For many people, leaving the hospital isn’t the end of a health journey; instead, it’s the start of ongoing care. Whether that’s physical therapy after surgery or occupational and speech therapy after a stroke, the next step is choosing the right post-acute care.
For patients and their families, this decision-making process can be stressful, confusing and rushed as they sort through options like home health care, skilled nursing facilities, inpatient rehab or respite care in assisted living.
To better understand how people make decisions about post-acute care, U.S. News surveyed 206 individuals who had recently been discharged from the hospital and needed to arrange additional care and their family members who were involved in care decisions. Below are the results of that survey, as well as expert advice on navigating these health care decisions.
[READ: How to Set Up Home Health Care After a Hospital Stay]
Post-Acute Care Recommendations
After a hospital visit, patients and their families turn to trusted sources of information for advice on their post-acute care.
“A patient and caregiver first need to speak with the interdisciplinary team member in the hospital who can assist with the potential options,” explains Dr. Stephanie Rogers, professor of medicine in the division of geriatrics and associate chief of clinical geriatrics programs at University of California San Francisco.
Usually, a social worker or case manager along with a patient’s providers will talk with you about eligibility requirements, local resources, needs and preferences, explains Rogers. Then, you can turn to other resources.
94% of the surveyed patients and their families reported that they relied on at least one source of information outside of the hospital’s recommendation for guidance.
Among the top sources of post-acute care information sources were:
— A hospital social worker or discharge planner (53%)
— The patient’s primary care physician (38%)
— Online searches (35%)
[READ: What Qualifies a Patient for Skilled Nursing Care?]
Types of Care Required
Post-acute care looks somewhat different depending on the reason for the hospital visit, a person’s health status and their individual needs. While a small percentage of people surveyed were discharged with no recommendations for post-acute care, most received formal recommendations from the hospital for at least one type of care.
Below are the most common formal recommendations from the hospital for each of the following types of post-acute care.
| Type of care | How often this type of care was recommended |
| Home health | 51% |
| Outpatient therapy services | 39% |
| Skilled nursing facility (SNF) | 38% |
[READ: Senior Rehab: Find the Best Care After a Hospital Stay]
Determining Post-Acute Care: How Individuals Made the Decision
The hospital and care team will offer discharge recommendations, but sometimes the patient and their family must make the decision to recover at home versus in another medical setting, such as a skilled nursing facility
.
“The three biggest factors that weigh into what type of post-acute care to choose should be guided by clinical and care needs, available caregiver support and patient preference,” Rogers says.
But what is it that patients and their families say they prioritize when faced with these decisions? Often, it comes down to cost.
Cost and insurance coverage are primary decision factors
To determine whether a patient should recover at a skilled nursing facility or at home, a majority of people said cost and insurance coverage were the primary factors.
On the other hand, a patient’s need for 24-hour medical supervision and the convenience for family caregivers were the least important factors.
Choosing home health vs. skilled nursing: Expert advice
A patient’s clinical needs should be prioritized when making the decision between home health and skilled nursing, Rogers explains, since they are appropriate for different circumstances.
The following is a breakdown of the clinical reasons someone would choose home health care after a hospital stay versus skilled nursing:
| Home health | Skilled nursing facility | |
| Type of need | Intermittent skilled needs (like wound care or medication management) and therapeutic care (physical, occupational, speech therapy) | High-level medical care and therapeutic care (physical, occupational, speech therapy) |
| Frequency of care | 2-3 times per week, usually | Daily |
| Activities of daily living (ADL) | Part-time help with ADLs (dressing, bathing) | Round-the-clock help with ADLs (dressing, bathing) |
[READ: Does Medicare Cover Home Health Care?]
Cost Matters: Post-Acute Care Costs and Insurance Knowledge
Cost was the most important factor that participants noted when considering home health versus skilled nursing care for themselves or their loved ones. However, most people noted confusion or a lack of knowledge about those associated costs during the decision-making process.
In fact, 71% of respondents noted having only “general” knowledge and being confused about specifics or knowing very little and having to learn everything during the process.
Liaising between home health agencies and determining what Medicare coverage you or your loved one has access to can be confusing and time-consuming for those looking for care.
Making sense of post-acute care costs
“The hospital case manager is going to be a really key person to speak to about what the coverage will be post-hospitalization,” explains Christen Bergeron, founder of Navigating Senior Living and the Aging Parent Answers membership community based in Bedford, New Hampshire.
There are specific requirements about a hospital stay, including whether someone is placed on “observation” status, that impact whether skilled nursing will be covered. Additionally, Medicare Advantage plans can further complicate care coverage, for any type of post-acute care.
The case manager at the hospital can provide guidance, but you may ultimately have to contact the number on the back of your insurance card or speak with Medicare to confirm coverage.
“Don’t assume that skilled nursing or home health care is going to be covered under either Medicare or your insurance plan. Always verify so that you’re not caught off guard when that stay or that home health care is not covered,” Bergeron advises.
Trustworthiness: Key Factor in Choosing a Care Provider
After a hospital discharge, a patient and their family or loved ones must choose a type of care and who will provide that care. With so much data available, from online reviews to references, ratings and rankings, what is it that people care most about when it comes to the critical choice of a provider?
Half of respondents said that trustworthiness was the “main factor” that they used to choose a provider, and 93% said that trust was extremely important or very important when selecting a specific provider.
Clinical care quality mattered strongly as well, but trust took priority in a majority of patient decisions.
Where does trust come from?
Each of the following contributed relatively equally to patients and their families’ perceptions of trust:
— Strong personal recommendation from a doctor or other health care professional (40%)
— Positive, professional experiences during initial phone consultations or tours (34%)
— Solid reputation based on local word-of-mouth (31%)
— Information, literature and website were clear, detailed and transparent (30%)
— Good track record of high staff retention and training (29%)
— Ability to interview or meet members of the care and/or wellness teams (28%)
Experts recommend taking stock of your goals and values when choosing a provider.
“I think the biggest factor in choosing a provider for your health care is finding someone who asks about what matters to you and someone who can tailor your health care to your goals and values,” Rogers says. “Our priorities and values change as we age, and so should your health care.”
Rogers recommends finding a geriatrician as a primary care doctor who can focus on the “Four M’s” of care:
— What matters to you (goals and values)
— Mobility and function
— Mentation (cognition and mood)
— Medication use (safe management and usage)
Making the Final Choice: Balancing Needs, Recommendations and Trust
Before being discharged from the hospital, patients and their caregivers have an idea about how they’d prefer to recover. While hospitals and providers will often recommend which type of care to pursue, these preexisting preferences also come into play. Before the official discharge,
— 41% said they strongly preferred recovery at home over a facility, if possible.
— 26% said they preferred the structure and supervision of a facility (such as a skilled nursing facility).
— 33% said they had no strong preference and focused only on the best medical outcome.
U.S. News Methodology
In January of 2026, U.S. News surveyed 206 U.S. adults who were recently discharged from the hospital and needed to arrange post-acute care and their family members.
About 56% reported that they were arranging care for a parent or step-parent, 17% for themselves, 10% for their spouse/partner, 16% for another immediate family member and 0.5% for a friend or nonfamily member.
Around 77% of those needing post-acute care were over the age of 65 at the time of the hospitalization.
Of the 206 people who responded, 50% identified themselves as male, and 50% identified themselves as female.
More from U.S. News
8 Questions to Ask a Geriatrician at Your First Appointment
Nursing Home Red Flags You Should Watch For
What to Pack in Your Hospital Bag Before a Surgery or Procedure: A Checklist
The Cost and Trust Factors Driving Patient Choice in Post-Acute Care: U.S. News 2026 Survey originally appeared on usnews.com
