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News & Resources

 

The Evolving Care Continuum: Strengthening Hospital-to-Home Transitions

January 9, 2026


As healthcare systems continue to emphasize shorter hospital stays and more seamless post-acute care, one critical moment that can help determine the success of a patient’s recovery journey is the transition from hospital to home. Whether a patient is returning home after surgery, illness, or rehabilitation, effective discharge planning and coordinated home care can make all the difference in reducing readmissions and promoting lasting recovery.

The Critical First 48 Hours

The first 48 hours after discharge from a hospital or rehab are critical to the safety and health of patients. This small window of time is when they are often at their weakest and at the greatest risk for a fall or other adverse event, which can result in a return trip to the hospital. Preventing hospital readmissions during this period not only improves patients’ quality of life but also saves hospitals and the healthcare system as a whole a tremendous amount of money.

Yet, there is often a gap in care from the time a patient is released from the hospital until their rehabilitation or Medicare services begin. That’s where responsive, compassionate home care can make a big impact.

Closing the Gap with Responsive, Compassionate Care

Family & Nursing Care partners closely with hospital discharge planners, social workers, rehabilitation teams, and other healthcare professionals to ensure clients experience a smooth, safe, and supported journey home. The company’s dedicated team is available 24/7 to coordinate services — often within hours of discharge.

From transportation home to immediate in-home assistance, medication reminders, mobility support, and meal preparation, caregivers provide compassionate, personalized care that builds confidence and comfort from day one.

“Our healthcare partners know that time is of the essence when someone is discharged,” said Mitch Markowitz, Vice President of Business Development at Family & Nursing Care. “That’s why we’ve made responsiveness part of our DNA. Half of our new clients start receiving care within 24 hours of contacting us — and three-quarters within 48 hours of their first call to us. When someone is discharged from the hospital or rehab, the first 24-48 hours after is when they are at their weakest and most likely to be readmitted. Being able to step in that quickly can have a real impact on recovery, safety, and peace of mind for everyone involved.”

A Trusted Partner in Every Transition

With more than five decades of experience, Family & Nursing Care has become a trusted partner to leading hospitals and healthcare organizations across the region. By bridging the gap between hospital and home, the company helps ensure that every client receives the continuity, compassion, and support they need to thrive.

To learn more about how Family & Nursing Care supports hospital-to-home transitions, visit our Home Care Services webpage.

 

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