May 1, 2024

There are options for receiving care at home. 

For decades, the traditional way to get health care was to go to a doctor’s office, or the hospital, in person. During the COVID-19 pandemic, telehealth became a more common option. There are other services that now make it possible for some people to get medical care at home, too.

Hospital at Home

Some patients who visit the Emergency Department and are admitted to the hospital can complete their hospital care at home.  
Vanderbilt University Medical Center offers Hospital at Home, care for certain conditions that otherwise would require a hospital stay. This is the same level of care that you would get in the hospital. Patients with a wide range of conditions are eligible: pneumonia, congestive heart failure, urinary tract infections, gallbladder disease, chronic obstructive pulmonary disease and others. 
This model of care began during the COVID-19 pandemic as a way to care for patients without requiring them to stay overnight in the hospital, often referred to as inpatient care. Demand for care within hospitals keeps rising, said Ryan Starnes, senior director of operations at Vanderbilt University Hospital. Hospital at Home served more than 585 patients by early 2024.  
To be eligible for this optional type of home care, someone must be medically stable enough to leave the hospital and meet certain medical and social criteria. 

Multiple daily home visits are made by a medical team that can include doctors, nurse practitioners, nurses, pharmacists, physical and occupational therapists and mobile radiology technicians. Their care includes giving IV fluids and medications, monitoring vital signs, doing some lab tests, providing oxygen, delivering medications and more. They can provide medical equipment, nutrition and transportation to in-person medical appointments if necessary. The team can monitor vital signs remotely through wearable devices. 

Vanderbilt’s Hospital at Home program also gives patients a tablet that allows connection to the care team by telehealth 24 hours a day. A caregiver, typically a relative or friend, is part of the care team and needs to stay with the patient while being cared for by this program.  

Patients like the hospital at home option because they can keep up with some of their daily routines, and sleep better in their own bed without the noises and disruptions common in the hospital. And they can be comforted by family, friends and pets while recovering.
People receive this hospital at home care until it’s no longer needed medically. Medical records are shared with patients’ regular doctors.  

Care at home unrelated to a hospital stay

A different type of at-home care is not tied to recovery after a hospital stay or emergency visit. Instead it’s usually for patients with certain diagnoses who need ongoing care for chronic conditions. This includes private-duty nursing.  
Vanderbilt’s Home Care service provides skilled nursing care (to manage IVs, wounds and medications, for example), physical or occupational therapy, care for neurological disorders (such as stroke, multiple sclerosis, ALS or dementia); and infusions for treating chronic autoimmune conditions, such as lupus. 
Home Care as offered by Vanderbilt also serves children who are medically fragile — for example, those with seizures, cerebral palsy or autism. The home health team can give medications and manage bathing and tube feeding, among other needs.

Each person’s needs are different, so the details of their home health care are customized. One person may need help with bathing, grooming and dressing; another may need help with a feeding tube, or caring for a catheter or ostomy bag. 
The Vanderbilt program cares for children and adults who live in seven Middle Tennessee counties: Cheatham, Davidson, Robertson, Rutherford, Sumner, Williamson and Wilson. 

Families should check with their health insurance to learn what home health care is covered; typically, insurance coverage depends on what at-home care is needed. 

On-demand care for non-emergencies

Other home services can send a medical professional for a home visit for non-emergency care.

Vanderbilt Health OnCall, for example, sends nurse practitioners to homes, workplaces, hotels and short-term vacation rentals. The service is an option for getting treatment for non-emergency problems, such as flu, strep throat, urinary tract infections, seasonal allergies, ear infections, pink eye, sinus infections and the like.  The service is for adults, age 18 and older.

Vanderbilt Health OnCall is available in five Middle Tennessee areas: Nashville (Davidson County) and the cities of Franklin, Brentwood, Nolensvillle and Hendersonville. Telehealth appointments are available if the patient is in Tennessee at the time of the visit. Most insurance plans are accepted.

A young nurse in blue scrubs sits with an older female patient checking her oxygenation level.

Personalized care at home

For some situations, it is easier and less expensive to receive care at home than in a doctor’s office or the hospital. Vanderbilt University Medical Center aims to provide personalized care, coming to where patients are, when possible.

Vanderbilt University Medical Center is the only one in Middle Tennessee offering Hospital at Home. Patient satisfaction scores for this program are even better than those for inpatient care. More details are available about Hospital at Home,  Home Care and Vanderbilt Health OnCall.

Vanderbilt also offers Home Care and Vanderbilt Health OnCall, depending on individual needs and insurance coverage.

Hospital At Home