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Providing Transitional Care to Prevent Hospital Readmission has always strived to be on the cutting edge of the latest developments in home care to provide the best services to clients. Their “concierge” style services provide the most personalization, including a Geriatric Care Manager to oversee the case.

The new “buzzword” in the home health care industry, “transitional care,” refers to transitioning patients from a hospital, nursing home or rehab facility to their own home in a way that bridges the gap between stages of recovery and aims to prevent often prevalent hospital readmissions. is now leading the way to assist the acute world in reducing readmissions, taking a comprehensive approach to patients’ total care experience that includes post-procedure private duty in-home care as part of the discharge process. 

According to a recent article published at, readmission rates were found to be an ineffective measure of a hospital’s quality because they did not account for readmissions from different hospitals. The article notes that using only same-hospital readmissions to calculate penalties resulted in 20 of the studied hospitals receiving unwarranted penalties. It’s not just about hospitals being penalized because of readmissions, but hospitals being penalized with high readmission rates due to patients not following procedures and follow up after they return home.

AdvantagePlusCaregivers to the Rescue

With its proprietary but simple transitional process, helps a patient transition home comfortably with all the tools necessary to avoid readmission.

Use of this program and trained caregivers at the time of discharge has shown great results in patient compliance with hospital/facility instructions and follow-through. Streamlined care plans and proper hospital discharge preparation, inclusive of family members in the home, are crucial for the prevention of multiple hospitalizations., a state-licensed Home Care Organization, offers a hospital-to-home transition program specifically designed to make the transition smooth for better outcomes and that is customized to meet the individual needs of each patient. A Transitional Care Manager (LVN/LPN or higher) will drive the patient safely back to the comfort of their home or provide for their safe transportation, as well as make sure they fulfill their discharge orders, in addition to educating patients and family caregivers in the home about medications and self-directed care, including follow-up appointments with their medical providers. They will perform a home safety and aids check to prepare the home in advance of the discharge and ensure that all needed supplies and equipment are in place. This program will have a tremendous impact on the health and quality of life of the patient post-hospitalization and ultimately reduce their chances of a readmission within 30 days. provides private duty in-home custodial care services for adults, specializing in geriatric care, rehab and workers’ comp. For more information, contact AdvantagePlusCaregivers at 805.322.8822 or visit

Melanie Farber, CEO, CSA, serves as Supervisor of Direct Care for in Camarillo.

  • Melanie Farber, CEO, CSA