Could Seniors and Rural Residents Save Hospital at Home?

That, she says, is where small, critical-access hospitals often have to transfer patients rather than manage care for them, and where a transfer can cover hundreds of miles, take hours, and separate patients from their family and community.

“That’s where we need this,” she says.

Like other Hospital at Home programs, Sanford Health’s model is a complex mix of virtual and in-person services, emanating from the hospital. The health system uses a virtual nursing platform and digital health tools to maintain a link with patients at home and coordinates daily visits with its in-house paramedicine program.

Jarvis says Sanford Health is using specific criteria for patient eligibility, focusing now on diagnosis-related conditions like pneumonia and dehydration as well as patients who’ve been in the hospital “and really just need monitoring for a couple of days.” Patients are evaluated through the ED, the prime candidates being those who are admitted and placed in overflow or holding rooms and waiting for a bed upstairs.

In time, as the workflows are defined and data is collected, the health system plans to expand both its patient eligibility criteria and the number of patients who can be treated in the Hospital at Home program, perhaps even creating a hub-and-spoke program that connects other hospitals in the Sanford Health network with small communities.

“They’re saying, ‘You’re telling me I need to be in the hospital, but I can go back home?’” she notes, saying some patients feel that because they need hospital-level care they should be staying in the hospital.

“We’re spending a lot of time with patients before they are [admitted],” she says, as well as developing additional marketing materials to address the home effect and caregivers.

Many patients can’t get out of the hospital soon enough, and that’s where the Hospital at Home strategy could gain steam. The argument in favor of the strategy has long been that many patients prefer their own bed to a hospital bed, and that they recover faster and better at home, where they can sleep more comfortably, use their own bathroom, eat their own food, play with their own pets and children and watch their own TV.

The value of this program in rural areas, Jarvis says, will undoubtedly grow. People living in small communities don’t want to travel long distances for healthcare (as an aside, on the day the program was launched, temperatures across South Dakota were 30 to 40 degrees below zero), and healthcare providers in those communities don’t want to send them elsewhere. A Hospital at Home program, she points out, will rely on “boots on the ground” resources, like the local critical care hospital, doctors, home health aides and even social services, to give that patient the necessary care. And those billable services will support the local community.

Sanford Health’s Hospital at Home anticipates addressing the care demands of a growing senior population, which is demanding services and technologies that allow them to age in place, avoiding grueling trips to and from the hospital or doctor’s office.

Addressing the Growing Need for Senior Care at Home

Improving home-based care for seniors was a pervasive topic at CES 2025, particularly in the Digital Health Summit and exhibit hall, which included large sections devoted to the smart home and AARP-supported services.

Some of the conversations there revolved around using remote patient monitoring (RPM) and Hospital at Home to bring care to seniors.

“The home is right there waiting for us,” said Gabrielle Goldblatt, partnerships lead for the Digital Medicine Society (DiME), which participated in the Digital Health Summit and had a booth in the AARP pavilion. “We can’t be spending billions of dollars on just another way to go to the hospital.”

And while hospitals are focused on the home front right now, they could pivot with the Hospital at Home strategy to other sites like skilled nursing facilities (SNFs) or assisted living complexes.

Doug Leidig, president and CEO of Asbury Communities, a Maryland-based collection of 11 senior living locations, said the network of close to 2,000 not-for-profit communities around the country should be partnering more extensively with healthcare providers to improve care services. But during a panel at the AARP’s Age Tech Summit, he also noted senior living communities aren’t incentivized to invest in healthcare technology.

“There is so much technology out there now that people become paralyzed” with indecision, he said, pointing out the need for innovating partnerships with healthcare technology companies and providers. “We could be their lab.”

Leidig noted the average senior has five doctors and eight to 12 prescribed medications, making it critical that they have reliable platforms in the home with which to communicate with their care team.

Hon Pak, who heads the digital health team at Samsung Electronics, said healthcare providers are the key to improving the smart home. Tech companies and others can create the best smart home available, layering sensors and digital health tools to capture data and enable virtual care, but unless the consumer has a good relationship with the care team, that technology won’t provide value.

“If you just say, ‘Hey, something’s wrong; go see your doctor,’ that’s an incomplete solution,” he pointed out.

“We need hospitals and provider groups to come in,” added Amelia Hay, VP of startup programming & investments at AARP Innovation Labs.

And that’s what DiME is doing. The organization is partnering with the Consumer Technology Association (CTA), UMass Chan Medical School and UMass Memorial Health on the Connected Health Collaborative Community, an effort to create sustainable and scalable Hospital at Home programs. Participating members include Highmark Health and the Mayo Clinic.

Goldblatt said the effort, alongside the U.S. Food and Drug Administration’s Home as a Health Care Hub, aims to better understand the ROI Hospital at Home and other programs that bring care into the home.

“Right now we need to understand the guardrails and provide education,” she said. “That starts with bringing people into the same room for these conversations.”

And at an uncertain time, with a new administration vowing to shake things up and prospects of a continued CMS waiver for Hospital at Home programs up in the air, these conversations may keep the strategy alive.

At Sanford Health, Jarvis says the waiver may be the key to survival for their program in its current state. She said she’d like to see the proposed five-year extension make it through current Congressional talks.

“I think it’s going to be hard without that CMS funding, and [there] won’t be nearly as many patients eligible for the program, and you know the payers tend to follow the lead of what happens with CMS,” she says.

“I really think five years will be a great time frame for proof of concept.”