Transition Care South Miami Families Trust

Your family in South Miami deserves transition care that keeps your loved one safe, healing at home, and treated with dignity after a hospital stay. Preferred Care at Home coordinates with Baptist Health South Miami Hospital and Larkin Community Hospital, giving your family peace of mind during this critical period.

Transition Care for Miami-Dade County families

Why Choose Us for Transition Care?

We’ve been helping families through hospital discharge and recovery since 1984, and our South Miami office is owned locally by Natalie Caldwell and Ricky Greene.

We use a 7-step caregiver screening process, and we’re committed to matching caregivers based on compatibility, not just availability. Our team coordinates directly with the care team managing your family member’s chronic conditions. Family members get real-time access to schedules, caregiver notes, and updates through our Transparency Room.

That transparency means you can be confident your loved one is well cared for, even during the stress and demand of a difficult recovery. We focus on treating every patient with dignity and respect, and we measure ourselves on outcomes, not just hours logged. Families across Miami-Dade County choose us because that commitment shows up in daily care, not just in a sales pitch.

Our approach works because it’s personal. Natalie Caldwell and Ricky Greene review complex cases directly. Families dealing with multiple chronic conditions or a complicated hospital stay always have a clear point of contact.

Our In-Home Care Services

Personal Care Services

When bathing, dressing, or personal hygiene becomes difficult, personal care helps your loved one stay comfortable and dignified at home. For older adults who want to age in place in South Miami, that support can make all the difference.

Our caregivers assist with everyday tasks like grooming, mobility, and medication reminders. We build each care plan around what your family member actually needs, and adjust it as those needs change.

Highlights:

Transition Care in Miami-Dade County
Transition Care in Miami-Dade County

Companion Care

Loneliness is one of the most common struggles for elderly people living alone. Companion care pairs your loved one with a caregiver who offers genuine conversation and emotional support in the comfort of home.

In South Miami, that can mean a stroll through Dante Fascell Park, a trip to the Shops at Sunset Place, or simply a shared meal. Companionship helps seniors stay connected to the community they know. Mahjong nights are hugely popular here right now, and a caregiver can get your loved one to the table and stay through the game.

Highlights:

Homemaker Care

When grocery shopping, meal preparation, and light housekeeping become overwhelming, home starts to feel like a burden. Homemaker care handles those daily tasks so your family member can focus on well-being instead of chores.

Our caregivers prepare meals, manage laundry, and run errands throughout South Miami, Coral Gables, and Pinecrest. For families in older homes, this means your parent’s home stays safe and livable.

Highlights:

Transition Care in Miami-Dade County
Transition Care in Miami-Dade County

Respite Care

Family caregivers carry an enormous load, and caregiver burnout happens when one person handles all the driving, meals, and check-ins alone. Respite care gives you a break while a trained caregiver steps in.

Private respite care through our office can begin quickly, even if you only need extra help a few hours a week to recharge.

Highlights:

24-Hour Care

For families facing serious illness or a long recovery, 24-hour care offers a steady presence and peace of mind. One caregiver stays around the clock to respond to changing needs.

We match each caregiver by personality and experience. That consistency matters when someone you love needs ongoing care and a familiar face every day.

Highlights:

Transition Care in Miami-Dade County
Transition Care in Miami-Dade County

Dementia and Alzheimer’s Care

Memory loss changes everything about daily life. Dementia care provides specialized in-home support for South Miami families managing Alzheimer’s, cognitive decline, or related conditions.

We focus on keeping your loved one in their own home, surrounded by familiar rooms and neighborhood sounds. That familiarity often helps more than any facility can.

Highlights:

Transition Care

A hospital discharge can be confusing. You get prescriptions to fill, follow-up appointments to schedule, and instructions to remember. Our Smooth-Transition Care program sends a trained coach to guide your family through every step.

For patients in South Miami, that means fewer missed appointments, clearer medication management, and someone who coordinates with your physicians at both hospitals. The goal is simple: heal at home, and stay out of the hospital.

Highlights:

Transition Care in Miami-Dade County

What To Expect: Our Process

Your care journey begins with a single phone call.

Your care journey starts with one phone call.

Step 01

Initial Contact

You call (786) 268-6706 and speak with our South Miami team about your loved one’s hospital stay and upcoming discharge.

Step 02

Consultation and Assessment

We review discharge paperwork, medications, and follow-up appointments to understand what the recovery process requires. This assessment also covers daily tasks like meal preparation and light housekeeping that may need coverage.

Step 03

Care Plan Development

We create a personalized care plan covering personal care, light housekeeping, meal preparation, and transportation. The plan adjusts as your loved one’s recovery progresses.

Step 04

Caregiver Matching

We match your loved one with a caregiver based on personality, experience, and comfort with their specific chronic conditions. This matching process is part of what keeps our clients with the same caregiver throughout recovery.

Step 05

Care Begins with Ongoing Monitoring

Your caregiver starts as close to discharge day as possible, and you get Transparency Room access for schedules, notes, and updates.

Common Transition Care Challenges in South Miami

We see these patterns across our South Miami and wider Miami FL clients. Each family’s plan reflects the specific chronic conditions and daily tasks involved.

South Miami’s older housing stock and snowbird population create specific challenges for local families managing recovery after a hospital stay.

Challenge

What It Looks Like

How We Help

Hospital discharge confusion

What It Looks Like

Families leave Baptist Health South Miami Hospital with new prescriptions, follow-up appointments, and rehabilitation instructions to manage alone.

How We Help

Our caregivers organize medication management, schedule follow-ups, and coordinate with physicians on your behalf.

Challenge

Snowbird recovery without local family

What It Looks Like

Seasonal residents recovering from surgery or illness often have adult children living out of state.

How We Help

Trained caregivers provide daily companionship and personal care while family members monitor remotely through our Transparency Room.

Challenge

Mobility risk in older homes

What It Looks Like

Many South Miami and Coral Gables homes have steps, tile floors, and layouts that raise fall risk during recovery.

How We Help

We assist with mobility, safe transfers, and home safety awareness throughout the critical period.

Challenge

Confusion about Medicare and Medicaid coverage

What It Looks Like

Families assume insurance covers ongoing home care after a hospital stay, then learn Medicare and Medicaid have narrow coverage for custodial support.

How We Help

We explain what coverage typically includes and where private transition care fills the gap.

Challenge

Caregiver burnout in the family

What It Looks Like

One family member manages meal preparation, transportation, and daily tasks until exhaustion sets in.

How We Help

Companion care and respite-style scheduling give family caregivers a break before burnout forces a rushed decision.

Meet Your Local Owners

Driven by Passion, Committed to Compassion

Natalie Caldwell, MSN, FNP-C, co-owner of Preferred Care at Home of South Miami

Natalie Caldwell

Natalie came to home care as a Registered Nurse with years in emergency medicine across South Florida. Working in the emergency department, she watched elderly people discharge from a hospital or skilled nursing facility and return within months, often because the right support simply wasn’t in place at home. That experience, and the outcomes she saw that didn’t have to happen, are why she is here.

She earned her Master of Science in Nursing and became a Family Nurse Practitioner, a credential that shapes how care plans are built at this office: around the whole person, not just the task list. Natalie’s role is overseeing client services and the quality of every care plan we develop. The clinical eye she brings makes a measurable difference, even in non-medical care.

Ricky Greene, co-owner of Preferred Care at Home of South Miami

Ricky Greene

Ricky Greene grew up in a Cuban-American household watching his mother provide full-time, unpaid care for his grandparents. She gave that care because that was how their family showed up for each other. Ricky built his career in long-term care operations because he wanted every family to have access to that level of care, not just the ones with someone who can give up everything to provide it.

His focus at this office is the caregiver side of the business: the hiring, the matching, and the oversight that determines whether the care actually works. When a family calls to say the caregiver feels like part of their household, that is the outcome Ricky works toward every day.

Brian Caldwell, Vice President of Operations at Preferred Care at Home of South Miami

Brian Caldwell

Brian Caldwell is Vice President of Operations. He runs the day-to-day side of the office: scheduling, caregiver coverage, and the systems that make sure the right caregiver reaches the right home at the right time.

Families rarely see the operational side of home care, but they feel it. Brian’s focus is on the details that make care dependable week after week, from consistent scheduling to the communication that keeps out-of-town family members in the loop.

Transition Care Across the South Miami Area

We understand the needs of South Miami seniors and families throughout the surrounding Miami-Dade County communities.

Our team provides education about coverage, coordinates transportation, and focuses on the well-being of every client we serve, not just the tasks on a checklist.

We Serve:

Frequently Asked Questions

What is transition care and how does it help after a hospital stay?

Transition care is non-medical support that bridges the gap between a hospital discharge and full independence at home. Preferred Care at Home coordinates medication reminders, transportation to follow-up appointments, and recovery monitoring. This support helps your loved one avoid the setbacks that often lead to readmission.

Medicare and Medicaid generally do not cover non-medical transition care, since both focus on skilled nursing and therapy ordered by a physician. Medicare may cover home health visits like physical or occupational therapy. Daily support with personal care, meal preparation, and light housekeeping falls outside that coverage. Some families use long-term care insurance to help offset the cost. We help South Miami families understand the difference so they can plan with confidence.

We aim to begin care the same day your loved one leaves Baptist Health South Miami Hospital or Larkin Community Hospital whenever scheduling allows. Starting the consultation before discharge day, rather than after, gives our team time to coordinate with the hospital’s care team. A caregiver is ready when your family member walks through the door.

Skilled nursing care involves medically trained and licensed professionals handling tasks like wound care, catheter care, or physician-ordered therapy. Transition care is non-medical support: personal care, companionship, transportation, and coordination that fills the space around any skilled nursing visits your loved one already receives.

Our caregivers track discharge instructions, confirm follow-up appointments, and communicate updates back to family members and physicians as needed. Families also get Transparency Room access, so schedules, caregiver notes, and progress updates are visible in real time. This works even for family members living outside Miami-Dade County.

Caregiver burnout is common by the time a loved one gets home. Family members often handle appointments, meals, and emotional support throughout the entire hospital stay. Transition care shares that load immediately, handling daily tasks and appointment transportation. Exhausted family members can rest and reconnect with their loved one instead of just managing logistics.

Yes. Our transition care supports adults recovering from surgery, chronic conditions, and acute illness, including joint replacement, cardiac events, and general hospital stays. Every recovery plan follows their specific care team instructions.

Yes. Miami-Dade County’s Alliance for Aging offers information, referrals, and subsidized support, though many programs have wait lists. For families who need help now, private transition care is a comfortable and approachable solution while you sort out longer-term coverage options.