Special Projects Fund

Grantee Name

Village Care of New York

Funding Area

Special Projects Fund

Publication Date

August 2011

Grant Amount


Grant Date:

January 2007 – February 2009


Nearly half of all patients who are discharged from hospitals following a stroke or congestive heart failure (CHF) are readmitted to the hospital within one year, highlighting the need for better recovery options.

To address this situation, Village Care of New York (VCNY) launched a pilot program to provide outpatient, short-term post-acute care in its Adult Day Health Center (ADHC) setting. The program was designed to demonstrate both the clinical benefits and cost-effectiveness of using this setting for post-acute patients who are not interested in or qualified for nursing home or certified home care, with the goal of reducing the number of patients who are readmitted annually to New York hospitals.

Outcomes and Lessons Learned

  • Installed new occupational and physical therapy equipment to better meet the needs of immediate post-acute patients.
  • Expanded the rehabilitation staff.
  • Contracted with the Lewin Group to evaluate the pilot program.
  • Established procedures for referrals from New York University Medical Center.
  • Created a comprehensive assessment and care plan for pilot participants and their caregivers.
  • Created Spanish and English marketing materials and distributed to referral sources.
  • Provided treatment services including: physical and occupational therapy; individual dietician sessions and health education group sessions; psychosocial support group sessions; and transition visits to the patient’s home.