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Skilled Home Health Service

Post-Hospital Recovery

Skilled support after a hospital stay, helping you transition safely back home during a critical recovery window.

Care in action
What It Includes

Skilled, physician-ordered care

Delivered by trained clinicians and guided by an individualized plan of care. Specific services depend on your physician’s orders and your assessment.

  • Symptom and recovery monitoring after discharge
  • Medication reconciliation and teaching
  • Coordination with the hospital and your physician
  • Support aimed at reducing avoidable readmissions
  • A care plan tailored to your discharge orders
  • Education for you and your caregivers

Who it’s for

Patients recently discharged from the hospital who need clinical follow-up at home.

We accept Medicare & Medicaid

Not sure if this service is covered for you? Call us — we’ll help you understand your options, with no commitment.

Call, fax, or text(317) 669-6685
How Care Works

From referral to first visit

Every service begins with a physician’s order and an individualized care plan.

1

Physician referral

Your doctor sends an order by phone, fax, or text.

2

Assessment

A nurse assesses needs and builds the care plan.

3

Skilled visits

Care is delivered at home as ordered.

4

Supervision

An RN supervises and reviews the plan.

5

Ongoing review

The plan adjusts as your needs change.

Talk to us about your situation.

Call, text, fax, or send a message. We’ll explain next steps and how to ask your physician for a referral — no commitment.

Phone, fax, or text(317) 669-6685
Emailhha@myguardian.care
Send us a message