If your loved one just came home from the hospital and home health never called, never scheduled, or never showed up, you’re probably feeling one thing:
Panic.
You were told someone would call.
You were told a nurse or therapist would come out.
You were told you’d have support.
And now?
It’s radio silence.
This is one of the MOST common failures in the entire post-hospital system – and almost nobody tells families how to handle it.
This guide breaks it down simply so you know exactly what to do next.
For more insight on why this happens in the first place, see:
→ When the Case Manager Says “You’re All Set” — Here’s What They Really Mean
Why Home Health Doesn’t Show Up
Here’s the part hospitals rarely explain:
Just because home health was ordered doesn’t mean they accepted the case.
Home health agencies can decline a patient if:
- They’re short-staffed
- The insurance authorization is delayed
- You live outside their coverage radius
- The order wasn’t specific enough
- The agency never received the paperwork
- The doctor didn’t sign the order
- The referral got lost (happens often)
So while the hospital ordered home health…
That doesn’t mean home health is actually coming.
Here’s how to fix it.
Step 1: Know the 48 – Hour Rule
Home health is supposed to contact you within 48 hours of discharge.
Not schedule the visit.
Just contact you.
If you haven’t heard anything within 48 hours:
Assume something went wrong.
And start the steps below immediately.
Step 2: Call the Home Health Agency Directly
Your discharge paperwork should list the agency.
If not, call the hospital operator and ask:
“Which home health agency did my loved one get referred to?“
Then call the agency and say:
“My loved one was referred to your agency after hospital discharge. We haven’t received a call yet. Can you check if the referral was received and accepted?“
They will:
- Search the system
- Tell you if the referral is missing
- Confirm acceptance or denial
- Tell you what they still need
If they NEVER received the order → jump to Step 3.
If they DID receive it but didn’t call → request a visit date.
Step 3: Call Hospital Case Management
If the referral never reached the agency, call the hospital and ask for:
“Case management for [patient’s name].“
Say:
“Home health never received the referral. Can you resend the order and confirm acceptance before the end of the day?“
Case managers can:
- Re-fax the order
- Send it to a different agency
- Call agencies on your behalf
- Re-confirm insurance authorization
This is their job.
Learn more here:
→ Care System Education Hub
Step 4: Ask for a Backup Agency
If the agency declines the case (very common), ask case management:
“Please send the referral to a second and third agency immediately.“
Home health agencies reject cases ALL THE TIME.
You need backups.
Step 5: Call the Primary Care Doctor (PCP)
Most families don’t know this:
Your primary care doctor can order home health at ANY time.
If the hospital system fails, call the PCP’s office and say:
“The hospital ordered home health but it never started. Can the doctor place a new home health referral today?”
PCPs generally do this same-day – especially after a hospitalization.
Step 6: Clarify What Services You’re Supposed to Receive
Home health includes:
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Home health aide (limited hours)
Ask the hospital OR the agency:
“Which services were ordered? And how often?“
This prevents you from being shorted on care.
Step 7: If Nobody Responds, Escalate (Calmly but Firmly)
Here’s the exact script:
“I’m concerned for patient safety. We were told home health was ordered, but no one has called or visited. We need to establish care today. What can we do to get this resolved right now?”
This phrase creates urgency without being confrontational.
Step 8: Document Everything
Keep a list of:
- Who you spoke with
- When
- What they said
- What they promised
- What the next step is
Hospitals and agencies respond faster when families stay organized.
Step 9: Know When to Go Back to the ER
If your loved one’s condition worsens AND home health still hasn’t started, you may need to return:
- New/worsening confusion
- Severe weakness
- Trouble walking
- Trouble breathing
- Falls
- New fever
- Chest pain
- Pain that is uncontrolled
- Signs of dehydration
- You feel unsafe caring for them
Never wait it out alone.
Why This Happens So Often (And Why It’s Not Your Fault)
The handoff from hospital → home health is one of the weakest parts of the healthcare system.
Not because people don’t care.
Because the system is fragmented.
You did nothing wrong.
You weren’t supposed to know how to navigate this.
And you don’t have to do it alone.
When You Want Help Navigating the Mess
If you’re sitting at home thinking:
“I’m completely unprepared and no one is helping us.“
That is exactly why Willow & Wells exists.
Book a 1:1 Concierge Nursing Session
We’ll:
- Call the agencies with you
- Walk through the discharge plan
- Create a step-by-step 72-hour home plan
- Explain symptoms
- Tell you what’s urgent and what’s normal
You get clarity.
You get safety.
You get support.
Screenshot This: “Home Health Never Showed Up” Checklist
Call in this order:
- Home health agency listed on your discharge paperwork
- Hospital case management
- PCP office for a new referral
- Backup home health agencies
- Return to ER if symptoms worsen
Say this phrase: “I’m concerned for patient safety. We need to establish care today.“
