Sarah Ireland, RN, BSN, CCM will provide a comprehensive evaluation of and ongoing assessment of needs in order to assist you in meeting the goal of achieving your optimal level of wellness. Sarah will be happy to assist you in navigating and understanding the maze of healthcare coverage, as well as provide education of the healthcare system as a whole.
Sarah has facilitated hundreds of hospital discharge planning meetings with patients, families, and caregivers, and can also attend discharge-planning meetings at facilities within the community.

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Social Work Counseling

Rita Paradise, LCSW, MSW will meet with you in your home, office or location of your choice to process your life’s journey. This may include hearing, vision or other physical impairments; loss and grief work, counseling regarding effects of aging and overall health issues, including loss of independence. Rita assists clients in managing their emotions, finding new sources of enjoyment and finding new support within the community. Rita also assists family members and caretakers to deal with their emotions and issues, communication,

and understanding the effects of illness.

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In-Home Safety Checks

The home safety check is a comprehensive review of your home environment and includes stairs, rails, entryways, rugs, medications, smoke and carbon dioxide detectors, lighting, heat, clutter, vision and hearing issues, bathroom safety, kitchen safety, pet safety, falls risk, emergency call supports; to name some but not all items being evaluated.

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Concierge Services

Let us lighten you and your caregiver's load and give you time to do the most important things, like finding some respite time, or time to just be…….
Concierge services can include but are not limited to:
⁕ medication reminders
⁕ pharmacy pick up
⁕ most household chores
⁕ laundry
⁕ grocery shopping
⁕ pet care
⁕ transportation to appointments
⁕ plant watering
⁕ coordination of general household repairs
There are really too many tasks to list here, but no task is too large or too small. We understand the little things add up and sometimes you hesitate to ask for help.


Initial  Consultation, Patient Advocacy, Professional Nurse Case Management, Social Work Counseling, In- Home Safety Checks, Concierge Services, Private Nursing, Coordination of Care with Ancillary Providers, Attorneys, Councils on Aging, Elder Services, Town Nurse, MassHealth Applications, Insurance Appeals Processes, and more.

We are professionally licensed and insured.

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Outer Cape Health Care Solutions is a case management and social services business offering private pay, home based services, to those living in the outer reaches of Cape Cod. Research and experience indicate gaps in care and unmet needs for provision of ongoing care in the home setting. Research has also shown, that increasing numbers of people needing supportive care services, prefer to remain in and receive services in the privacy of their own home. These needs are frequently unable to be met by today's standard healthcare options or are unable to be met by other community agencies.
We strive to be the providers of choice for private pay services when your needs encompass coordination of care focused on supporting your successful community living choices. We are value based and family centric, fully understanding there are numerous gaps in care that would allow you to remain in your home in a safe and supportive manner. We offer choices for guided decisions at each step along your journey and are able to assist you in navigating today's healthcare maze.





Outer Cape HealthCare Solutions is committed to custom, collaborative solutions meeting the needs unmet by today's standard healthcare options. We create and implement reliable, responsible and professional plans for families and loved ones.


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