This article was written by Sue Gregg, the Regional Director of Caregiver Homes Ohio and Indiana.

When a person has completed inpatient treatment in a hospital and requires ongoing care, case managers or discharge planners have a responsibility to ensure the person transitions to a safe environment where they will not be at risk for re-hospitalization. For an individual who does not require assistance with activities of daily living, (such as eating, bathing or dressing), a discharge plan may be as simple as allowing the person to go home and recover. But some individuals do require such assistance. Whether or not that was the situation prior to the patient being in the hospital, the duty to ensure a safe discharge remains. 

There is a relatively new option for consumers who require help with activities of daily living. For Medicaid beneficiaries, there is an alternative to nursing facility placements called Structured Family Caregiving, which is commonly referred to as Adult Foster Care. 

What is Structured Family Caregiving? 

Structured Family Caregiving is 24/7, at home, person-centered care for elders and persons with disabilities living with a professionally supported, technology enabled, paid live-in caregiver, who may be a family member or a non-family caregiver. 

Why is Structured Family Caregiving an important option to hospital case managers and discharge planners?

Time is of the essence when developing a good discharge plan for elders, people who are chronically ill, and individuals with disabilities. Often, the list of options in the community is limited for these populations, so many are sent to facility-based settings by default or because of insurance coverage requirements that determine where care must be rendered. Usually the location is a skilled nursing facility (known to many people as “nursing homes”). 

Structured Family Caregiving closes a gap in the home and community-based option of services by training and supporting family caregivers so they are able to care for the consumer in their preferred home setting. For individuals already enrolled in Structured Family Caregiving with Caregiver Homes, the care team assists in the transition between the hospital and returning home. By having continuity in clinical oversight prior to, during and after a hospitalization with the same care tea–which includes the family caregiver–overall rates of unnecessary emergency room visits and re-hospitalizations have decreased.