How does home care work after a rehab or skilled nursing discharge?

A discharge home from a rehab facility or SNF is usually a longer runway than a hospital discharge — patients come home with more strength but also with a longer list of restrictions (weight-bearing limits, no stairs alone, medication changes from the SNF stay). The care plan reflects that. Most Southeast Michigan families start with 6-to-8 hours per day, seven days a week, for the first two weeks.

Typical shift work includes safe transfers using the technique the SNF PT taught, gait supervision during any household walking, medication reminders on the updated post-discharge schedule, meal preparation, hygiene support, and daily observation for signs the patient is overreaching. The caregiver logs pain, sleep, and mobility so the family can spot trends.

Rate at typical 2026 Southeast Michigan agency prices: Personal Care $29–$37/hr. Higher-acuity discharges (advanced dementia, complex transfers, two-person assists) step up to Specialized Care $35–$42/hr. Where 24/7 supervision is needed and the household can offer a private bedroom with 5 uninterrupted sleep hours, live-in ($400–$500/day) is often the better economic model.

Medicare skilled home health — nurse, PT, OT — visits 2 to 3 times per week for the covered window (typically 30 to 60 days). Home care and home health run in parallel, then home care usually continues at reduced hours once the Medicare skilled window closes.

For the full breakdown, see the cornerstone: Hospital Discharge Home Care guide.