Home care Q&A

As the saying goes, “There’s no place like home,” and when it comes to the impact of home care, that saying rings even more true: Studies show that 62.5% of older adults return to their full function within 90 days of starting home health. Other studies show home health care lowers the risk of rehospitalization to 20-26%.

So how do you know whether home care is right for you or your loved one? Colleen Nunes, administrator for Home Care at Montefiore Nyack Hospital, shares her insight on what home care offers patients and what to look for in a program.

What is home care?

Colleen: Home care is skilled health care delivered directly in a patient’s home rather than the hospital or facility. A Certified Home Health agency, like Montefiore Nyack Home Care, provides nursing, physical and occupational therapy, medical social work, and home health aide services, all coordinated by a physician-directed plan of care. The care we provide is short-term and intermittent, and patients must be homebound.

Who should consider receiving home care?

Colleen: Home care is a good fit for anyone who needs skilled medical care but doesn’t want to be in the hospital or a facility like rehab or a nursing home. Several examples might be:

• Patients who have been acutely ill and recently discharged from the hospital or a rehab stay.
• People with chronic conditions like COPD, diabetes, heart failure, or wound care who might need ongoing monitoring and education to remain stable and stay at home.
• People who are homebound due to illness, injury, or mobility limitations, and getting out of the house to medical appointments is a significant burden.
• Anyone who has a new diagnosis or treatment such as post-orthopedic surgery may need physical and occupational therapy to regain their strength and independence.

What are the signs of a great home care program?

Colleen: You want to choose an agency with strong clinical outcomes, clear communication, responsiveness, and patient-centered care. Patients and their families can tell the difference between an agency that is just meeting the requirements and one that truly cares about their recovery.  An agency that treats patients like people, not cases, and genuinely listens to what they say and their family's needs.

Is home care paid for through insurance?

Colleen: Yes, Medicare, most Medicaid plans, and most private insurance companies cover home care. When we receive a referral, we always check the insurance and inform the patient and their family of any costs, since many plans have co-pays or coinsurance.

What services does Montefiore Nyack Home Care offer?

Colleen: At Montefiore Nyack Home Care, we serve many different patients, adults 18 years and older, with different diagnoses. Our team provides skilled nursing, a certified wound/ostomy nurse, physical and occupational therapy, medical social work, and home health aide services. We have a certified wound/ostomy nurse, and we take IV antibiotic cases.

What care options does Montefiore Nyack Home Care offer?

Colleen: Our staff is typically in the home 2-3 times a week for 4- 8 weeks. Some patients, like a wound case, may be in the program longer. If our staff, patients, or family find they need more care, our medical social worker can go out and discuss their options with them. Sometimes it is as easy as hiring an aide through a licensed agency for additional support. Other times, our social worker assists the family in long-term planning – completing applications and referring them to various resources in the community.

What distinguishes the home care Program at Montefiore Nyack Hospital?

Colleen: So many wonderful things – first is that we are part of the Montefiore system. Many of our patients are referred from our own hospital, Montefiore Nyack Hospital, or from our doctors at Highland Medical or Burke Rehabilitation. This allows for a continuum of care.

Second, we assess each patient and personalize their treatment plan to their specific needs. Our staff communicates with each physician to ensure the medications, treatments, and care they receive are appropriate.

But what matters most to me is our staff's compassion. Our clinicians go above and beyond for their patients – there are so many examples I could give, from small things such as taking out the garbage to waiting with the patient when their family member passed, and their other family was in transit. I’ve had staff go out and pick up food for a patient who just came home from the hospital, only to find a refrigerator full of spoiled food. Just amazing, generous, caring acts.

The care we provide has been recognized by Strategic Healthcare Partners with the Superior Performer for Patient Experience Award for four years in a row (2022-2025), as well as U.S. News & World Report, as we were named to their inaugural Best Home Health Agency list in 2026.

What it really comes down to is that we have an outstanding team – from the clerical support, the insurance liaisons, intake staff, managers, and the field staff–who all have heart, are professional, and go above and beyond to provide compassionate, dignified, and exceptional care to our patients and families we serve here in Rockland County.