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Post-discharge decision guide

Home Health vs Nursing Home Decision Guide

Home health and nursing home care solve different problems. Home health is usually intermittent skilled care at home. Nursing homes can provide 24-hour facility-based care. The right path depends on medical need, safety, caregiver capacity, coverage, and discharge timing.

Home health may fit when

  • The senior is homebound or has difficulty leaving home and needs intermittent skilled care.
  • Nursing, therapy, aide services, or medical social services are ordered.
  • The home is safe enough with caregivers, equipment, and follow-up support.
  • The family can manage gaps between visits.

A nursing home may fit when

  • 24-hour supervision, skilled nursing, rehab, or facility-level support is needed.
  • Home is not safe enough even with equipment and intermittent visits.
  • Caregiver capacity is not enough for transfers, toileting, dementia supervision, or medical complexity.
  • Post-hospital rehab or longer-term custodial care is being considered.

Questions before discharge

  • What level of care is ordered and why?
  • Is the goal short-term rehab, long-term care, or home recovery?
  • What DME must arrive before the senior gets home?
  • Which providers are covered by Medicare, Medicare Advantage, Medicaid, or private pay?

Questions to ask

Is the senior safe between home health visits?
Can family or paid caregivers cover nights, transfers, meals, and toileting?
Is the need skilled, custodial, rehab, or hospice?
Does the plan require prior authorization?
Which DME must be delivered before discharge?