Recuperative Care for CalAIM Members in Solano & Sonoma Counties

Medical respite with nursing oversight for post-hospital recovery

When patients need more than housing but less than skilled nursing, Hammock Homes provides recuperative care (medical respite)—helping hospitals and health plans ensure safe transitions for eligible Medi-Cal members across Northern California.

Medical monitoring and support in Northern California when you're too sick for shelter but don't need a hospital

Hammock Homes provides recuperative care services throughout Northern California for people who are unhoused and need a safe place to recover after illness or injury. Our medical respite program offers the care and stability you need to heal.

What is Recuperative Care?

Recuperative care, also known as medical respite, provides short-term residential care for individuals recovering from illness or injury who are unhoused or experiencing housing instability. Our medical respite in Northern California serves as a vital safety net when standard discharge options aren’t available. When you’re too sick to return to the streets or a shelter but no longer need to stay in the hospital, recuperative care provides the medical support and safe environment essential for recovery.

Who Qualifies: Who We Serve

Our medical respite services in Solano County and Sonoma County are designed for individuals who meet the following criteria:

Are Currently unhoused or experiencing housing instability

Are Recently discharged or preparing for discharge from a hospital

Are Still need medical monitoring but no longer require hospital-level care

Are Have Partnership HealthPlan or other Medi-Cal coverage

Are Able to perform most activities of daily living with minimal assistance

Are Medically and behaviorally stable for a community setting

Medical Comprehensive Included

Daily Medical Monitoring

Vital signs checks, health assessments, and symptom tracking to ensure your recovery stays on course.

Wound Care Oversight

Professional monitoring and management of surgical sites, injuries, or chronic wounds.

Medication Management and Education

Support taking your medications correctly and understanding what each one does.

Coordination with Healthcare Providers

We communicate with your doctors and specialists to ensure continuity of care.

Transportation to Medical Appointments

Assistance getting to follow-up visits, lab work, and specialist appointments.

Connection to Primary Care

Help establishing or reconnecting with a primary care provider for ongoing health management.

On-Call Nursing Support

Access to nursing staff when medical questions or concerns arise.

Individualized Care Plans

A recovery plan tailored to your specific medical needs and goals.

Wraparound Support Beyond Medical Care

Comfortable Accommodations

Private or semi-private rooms in a home that promotes rest and healing.

Nutritious Meals

Three balanced meals daily to support your physical recovery.

Case Management

Dedicated support to help you navigate systems, access benefits, and plan for stable housing.

Benefits Enrollment Assistance

Help applying for disability, food assistance, and other critical support programs.

Housing Navigation Services

Support finding and securing your next housing placement when you're ready.

Behavioral Health Connection

Links to mental health and substance use services when needed.

Life Skills Support

Assistance with daily living skills and preparation for independent living.

Discharge Planning

Coordinated planning to ensure a smooth transition to your next placement.

Length of Stay

Flexible Based on Medical Need

Recuperative care stays typically range from 3 to 6 months, determined by your specific medical recovery needs.

Extensions Available

Additional time may be approved with medical justification when recovery requires more time.

CalAIM Guidelines

Recuperative care is subject to the six-month room and board cap when combined with other CalAIM housing services.

How to Access Recuperative Care Services

Hospital Discharge Planners

Contact us directly to refer patients preparing for discharge who need medical respite

Partnership HealthPlan Case Managers

Coordinate with your team to initiate referrals for eligible members.

Individual or Family Inquiry

If you or a loved one needs recuperative care, reach out to us. Medical documentation will be needed.

Other Managed Care Plans

We consider referrals from other Medi-Cal managed care plans on a case-by-case basis.

Authorization Timeline

Referrals are typically reviewed and authorized within 24-48 hours.

Outcomes That Matter

Our recuperative care program in Northern California achieves meaningful results:

Reduced Hospital Readmissions

Medical monitoring and support prevent complications that lead to rehospitalization.

Successful Housing Transitions

Case management and housing navigation help individuals move into stable housing.

Improved Medication Adherence

Education and support lead to better understanding and management of medications.

Primary Care Connections

Participants establish relationships with primary care providers for ongoing health management.

Cost Savings

Recuperative care provides appropriate care at significantly lower costs than extended hospital stays or repeated emergency visits.

Why Choose Hammock Homes for Medical Respite

Home-Like, Not Institutional

Our recuperative care facilities feel like homes, not medical institutions. Healing happens best in comfortable, dignified environments.

Experienced Medical Oversight

Professional staff trained in post-acute care and the unique needs of individuals who are unhoused.

Multi-County Coverage

Serving both Solano and Sonoma counties means we can accommodate more patients across Northern California.

Established Partnership HealthPlan Provider

Our strong relationship with Partnership HealthPlan ensures smooth authorizations and coordinated care.

Focus on What Comes Next

We don't just help you heal, we help you plan for stable housing and ongoing health management.

Recovery from illness or injury shouldn’t happen on the streets or in shelters. Our CalAIM
recuperative care program provides the medical support, safety, and stability you need to heal.

Recuperative Care FAQ

Recuperative care is short-term, supportive housing combined with medical oversight for individuals who need a safe place to recover after discharge from a hospital but are not ready to return home, including those experiencing homelessness or housing instability. This type of post-hospital recovery housing bridges the gap between hospital care and independent living, ensuring clients heal safely while receiving wraparound services.

Eligibility includes adults recently discharged from hospitals or emergency departments who do not require inpatient care but lack stable housing or living support. Special consideration is given to homeless individuals, those in unstable housing, or clients unable to care for themselves during the recovery period due to their medical condition.

Hammock Homes accommodates a wide range of conditions such as post-surgical recovery, chronic illness management, wound care, mobility issues, and medical stabilization needs. Each client’s care is tailored to their individual health requirements.

Clients receive medical oversight, health assessments, medication management, wound care, coordination with primary care providers, discharge planning, and transportation to medical appointments. Case management and social services are also provided to promote long-term stability.

Services include coordinated accommodations, nutrition and meal support, assistance with social determinants of health, behavioral health linkages, and help with daily living tasks, ensuring whole-person recovery.

The length of stay is determined by individual recovery needs but typically ranges from a few days to several weeks, until the client is medically stable and safe to transition to more permanent housing or community resources.

Hammock Homes provides recuperative care in multiple locations throughout Northern California, including Solano and Sonoma Counties, with safe and nurturing environments designed for healing.

Referring professionals can contact Hammock Homes directly via the website’s referral form, or by phone. The intake team coordinates promptly with hospital discharge planners, social workers, or case managers for a seamless transition.

Hammock Homes offers nurse-led, non-institutional environments, experienced medical coverage, coordinated discharge planning, individualized service plans, and strong hospital partnerships—ensuring superior recovery outcomes and housing stability.

Visit the Hammock Homes website and complete the intake or referral form, or call the intake coordinator for immediate assistance. The staff guides both providers and individuals through the intake and placement process for medical respite.