DALLAS, Texas — When Carrollton resident David Ratliff returned home after having part of a toe amputated, he still needed the kind of medical care normally provided inside a hospital. But instead of spending additional days in a hospital bed, he received intravenous antibiotics, nursing visits and daily physician consultations in his own home.
Ratliff was among more than 1,600 patients treated through Parkland Health's Hospital at Home program, which allows eligible patients to receive hospital-level medical care without remaining inside a traditional hospital.
The program has also shown promising financial results. A February 2026 evaluation found that a Hospital at Home episode cost approximately 30% less than traditional inpatient hospital care.
For Ratliff, the arrangement meant recovering alongside his family while remaining connected to his Parkland medical team.
“I wasn’t quite sure what to expect when they first told me I could go home and still be a hospital patient,” Ratliff said. “But once they explained how it would work, going home sounded pretty good. I could sleep in my own bed, be with my family and still have the Parkland team taking care of me.”
Hospital Care Without Leaving Home
Ratliff developed a bone infection in the middle toe of his right foot that required surgery and continued intravenous antibiotic treatment.
Before he returned to his Carrollton home, Parkland staff prepared him and his wife, April Foran, for the transition.
They received medications, medical equipment and instructions for staying connected with the hospital around the clock.
The equipment included a pulse oximeter, portable blood pressure cuff, remote monitoring device and digital tablet for virtual appointments with nurses and physicians.
Ratliff met virtually with a physician or advanced practice provider every day. Nurses visited twice daily to monitor his vital signs, administer medications, change his surgical dressing and replenish supplies.
Depending on a patient's needs, the program can also provide laboratory testing, infusion therapy, rehabilitation services, oxygen therapy and other medical support.
Foran, who serves as Parkland's director of corporate communications, said the nursing staff made the experience especially reassuring.
“What impressed us most was the caliber of the nurses who walked through our door,” Foran said. “Every single one was professional, knowledgeable and compassionate. They were not simply coming into our house to give David an IV. They took care of him, talked with us, answered questions and made us feel that we were still connected to Parkland.”
Even the couple's dogs became familiar with the routine, watching from behind a kitchen gate as nurses cared for Ratliff.
Parkland Program Has Served 1,660 Patients
Parkland launched Hospital at Home in April 2022 after receiving approval from the Centers for Medicare & Medicaid Services and the Texas Health and Human Services Commission.
Since then, the program has expanded to treat patients with increasingly complex medical conditions.
As of August 17, 2026, the program had recorded:
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1,660 patients treated through Hospital at Home.
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11,637 hospital bed days created through the program.
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7.5 days as the average Hospital at Home stay during fiscal year 2026.
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Approximately 30% lower costs per episode compared with traditional hospital care, according to a February 2026 evaluation.
Infectious diseases account for the largest share of patients, including urinary tract infections, diabetic foot infections, cellulitis and bloodstream infections.
The program also treats patients with kidney and cardiac conditions and has expanded to offer wound vacuum therapy, continuous heart monitoring, oxygen therapy and point-of-care laboratory testing.
Dr. Stephen Harder, lead physician and medical director of Parkland's Hospital at Home program, said the goal is to provide appropriate medical treatment in the setting that best meets each patient's needs.
“The goal is not simply to get someone out of the hospital sooner. It is to provide the right level of care in the right setting,” Harder said. “And if a patient’s condition changes and the hospital becomes the safest place for that care, we can recognize that change and quickly transition them back.”
A Sudden Medical Emergency Tests the Program
Ratliff's recovery initially went well.
He had been receiving care at home for nearly two weeks when he suddenly developed a cough and began struggling to breathe.
“It was almost like someone flipped a switch,” Foran recalled. “David began coughing and having difficulty breathing. He was declining very quickly, and I knew something was not right.”
Foran contacted Harder about her husband's symptoms. After initially monitoring his condition, she called again about an hour later as his breathing difficulties continued.
“I said, ‘We need to go to the hospital.’ From that moment, the Hospital at Home team paved the way for us,” she said. “By the time we arrived at the Emergency Department, the team was ready for him.”
At Parkland, doctors performed X-rays, blood tests and an evaluation through the hospital's Rapid Assessment Team.
Ratliff was diagnosed with pneumonia and admitted to the intensive care unit.
His medical team determined that the pneumonia resulted from a rare reaction to the high-dose antibiotic he had been receiving for his foot infection.
Because Ratliff remained connected to Parkland throughout his home treatment, his care team was able to coordinate his return when his condition deteriorated.
“We were not on our own at home,” Foran said. “David was still a Parkland patient, and when he suddenly needed to be back inside the hospital, the people who had been caring for him were right there.”
Nurses Build Personal Connections With Patients
Parkland officials say the program offers benefits beyond the convenience of recovering at home.
Kassidy James, lead advanced practice provider with Hospital at Home, said visiting patients in person allows clinicians to better understand the conditions affecting their recovery.
“There is so much we can learn when we step into a patient’s home that we may never see during a virtual visit,” James said.
Senior registered nurse Kemunto Kenani, who joined the program in 2023 after working in acute care, said patients often feel more comfortable in familiar surroundings.
“Patients tend to be more comfortable at home. They rest better, and that peace of mind can help with their healing,” Kenani said.
Another nurse, Sherlyn Joy Cowdrey, emphasized the relationships that develop when caregivers spend time with patients and their families.
“First and foremost, they are human beings. Human first, patient second,” Cowdrey said. “You are not just treating an illness. You are caring for a person.”
For Ratliff, those relationships continued even after he returned to the hospital. Members of his Hospital at Home team visited him during his hospitalization and brought balloons to brighten his stay.
By the time he recovered enough to return home again, he no longer needed hospital-level care.
“I was certainly glad I didn’t need that level of care anymore,” Ratliff said. “But after seeing those nurses twice a day, you get used to having them around. They were not strangers coming into our house. They became people we looked forward to seeing.”
