09/08/2026
The ER Can Treat the Crisis. It Can't Prescribe a Home - At Least Not Here, Not Yet.
By Melissa Stout, BSN, RN
As a former ER nurse, I know how much a discharge plan quietly assumes. Go home and rest. Keep the wound clean and dry. Follow up next week. But what happens when there is no home to go to? The emergency department can treat an infection, stabilize an injury, or manage an immediate crisis. What it cannot provide is the safe place someone may need to recover.
Fortunately, Central Florida is beginning to expand resources that address this gap. Pathways to Care in Casselberry provides 34 medical-respite beds and serves about 200 people each year. And the Health Care Center for the Homeless, Inc. has launched a pilot program — Health 2 Housing — connecting highly vulnerable, medically needy unhoused seniors with temporary single-residency occupancy housing and structured healthcare. That work matters, but the capacity remains limited compared with the need.
Other cities show what can happen when recovery includes addressing housing needs. In Cleveland, Ohio, a medical-respite program for women experiencing homelessness was evaluated using admissions from 2022 to 2024. At discharge, 45.2% had transitioned to permanent housing and another 19.2% to skilled nursing facilities. Researchers also reported improvements in self-care, medication management, health knowledge, and primary medical conditions, along with fewer hospitalizations and emergency-department visits. In Denver, Colorado, supportive housing participants had 40% fewer emergency-department visits after two years. Three years after entering housing, 77% of living participants remained stably housed, and the program reduced other emergency public-service costs by about $6,876 per person each year.
Housing is not medical treatment, and emergency departments should not be expected to solve homelessness on their own. However, a treatment plan only works when a patient has a realistic way to follow it. Central Florida has already begun building that bridge between leaving the hospital and having somewhere safe to recover.
The question is this: how much illness, repeat crisis care, and public expense could be prevented if more people had somewhere safe to recover?