Subacute Rehab at Home (SARAH): Redefining Recovery

In 2025, UMass Memorial Health advanced home-based care through our Subacute Rehab at Home (SARAH) program, a state-funded pilot for patients who would otherwise be discharged to a skilled nursing facility (SNF).

SARAH builds on the success of our Hospital at Home Program, which cares for patients requiring acute care services. SARAH focuses on patients recovering from surgery, injury or illness.

“Patients love being at home,” said Wendy Mitchell, MD, Medical Director of the UMass Memorial program. “They sleep better, feel more comfortable and therapy is tailored to their environment — managing stairs, getting in and out of the shower, or maneuvering a walker in their own bathroom. It just makes sense.”

Launched in August 2024, SARAH operates as part of a state-sponsored, randomized, controlled clinical trial led by UMass Chan Medical School. Hospital and research staff identify eligible patients, who, if they consent to participate, are then randomized either to traditional SNF rehab or to SARAH. Patients in SARAH typically spend 10 to 14 days receiving daily physical and occupational therapy, with skilled nursing visits in person or virtually as needed.

SARAH actively involves caregivers and addresses social and environmental factors that affect recovery. “There’s nothing better than medication reconciliation in the home,” Dr. Mitchell said. “You see the reality — patients taking expired meds or family members’ meds — and you can correct it right on the spot.”

Patients and families report feeling empowered and supported. “In the hospital, care happens on the team’s schedule, on their turf. In the home, we’re the guests. Patients ask more questions, they feel heard and they feel cared for,” she added.

As the trial continues through 2026, our team aims to show that subacute rehab at home can match or surpass facility-based outcomes, provide a healing environment that patients and families prefer, while helping our hospitals manage capacity. •