Chronic illness management/Chronic Care Management(CCM) is a critical component of your health care. CCM is the management of two or more chronic conditions. Examples of CCM include but not limited to Alzheimer disease, diabetes, COPD, and Cardiovascular disease. Community Transition Nurse (CTN) Mobile Home Based Health Care provides Management of chronic diseases, which includes screenings, check ups, monitoring and coordinating treatment and patient/family education for self-care management. Management of Chronic Diseases helps to avoid the avoidable ER visit, prevent or minimize the effects of a disease and improve quality of life while reducing your health care cost.