Pilot · Post-Discharge Service Expansion & Risk Monitoring
Under PDGM, patients are discharged before they’re fully independent. Linda follows up automatically to catch risk early and surface warm Private Duty leads — without spending a dime on marketing.
No EMR integration · $5,000 implementation fee waived · HIPAA & SOC 2 compliant · BAA · Live in 14 days
Discharge from your skilled home health (HSA) program creates a dangerous “blind spot.” Under current Medicare payment models like PDGM, episodes are shorter, so patients are often discharged before they’re fully independent in their Activities of Daily Living (ADLs).
Without continuous follow-up, these patients are at high risk for falls, medication errors, and preventable hospital readmissions. And by simply letting them go, your agency leaves massive revenue on the table by failing to transition them into your Private Duty or Personal Care service lines.
Send us a list of patients discharged from your HSA program over the last 14 to 30 days.
Linda proactively calls them to check on their ongoing recovery — screening for medication adherence, emerging health risks, or the need for daily living assistance (ADLs).
Linda serves as an automated safety net. She filters out the patients who are thriving and immediately flags those who are struggling — actively preventing post-discharge adverse events.
She also automatically surfaces “warm leads” that your agency can transition into your Private Duty division — extending the lifetime value (LTV) of the patient without spending a dime on marketing.
40%
Of 30-day post-home-health readmissions are potentially preventable
1.5M+
Medicare beneficiaries analyzed in the study
19.5%
Of new Private Duty referrals come from former clients & families
Clinical research highlights a massive gap in post-home-health care. A study in the journal Medical Care analyzing over 1.5 million Medicare beneficiaries found that 40% of 30-day readmissions following home health discharge were for conditions considered potentially preventable.
On the financial side, expanding the services you offer existing patients is vital for agency margins. According to recent Private Duty benchmarking data, a staggering 19.5% of all new Private Duty referrals come from former clients and their families. By automating post-discharge check-ins, Linda helps you capture that 19.5% referral base before they look for help elsewhere.
Sources