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Home Care Helps Patient Recovery And Reduces Hospital Re-Admissions

According to the results of the 2010 Private Duty Benchmarking Survey, hospital discharge planners are the third most common referral service for home care agencies. This is a trend that is expected to increase significantly over the next three years.

Why so many referrals? Because home care agencies help save the government and providers money. The Centers for Medicare and Medicaid Services (CMS) reports that up to 75 percent of hospital re-admissions are potentially preventable, and “by encouraging providers to reduce preventable re-admissions, the US government expects cost savings of over $26 billion in the next ten years.”

Healthcare reform legislation requires CMS to modify reimbursements in ways that create penalties for hospitals for re-admission rates above the national averages. Hospitals are looking for ways to identify resources that can help reduce the re-admission rates. Increasingly, home care agencies are being looked at as a way to bridge the gaps during this transitional period of recovery and provide non-medical services that address and typically prevent the most common reasons for hospital re-admission. Such causes include missing follow-up visits, having difficulty complying with medication schedules and having a poor understanding of “red flag” symptoms.

Private duty home care services play an integral role in these transitional periods by coordinating with medical services covered by Medicare and general medical insurance in order to provide the necessary care for a full recovery and prevent patient re-admittance. Two of the most well established models for reducing preventable hospital re-admissions, the "Care Transitions Intervention" and the "Transitional Care Model," both identify non-medical home care staff as playing a substantial role in increasing compliance to government regulations for reducing re-admittance rates.

A fully licensed, private duty home care company should offer full "Transitions of Care" services to prevent hospital re-admissions, including:

  • Meeting the patient at the hospital or rehabilitation facility and providing safe transportation home for them and their equipment and belongings
  • Picking up prescriptions, groceries and supplies
  • Helping prepare meals and ensure proper nutrition
  • Monitoring medication compliance
  • Assisting with activities of daily living while a person may be continuing to build strength
  • Assisting with strengthening exercises per physical therapist
  • Transporting client to follow-up appointments


Home care agencies offers many additional services personalized for the needs of each client. These services can extend past the rehabilitation period for people who would benefit from additional companionship and help with everyday chores. When hands-on assistance is needed for activities of daily living, such as bathing, a home health care aide is necessary. Some agencies offer both types of help, while others specialize in one or the other.