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Hospital-to-Home and Transitional Care

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Returning home after hospitalization, surgery, or rehabilitation can be one of the most vulnerable periods in a person's recovery.


Our Hospital-to-Home & Transitional Care services provide short-term, coordinated support to help clients transition safely, continue their recovery, and reduce gaps between hospital and home-based care.

Helping You Transition Home Safely

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Discharge Accompaniment & Home Transition
Our team can assist with discharge, transportation coordination, arrival at home, immediate personal needs, and initial home setup.


Medication & Treatment Support​

Nursing support can help clients understand and follow new medication schedules, treatment instructions, and other aspects of their discharge plan.

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Post-Operative & Wound Care​

Nursing care can include wound assessment, dressing changes, symptom monitoring, pain management support, and identification of potential complications.

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Personal Care & Recovery Support

PSWs can assist with bathing, dressing, grooming, meals, mobility, transfers, toileting, and other activities while the client recovers.​


Rehabilitation After Discharge​

Occupational Therapy, Physiotherapy, and rehabilitation support can help clients regain mobility, function, confidence, and independence following hospitalization.

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Transitional Care Coordination

Our Care Coordinators can help organize nursing, personal support, rehabilitation, appointments, equipment, and communication with the client's healthcare team.

  • Central West
    • Brampton, Caledon, Orangeville, Malton, Mono, Shelburne
  • North Simcoe, Muskoka
    • Barrie, Bracebridge, Collingwood, Gravenhurst, Huntsville, Midland, Orilla, Penetanguishene, Wasaga Beach
  • Central
    • Alliston, Aurora, Bradford, Georgina, Maple, Markham, Newmarket, North York, Richmond Hill, Stouffville, Vaughan, Woodbridge
  • Toronto Central
    • Don Mills, Downsview, East York, Etobicoke, Harbourfront, Islington, Leslieville, Liberty Village, Parkdale, Trinity-Bellwoods, Weston, York Mills​
  • Central East
    • Ajax, Bowmanville, Campbellford, Cobourg, Haliburton, Lindsay, Oshawa, Peterborough, Pickering, Scarborough, Whitby
  • South East
    • Bancroft, Bellville, Brockville, Kingston, Napanee, Perth, Picton, Smith Falls, Trenton
  • Champlain​
    • Arnprior, Almonte, Carleton Place, Cornwall, Deep River, Hawkesbury, Ottawa, Pembroke, Renfrew, Rockland​
  • North West
    • Dryden, Fort Frances, Greenstone, Kenora, Manitouwadge, Marathon, Red Lake, Sioux Lookout, Thunder Bay​​​
  • North East
    • Cochrane, Elliot Lake, Fort Albany, Hearst, Iroquois Falls, Killarney, Mattawa, New Liskeard, North Bay, Parry Sound, Sault Ste. Marie, Sudbury, Timmins
  • Erie St. Clair
    • Chatham, Dresden, Essex, Grand Bend, Leamington, Point Edward, Sarnia, Windsor​
  • South West
    • Hanover, Ingersoll, London, Meaford, Owen Sound, St. Tomas, Stratford, Strathroy, Thornbury, Tobermory, Woodstock
  • Waterloo, Wellington
    • Cambridge, Elora, Guelph, Harriston, Kitchener, Waterloo
  • Hamilton, Niagara, Haldimand, Brant
    • Brantford, Burlington, Fonthill, Fort Erie, Grimsby, Hamilton, Niagara Falls, Port Colborne, St. Catharines, Thorold, Welland
  • Mississauga Halton
    • Acton, Georgetown, Milton, Mississauga, Oakville
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