Every Week Without Therapy
Is a Week She Does Not Get Back
In-home therapy in New York City: physical, occupational and speech
The discharge sheet says PT, OT, ST. It does not say who arranges them, who pays, or what happens while nobody calls. Strength lost in the first weeks is the hardest to win back. A licensed therapist comes to the apartment and works on the real stairs, the real bathroom, the real distance from the bed at two in the morning.
Which therapy do you need at home?
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Talk to a Nurse About the Order
A registered nurse calls you back and goes through the discharge paperwork with you.
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Which therapy does your family need?
After a knee, a hip, a stroke, a fall. Or nothing in particular: she is simply doing less each month, and someone finally said the word therapy. Three therapies come to the apartment, and below each one is described by what goes wrong at home rather than by what the profession is called.
What therapy at home is, and how it differs from a clinic
In-home therapy means a licensed therapist treats the patient in their own apartment. Rehab at home is not the same as doing clinic exercises in a different room. A clinic teaches your mother to climb a set of practice stairs with a handrail on both sides. Her building has eleven steps, a rail on one side, and a turn at the top.
- Those eleven steps. The tub she actually has to step into. The doorway her walker does not fit through.
- Nothing has to transfer afterwards, because the practice already happened in the place where it counts.
- No trip at all, which for someone whose balance is the problem removes the most dangerous part of the day.
- Practice stairs with a rail on both sides, in a room laid out like nobody’s apartment.
- Equipment no apartment can match: parallel bars, body-weight support, a full gym.
- Getting there and back, every session, for the whole course.
That trip is worth taking seriously. Getting down the stoop, into a car and across a parking lot happens before the session even starts, and in our experience it is the trip, more than the therapy, that ends a course early. Rides fall through, weather turns, the family member who drives goes back to work, and by week three the appointments stop. Home rehabilitation takes that out of the equation.
Where a clinic genuinely wins is equipment, and none of it fits in a Brooklyn apartment. For someone rebuilding toward that level, physical therapy at home is usually the bridge to a clinic rather than a replacement for one, and a good therapist will tell you when that point arrives.
Do you need a referral for therapy at home?
Yes. All three therapies at home require a written physician order in New York, and it applies no matter who is paying.
People use “referral” and “order” to mean the same thing here, and either word will get you the right document. Any doctor who has seen the patient recently can write it: the surgeon, the neurologist, the primary care physician. It names which therapy and why.
Why families ask for therapy at home
- Someone came home from the hospital weaker than they went in, and therapy is one part of a wider recovery at home.
- Someone had a stroke and is relearning how to walk, dress or speak.
- Someone had a hip or a knee replaced.
- Someone fell, and has been moving less ever since because they are afraid of falling again.
- Someone with Parkinson’s or dementia is losing ground gradually rather than suddenly, and the goal is to slow it down. Where memory is the main problem, dementia care at home is usually the larger question.
You do not have to be homebound
That requirement belongs to Medicare home health, not to therapy in general, and it is one of the things families most often have backwards on the first call.
Children and age
Age is not a filter here. Most of home therapy is adults, and that is who the pages above describe, but a child is not turned away for being one: with a physician order the route is the same. What is different is the state programmes for children, Early Intervention for the under-threes and CPSE or CSE through the school district. Those run on their own approvals rather than on a doctor’s order, so if that is the route you are on, say so first and we will tell you plainly whether we are the right call.
How much therapy at home costs, and how long it takes
For physical therapy we publish the price openly, which almost no agency in New York does.
Prices depend on the borough. The figures above are for physical therapy on private pay and hold for the areas named; travel time across the city differs enough that one flat number would not be honest. Your address is confirmed on the call before anything is scheduled, and the rate is confirmed with it.
Occupational and speech therapy we quote on the call, because the shape of a course varies enough that a single public figure would mislead more than it helps. And if a certified home health agency is already following the case, it bills the family under its own contracts and our price does not enter into it.
How long a course runs
There is no single answer, because the reason for the therapy sets the shape of the course. Pick the one that fits and the numbers below change with it.
Therapy usually starts two to four days after discharge. The first visit is a home safety check as much as an assessment: where the walker does not fit, which chair is too low to get out of. Then range of motion, walking, and the stairs of your own building. Many people finish at home and move on to an outpatient clinic for the heavier equipment.
Stroke recovery rarely uses one therapy alone. Walking and transfers, dressing and the kitchen, speech and swallowing are often worked on at the same time by two or three therapists. Courses tend to run in blocks with breaks between them, because goals change as function returns.
Fear of falling makes people move less, which makes the next fall more likely. Structured balance and leg strength programmes such as Otago are built around a handful of visits over two months and daily exercises in between, and trials of that approach report roughly a third fewer falls. Most of the work happens on the days nobody comes.
Large-amplitude programmes such as LSVT BIG run sixteen one-hour sessions across four weeks with homework every day, which is a heavier commitment than a usual course and the reason it works. It requires a certified therapist, so ask about certification before you commit to it.
No single event, just less movement than last year and then less again. Strength, balance and getting the ordinary day back. Two visits a week with real practice in between beats three a week with none.
These are typical shapes, not a plan. The therapist sets the real schedule after the first assessment and revises it as goals change: after a knee or a hip it is often at the shorter end, after a stroke it can run considerably longer.
More visits are not automatically better. Two a week with real practice in between beats three a week with none. What happens on the days nobody comes matters as much as the visits themselves.
Who pays for therapy at home
Home therapy services are paid for in two ways here, and being straight about that is more useful than a longer list would be.
Paying privately
The fastest route and the one most families use. There is no authorization to wait for and no plan to negotiate with. You decide, and scheduling starts. Physical therapy prices are published in the section above; for the other boroughs, and for occupational and speech therapy, we quote on the call rather than guess in public. Almost no agency in the city publishes any of this, which is the reason we do.
Through a certified home health agency
If a CHHA is already following the case after discharge, a therapist can come from ProLife under contract with that agency. Nothing changes on your side. You tell the CHHA you would like ProLife, and the arrangement happens between the two agencies.
Medicare home health, therapy included, is paid only through a certified home health agency, a CHHA. ProLife is a licensed home care services agency, an LHCSA: a different licence with a different role, so we do not bill Medicare directly. The New York State Department of Health describes LHCSAs the same way on our public listing.
For the same structural reason we do not deliver therapy through Medicaid managed care plans, even though we do provide home health aide and personal care through them. If the care is running through an MLTC plan, therapy is a question for the plan or for a CHHA. If it is easier, call us and we will point you at the right door rather than take a case we cannot see through.
- Service
- Physical, occupational and speech-language therapy, delivered at home
- Where
- Patient's own home
- Counties served
- Kings, Queens, New York, Bronx, Richmond, Nassau
- Licence
- NY DOH License #2572L001, licensed home care services agency (LHCSA)
- Physician order
- Required
- Typical frequency
- 1 to 3 visits a week per therapy
- Typical course
- 4 to 8 weeks, reassessed as goals are met
- Paid by
- Private pay, or under contract with a certified home health agency
- Not billed
- Medicare and Medicaid managed care, which require a CHHA licence
- Clinical oversight
- Registered nurse writes and reviews the plan of care
From the first call to the first visit
You call, and a nurse goes through the case
Fifteen minutes on the phone. What the discharge paperwork says, what the apartment looks like, how many steps to the front door, who is home during the day. No cost, and it commits you to nothing.
The physician order
Therapy cannot start without one, and any physician who has seen the patient recently can write it: the surgeon, the neurologist, the primary care doctor. After a hospital stay it is often already in the discharge paperwork. If you do not have one yet, say so on the first call and we help arrange it rather than sending you away to sort it out alone.
A therapist comes and assesses
The first visit is an evaluation, not a workout. The therapist watches how the person actually moves through the apartment, checks what is safe and what is not, and talks to whoever is doing the caring.
A plan, and a schedule you can hold
Usually two or three visits a week over four to eight weeks, adjusted as things change. The therapist writes and runs that plan themselves and reports to the physician who ordered it, while our nurse keeps it aligned with the rest of the care. A first visit can usually be arranged from 24 hours after your call.
Still not sure this is your case? Read out what the discharge sheet says and a nurse will tell you in one call whether therapy at home fits, and what it would cost.
Occupational therapy vs. physical therapy, and where speech fits
Everyone asks this first, and the answer fits in one line: physical therapy is about moving; occupational therapy is about doing. One works on the body: walking, balance, strength. The other works on the task: whether she can actually dress, wash and put a meal together at the end of it. Someone can regain the strength to stand at a counter and still be unable to cook, because cooking is a sequence of reaches, grips and steps rather than one movement.
Speech therapy sits apart from both. It covers talking and understanding, and it covers swallowing, which is the half families never think to mention.
| Therapy | What it works on | Typical reasons | Physician order | Usual frequency |
|---|---|---|---|---|
| Physical | Walking, balance, strength, transfers, stairs | Hip or knee replacement, stroke, a fall, Parkinson’s, weakness after a hospital stay | Required | 2–3 visits a week |
| Occupational | Dressing, bathing, cooking, using the apartment safely, equipment and modifications | Stroke, dementia, arthritis, a shoulder or wrist fracture, low vision | Required | 1–3 visits a week |
| Speech-language | Speech, understanding, memory for conversation, and swallowing | Stroke, brain injury, Parkinson’s, dementia, coughing or choking while eating | Required | 1–3 visits a week |
Therapy and an aide, from one agency
In-home therapy works best when the aide and the therapist come from one agency, because most of the practice happens between visits. A therapist comes twice a week; the other five days belong to whoever is in the apartment, usually a daughter, sometimes an aide. That is where the exercises either happen or stop happening, and it is the biggest single thing separating a course of therapy that works from one that does not.
When the aide and the therapist come from the same agency, they work from one plan of care. What the therapist writes down on Tuesday is what the aide is practising on Wednesday, and when something changes, one phone call reaches everyone instead of three. Families who arrange therapy through one agency and an aide through another end up doing that coordination themselves, usually while holding down a job. The division is worth stating plainly: each therapist is independently licensed and answers clinically to the physician who wrote the order, while our registered nurse owns the plan of care that the aide works from. Nobody oversees the therapist’s clinical judgement, and nobody should. What we coordinate is everything around it.
The physical, occupational and speech therapists we contract with are independently licensed by New York State. What ProLife adds is the case around them: nursing oversight, aide hours, scheduling, and one number to call.
Home health aide services · Private duty nursing · All services
Therapy at home across New York City and Nassau County
Therapists visit homes across Brooklyn, Queens, Manhattan, the Bronx, Staten Island and Nassau County, under NY DOH License #2572L001. Coverage is not identical everywhere: a therapist in Bensonhurst or Forest Hills is easier to schedule than one on the south shore of Staten Island, and we would rather say that on the first call than have you wait and find out. A first visit can usually be arranged from 24 hours after you ring. What decides the date is the address rather than the borough, so give us the cross streets and we will name a realistic day instead of an optimistic one.
All 48 neighborhoods
All 47 neighborhoods
All 32 neighborhoods
All 43 neighborhoods
All 37 neighborhoods
All 39 neighborhoods
A nurse reads the order before a therapist rings your bell
Anna Klyauzova, RN, MSN, MPA
Anna reviews every plan of care before anyone is assigned, and therapy is where that review earns its keep. A discharge sheet listing PT, OT and ST says nothing about how those visits fit around the hours an aide is already covering, or who is in the apartment on the days nobody comes. That is the part she sorts out with the referring physician before scheduling starts.
She has nursed since 2011, at Jacobi Medical Center and then at Mount Sinai, where she ran an operating room team before co-founding ProLife in 2017. Her profile is public on LinkedIn, and the agency licence is public on NYS Health Profiles.
Families who called us first
4.9★ from 120 verified Google reviews across Brooklyn, Queens, Manhattan, the Bronx, Staten Island and Nassau County.
“Best home care agency in Brooklyn. Georgian-speaking caregiver, reliable, and they actually answer the phone. My family is so grateful.”
“All staff are very professional. They always follow the guidelines from the Department of Health and Department of Labor. Very reliable agency.”
“This agency has been a great help to several elderly members in my community. The company staff is knowledgeable and truly cares about the people they serve.”
These are reviews of the agency rather than of a particular therapist: families write about the office, the coordinators and the aides more often than about a course of therapy. All of them are public and can be read in full on our Google profile.
Things families ask us first
The therapy is not the hard part. Arranging it is.
Leave a number and a nurse calls you back to go through the case: which therapy was ordered, what it will involve, and what it will cost. The call is free and commits you to nothing.
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