Inside Central Virginia’s first Hospital at Home program
Since launching in 2023, VCU Health Hospital at Home has served nearly 800 hospitalized patients in Central Virginia.
December 01, 2025
VCU Health Hospital at Home provides hospital-level inpatient care in the comfort and safety of a patient’s own living space. (Getty Images)
By Joan Tupponce and Sara McCloskey-Nieves
Julia Breton, M.D., recalls a recent patient with dementia who was being treated for an infection at VCU Medical Center. She was delirious – a change in mental status that is very common in older hospitalized adults, especially those with dementia or sensory impairments, when they are sick and under stress.
“She wasn’t eating or drinking,” Breton said. “We were able to bring her home to finish the IV antibiotics. When she got back home, she perked back up. She started eating and drinking on her own... Being at home is like the antidote to delirium.”
For some patients, like this one, being in a hospital setting might not be the best environment for them to recover from an illness. At VCU Health, there is an option to have the same high-quality hospital care at home.
VCU Health Hospital at Home (HaH) provides acute inpatient care in the comfort and safety of a patient’s own living space. Founded in 2023, the program has served nearly 800 patients. Those who use these services oftentimes are immunocompromised or are at risk of developing other infections during a traditional inpatient hospital stay.
“We take care of a wide variety of patients who are hospitalized. A lot of patients have heart failure exacerbation and need IV diuretics,” said Breton, the co-medical director of the VCU Health Hospital at Home program. “We also treat different infections that require IV antibiotics, and we provide monitoring and support for respiratory illnesses.”
Research shows that healing at home has a lot of added benefits for patients and their caregivers. Not only do patients have fewer infections and return visits to the hospital, but they also tend to be less anxious, sleep better and are not in as much pain.
“Patients also have improved function in Hospital at Home,” Breton said. “At home, they are able to maneuver around the home environment. People don’t get as weak as when they are in the hospital, so there is less need for rehab after hospitalization.”
These programs are used widely across the country and internationally. But in Central Virginia, VCU Health is the only health system to offer a Hospital at Home option to patients. Breton sees the acceptance of these types of programs as a silver lining of the pandemic.
“The pandemic helped health systems think more openly about how we deliver hospital-level care,” she said.
What does hospital-quality care look like at home?
A patient will be assessed by a doctor at VCU Medical Center to determine if they have a medical condition or symptoms that can be safely and effectively managed outside the hospital. If they are approved for Hospital at Home, the patient will be transferred to their home directly from the emergency department or inpatient unit.
Once back in their residence, the Hospital at Home care team coordinates a variety of different services depending on the patient’s needs, including:
- Medical supplies and equipment, like wheelchairs, walkers or bedside commodes
- Imaging services, like X-rays and ultrasounds
- Laboratory tests
- Meals and nutrition services
- Medication support, including IV treatments
- Rehabilitation services, including physical and occupational therapy
- Transportation (non-emergency)
Patients have access to their Hospital at Home care team 24/7 with a tablet provided by the program. They are also given devices to monitor their vitals. Every day, patients have a minimum of two scheduled in-person visits from a VCU Health nurse or paramedic. On top of this in-home care, patients have full-time virtual support from their care team.
Research on Hospital at Home initiatives shows that the care is safe and prevents further complications that might arise after a patient returns home from a hospital stay.
“[Hospital at Home] has also reduced the rate of readmission. A lot of that is due to the fact that we are going into the home and can see firsthand the support that patients do and don’t have,” Breton said.
What patients are saying about VCU Health Hospital at Home
While virtual visits with a doctor or nurse may seem less personal, the feedback Breton's heard from patients is overwhelmingly positive. She says patients tell her that they receive more attention from their care team at home than they do in a brick-and-mortar hospital.
“When a doctor is on video with them, they get 100% of the doctor’s attention,” Breton said. “A nurse at home can provide undivided attention and that leads to better patient care and experience. It’s very satisfying to our team to be able to provide that high quality of care.”
Being able to get care at home is also less disruptive for families, which patients who participate in the program say they really appreciate. A good example was a mother who needed IV medication and monitoring for a serious infection. With Hospital at Home, she could get the care she needed and take care of her two small children. Another patient was a grandparent who is the main caretaker of her grandchildren. Hospital at Home made sure that she could get the kids on and off the bus and still receive supervised treatment.
“This is a group of patients that really appreciate this care,” Breton said. “If we can provide high-quality, safe hospital care to patients in their home, it is a huge benefit for the health system and our patients."
