Our client was in long-term nursing care due to a fall at home. She had resided in the nursing home for two years. The client, along with her family, had a strong desire for her to try return to living in her own home. Through several visits with the client and her daughter, our Elder Care Coordinator was able to come up with a detailed plan and identify the appropriate support resources that would be needed for the client to return home. At our ECC’s recommendation, the family spent several weeks preparing the house, installing a wheel chair ramp, placing a hospital bed in the bedroom, and remodeling the bathroom. Our client was able to return to living at home with the assistance of in-home care. Our ECC coordinated with the family to get Community Transitions to do a care evaluation and to assess the level of care she would need at home. The client is currently back at home and is receiving 24-hour home health care. In addition, our ECC arranged to have weekly skilled physical and occupational therapies at home. By working closely with the elder, family members and community resources, our ECC was instrumental in having her return to living at home which was the ultimate goal for the family.