Home-based skilled nursing care for rehabilitation
Skilled Nursing Facility at Home Trial
This study is testing whether home-based nursing care can help people recovering from hospitalization do better than those who go to a rehab facility.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 650 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Massachusetts, Worcester Academic / other |
| Drugs / interventions | chemotherapy, radiation |
| Locations | 2 sites (Springfield, Massachusetts and 1 other locations) |
| Trial ID | NCT06547645 on ClinicalTrials.gov |
What this trial studies
This trial evaluates a home-based model for post-acute care by enrolling 650 hospitalized patients who need rehabilitation or skilled nursing support after discharge. Participants will be randomly assigned to receive either home-based care or traditional facility-based care. The study will assess outcomes such as hospital readmission and mortality rates within 30 days, as well as secondary outcomes related to quality of life and healthcare costs. The trial is conducted across two health systems in Massachusetts, ensuring a diverse patient population.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18 or older who require post-acute care and can safely receive care at home.
Not a fit: Patients who require long-term care, palliative care, or have significant mobility limitations may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could reduce hospital readmissions and improve recovery outcomes for patients requiring post-acute care.
How similar studies have performed: Other studies have shown promising results with home-based rehabilitation models, indicating potential for success in this approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age 18 or older * Admitted to an inpatient unit OR receiving home health and requiring an escalation to skilled-nursing facility care * Require post-acute care in a skilled nursing facility based on the clinical inpatient team's assessment (or, if the participant is coming from home, based on the home health team's assessment) * Pass the home readiness assessment * Reside within Greater Worcester or Greater Springfield Exclusion Criteria: * Inability to return to a home residence where care can be provided * Inability for patient or their proxy to provide informed consent for the study * Requires long-term care * Requires palliative or hospice care * On active chemotherapy * Post-transplant surgery * Requires hemodialysis * Requires radiation therapy * Requires two-person assist or mechanical lift * Expresses unwillingness to be randomized to SNF OR SNF at Home care * Considered clinically inappropriate by SNF at Home clinical team
Where this trial is running
Springfield, Massachusetts and 1 other locations
- Baystate Medical Center — Springfield, Massachusetts, United States (Recruiting)
- UMass Memorial Medical Center — Worcester, Massachusetts, United States (Recruiting)
Study contacts
- Principal investigator: Principal Investigator — University of Massachusetts, Worcester
- Study coordinator: Study Team
- Email: homerehab@umassmed.edu
- Phone: 508-523-1284
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.