Over the past two years, NYU Langone Health has sought innovative ways to address a growing challenge: a surge in medically stable patients experiencing housing instability who lack safe environments for recovery.
In January 2023, the New York City-based health system saw 240 patients per month experiencing housing instability. By September 2025, that number had climbed to over 400 per month, underscoring an escalating crisis that leaves hospitals struggling to discharge patients who no longer need acute care but have nowhere appropriate to go.
“We were really looking for an option for individuals who didn’t need to be in the hospital, but they didn’t have a healthy, clean or ideal environment for recovery,” said Michelle Romano, director of the department of social work and case management services at NYU Langone.
To address this critical gap in post-acute care, the system launched a medical respite program in March through a partnership with Comunilife, a nonprofit housing and social services provider.
Since launching, the program has discharged 13 patients from the hospital and connected them to transitional housing and “wraparound” services, which assist clients with day-to-day issues that arise from being unhoused, such as a lack of documentation, food or clothing.
“We were seeing these patients continuously discharged to shelters and then continuously coming back to the emergency department with new infections, new issues and missing follow-up appointments,” Ms. Romano said. “We really needed a solution.”
NYU Langone Health leases beds through Comunilife, which operates around 3,000 transitional, supportive and affordable housing units across New York City. Upon arrival at their housing unit, patients are assigned a counselor who helps coordinate follow-up care and connect them with social services, including accessing the Supplemental Nutrition Assistance Program and navigating applications for longer-term housing.
The program has been beneficial to both patients’ health and health system operations, leaders said. The average length of stay for patients in the respite housing program is 57 days — time that may otherwise be spent in acute care beds at around $3,840 per day, according to recent data from Kaiser Family Foundation on inpatient expenses.
The health system has also tracked ED utilization among several program participants and has seen significant reductions in ED visits since the program launched.
A recent report from the Institute of Community Living and Comunilife found New York City hospitals could save an estimated $15 million annually by adding 75 beds to the city’s network of medical respite housing, pointing to broader cost savings potential generated through shorter inpatient stays and improved capacity management.
Ms. Romano said operationalizing the program required extensive cross-departmental collaboration. The social work team partnered with NYU Langone’s department of strategy and financial analysts to model potential savings from improved throughput and bed turnover.
“All of those steps really helped get the administrative support we needed to go forward with the contract,” she said.
Ms. Romano noted that the program serves a diverse patient population beyond those experiencing homelessness, including individuals in complex living situations that are incompatible with post-acute recovery needs.
“There’s very different types of situations patients are facing where they just need somewhere to stay temporarily in order to recover and get into a better situation longer-term,” she said.
Arielle Bonne, manager of social work at NYU Langone Orthopedic Hospital, said the health system works with one insurer that covers respite services and emphasized the need for broader expansion and coverage of these types of programs.
“We’re all hopeful that more respite will be built and more programs will be operated and funded,” Ms. Bonne said. “It’s filling such a need that we don’t have in the shelter system.”
Ms. Romano said the program represents more than just a discharge solution. “It’s a great opportunity for our patients not only to have somewhere safe to heal after their hospitalization, but also to help connect them to longer-term housing options and hopefully help them have better health outcomes for the long-term.”
