Hospital care at home, for kids
Plus: A star-studded summer basketball camp; arts go BOOM in U-City; reader mailbag on retirement series; how Dean Smith's son changed the course of Charlotte FC; Mecklenburg Democrats pick new leader
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Atrium Health launches the first program in the nation that offers full, hospital-level care to children in their homes. Many parents love the idea, while critics worry about the risks.
At home and at ease, 6-year-old Mackenzie Conlon plays with stickers as a paramedic connects her with her doctor via a video call. (Photo courtesy of Atrium Health)
by Michelle Crouch
When 6-year-old Mackenzie Conlon was hospitalized with the flu at Atrium Health Levine Children’s Hospital in February, all she wanted was to go home, her mother Stephanie Conlon said.
Mackenzie, who has complex medical needs due to cerebral palsy, had been fighting high fevers, dehydration and pain so intense her constant crying left her nearly voiceless. Conlon, 46, said she would watch helplessly when her daughter pointed at the hospital door in a plea to leave.
But after five days of round-the-clock hospital treatment, Atrium’s providers offered the family an unexpected alternative: continue Mackenzie’s hospital care at her Charlotte home.
Thanks to Atrium’s new pediatric hospital-at-home program, Mackenzie could recover in her own bed, with access to her favorite TV shows, foods and toys, while still receiving hospital-level care.
The family jumped at the chance.
“As a parent, watching your kid be in a hospital is just the most heartbreaking thing,” Conlon said. “So finding out that we were able to go home just completely switched the mood. … This is where all of her favorite things are. For me as a parent, knowing I could sleep in my own bed, knowing I could take a shower, those little comforts made all the difference.”
More comfort for patients, less hospital crowding: Atrium’s is the first hospital-at-home initiative in the nation designed specifically for children, the hospital system said. Modeled after similar programs for adults, it combines home visits from paramedics, remote monitoring and virtual check-ins from doctors and nurses to deliver hospital-like care while patients heal at home.
Hospital-at-home programs have taken off in recent years, spurred by the loosening of hospital regulations during the Covid pandemic. Today, 142 health systems in 39 states, including Novant Health in Charlotte, have federal approval to provide home hospital care.
For patients, the appeal is obvious. You get to recover in the comfort of your own home without constant interruptions, omnipresent fluorescent lights and beeping machines, or the risk of hospital-acquired infections. That’s especially important for kids, who may not understand why they’re in the hospital and may feel more anxious in an unfamiliar environment.
For hospitals struggling with capacity, it gives them a way to open up more beds for the sickest patients.
Early research on the adult programs has been promising. A 2024 report to Congress found that most patients were happy with the care they received, and that their health outcomes were better than those of similar patients treated in the hospital, although the researchers cautioned that the data was limited and potentially biased.
Concerns about safety and cost: Critics say that shifting hospital care into the home, especially for kids, is a risky move.
They argue family members aren’t equipped to handle emergencies, technology can fail or miss subtle signs of a patient’s decline, and that if something goes wrong, help might not arrive fast enough. (The federal government requires patients to be close enough that the hospital can respond to a change in their condition within 30 minutes.)
“In the hospital, we’re right there with the tools to save a child’s life,” said Michelle Mahon, director of nursing practice at National Nurses United, a California-based nurses group that opposes the programs. “At home, it could take 30 minutes for an ambulance to arrive — and that’s too late. It’s alarming that vulnerable infants and children would be placed in this type of precarious program.”
Mahon added that hospitals have a financial incentive to create the programs because they can charge the same rates as if the care was happening inside a hospital — including facility fees — even though they don’t face the usual overhead costs.
Eileen Appelbaum, an economist and co-director of The Center for Economic and Policy Research, agrees there are risks — but said it comes down to how the programs are designed and run.
“If the decisions are made carefully, if patients are selected carefully, if the parent is able to provide the support the patient needs, and if the family is computer savvy so they can deal with telehealth connections, then I do think it can be positive,” said Appelbaum, who co-authored a 2023 report analyzing the model.
She’s concerned, though, about some of the choices hospitals are making, such as relying on paramedics instead of nurses for the at-home visits. Paramedics are less expensive than nurses, Appelbaum said, but they have less training.
In a statement, an Atrium Health spokeswoman said patient safety is its top priority.
“We carefully evaluate patients for hospital at home, including caregiver support availability and willingness, much like we do when we evaluate patients for full discharge,” the statement said. “The informal feedback we receive from our families is that this decreases burden on them because being home is easier.”
The paramedics who make the home visits receive additional training, the hospital said, including tips from child life specialists about how to make children comfortable during difficult procedures.
Goal — 10% of patients treated at home: Atrium’s adult hospital-at-home program, one of the largest in the country, serves about 90 adults a day. Hospital leaders started talking about offering a similar program to children about a year ago, said pediatrician Stefanie Reed, the program’s medical director.
“We were looking at ways to help make sure that children were able to receive great care with us despite our growing capacity constraints and the growing nature of our city,” she said, noting that some pediatric patients face long delays waiting for beds. “This is the right thing for our patients, and it's the right thing to help our capacity and growth.”
As of mid-April, about 40 children and adolescents had been admitted to the program, she said, and the feedback has been overwhelmingly positive. Eventually, she said, Atrium hopes to expand the program to its other hospitals, with a goal of treating 10 percent of its pediatric patients at home.
To ensure safety, the hospital has specific criteria about which types of patients are eligible, Reed explained, and families always have the choice to stay in the hospital.
One recent patient was a teenager with pneumonia who couldn’t wait to get back to her video games, see her dog and finally have a little space from her parents, she said.
The teenager “had a type of pneumonia that required closer monitoring and IV therapies — not something she could do outside hospital care,” Reed said. Without the program, she probably would have had to spend another week in the hospital, Reed said.
A new kind of house call: After Mackenzie’s family made the decision to shift to home care, paramedics set up the necessary equipment and visited twice a day, connecting to Mackenzie’s doctors via video while performing a physical exam.
Billy Long, 32, the community paramedic who usually visited Mackenzie, used a digital device that allowed the doctor to listen to Mackenzie’s heart and lung sounds and to look into her ear canal and throat.
While he administered IV fluids, Long kept Mackenzie entertained with games and stickers.
A long-time ambulance paramedic, Long worked part-time in an Atrium Health pediatric emergency room before switching to home hospital care. He said his new role is less stressful, and he especially likes working with kids.
“It’s just fun,” he said. “My last patient I saw was just happy as a clam, sitting in grandma’s lap while I was on the tablet with Dr. Reed. Then the other day, I had a 30-month-old pulling me around by my finger, showing me every single toy he owned.”
More cozy and comfortable: Mackenzie was enrolled in the program for three days. Conlon said being at home, where she and McKenzie could eat their normal foods, go for walks outside and sleep in their own beds, made them both more comfortable.
“I could just curl up in bed with her or do a breathing treatment for her with just the night light and sound machine on — things that are very cozy to her,” she said.
It was also reassuring, she said, that her daughter’s healthcare team was just a click away.
“There were so many times where I was texting the nurse at four in the morning,” she said. “I always got responses immediately.”
Conlon said knowing home-based care is available will make it easier the next time she has to take Mackenzie to the hospital.
“It really changes your perception because if you do need to go to the ER, you know you have the potential to be home sooner,” she said. “I would do this again in a heartbeat.”
Michelle Crouch covers health care. Reach her at mcrouch@northcarolinahealthnews.org. This article is part of a partnership between The Ledger and North Carolina Health News to produce original health care reporting focused on the Charlotte area.
Today’s supporting sponsor is Carnegie Private Wealth. At Carnegie Private Wealth, we bring clarity to complexity. Through thoughtful planning and personal attention, we transform your financial aspirations into actionable strategies. Providing you with less stress and greater confidence in your future.
Queens basketball camp gets some Hornets buzz
Queens University of Charlotte is offering kids who sign up for its summer basketball camp a little extra excitement this year.
Thanks to construction at the Charlotte Hornets’ new practice facility, the NBA team will be training at Queens facilities this summer — the same ones the campers will be using.
“This will give our campers the unique experience of being able to view some of their workouts and maybe get a chance to meet some of their favorite players,” the camp said in an April 24 email to families with the subject line, “Exciting camp news!!!!”
Camp director Dan Bailey, an assistant basketball coach at Queens University, said Sunday he hadn’t had a chance to check registration numbers yet, but he has already noticed a spike in calls and emails from interested families.
“The response has been great,” he says. “We always have a lot of interest in the camp, but to have the chance to see NBA players, that’s really exciting for the kids.”
The camp offers four one-week sessions with full-day and half-day options. —Michelle Crouch
A weekend for the arts to BOOM in University City
The annual BOOM Charlotte performance and visual arts showcase took place over the weekend near the lake in University City, with more than 130 shows and programs as well as dozens of vendors. On Sunday, crowds enjoyed the Southern Eagle contemporary southern singing drum group from Maxton, N.C., (left) as well as Ballet Folklórico Corazón de México from Greensboro (right).
📫Ledger mailbag: Readers chime in on retirement readiness, choosing a 55+ community
The Ledger’s special “Retiring Well” series, which we published earlier this month exclusively for paying members, inspired thoughtful comments from readers about considerations when choosing a 55+ community and retirement life.
Here’s a sampling of the comments, some of which have been lightly edited for brevity:
Thank you, another excellent and informative series. As a baby boomer my retirement is different than that of my parents. I have more intention to stay involved and engaged with family and friends, and with my community. My life is so different yet fulfilling in so many aspects. Staying engaged and lifelong learning is a big part of my daily routine. Learning and using the internet and the newest technology is vital. And balancing this with spending quality time with people is important. Thanks again for this series. —Vicki
When I knew retirement was a possibility 2-3 years in my future, I questioned colleagues who had gone before me. “How did you know it was the right time to retire?” Head thrown back, laughing loudly, each individual responded “Oh, you'll know. YOU’LL know.” They were right. One day I looked around and realized how young all my colleagues were, how the little things years before had become nuisances and then frustrations and then misery.
The obverse is that if one loves what one does and cannot think of living otherwise it will be a great regret to retire. —John C.Advice on shopping for a CRCC (continuing care retirement community) is much needed. While independent living options differ very little from one facility to another, the continuing care options need to be given consideration. For instance: in assisted living, will you be living in one room or does this area offer accommodations that include a living area, a bedroom and, hopefully, a nook for a refrigerator, microwave and coffee maker? Do dementia care facilities offer certified dementia care which requires the patient have easy access to outside secured areas? An occasional walk outside is not the same for these patients. Does the facility offer hospice care or a visiting hospice nurse who comes at intervals? It would be a great service to the public if you found it possible to expand on shopping advice on CRCC’s. —Jane
I wish this article differentiated between the for-profit (month-to-month) and not-for-profit CCRCs. I’m not an expert like the team at Caregiving Corner, but I did navigate a care community search for my widowed mother-in-law, and I didn't even consider the month-to-month for-profit communities to be CCRCs.
It is worth knowing the difference if you’re looking into these options. —Will
In Fútbol Friday: How a son’s leap of faith changed the course of the Charlotte FC franchise
The latest edition of Fútbol Friday is not only a compelling soccer story, but a poignant family story. Ledger writer Carroll Walton describes how Charlotte FC’s rise to first place in the Eastern Conference traces back to a decision made years ago by Jamie Smith — a move to the U.S. that eventually led his father, Dean Smith, to Charlotte.
After Jamie’s college soccer journey brought the family closer to the Carolinas, Dean was drawn to the club, signed on as head coach, and has since helped build a winner. Now, both Smiths are thriving here, with Dean recently signing a contract extension through 2027.
You might be interested in these Charlotte events
Events submitted by readers to The Ledger’s events board:
TONIGHT: Sustain Charlotte Awards, 6-9 p.m. at The Revelry at Camp North End. Each year, we highlight the achievements of local sustainability leaders and the issues that shape the sustainability of our region. The memorable evening includes dinner, an awards presentation, and uplifting stories that will leave you inspired. $125.
TUESDAY: Artist Talk with Photographer Maya Goded, 7-8:30 p.m., The Mint Museum, 2730 Randolph Road, Charlotte. In conjunction with The Mint Museum’s exhibition “Women of Land and Smoke,” internationally renowned photographer Maya Goded joins Jen Sudul Edwards, PhD, chief curator and curator of Contemporary Art at the Mint, for a discussion about relationships with her subjects and her career as a photographer. Free.
MAY 8: The Charlotte Ledger’s 40 Over 40 Awards presented by U.S. Bank, 6-9 p.m. at Heist Brewery and Barrel Arts, 1030 Woodward Ave., Charlotte. In its 6th year, the 40 Over 40 Awards presented by U.S. Bank has become a beacon of recognition for those over the age of 40 who continue to shape the future of Charlotte. Join us for a fun night out of networking, dinner, drinks, live music from Uptown Dueling Pianos, award ceremony, and more. $95.
➡️ List your event on the Ledger events board.
In brief:
Officers remembered: Thousands gathered Sunday at Bank of America Stadium for the Tunnel to Towers stair climb, honoring the four law enforcement officers killed in Charlotte’s April 29, 2024, mass shooting. Family members, first responders, and city leaders talked about resilience, remembrance, and community healing ahead of the one-year anniversary. (Observer)
New peeping charges: A former Davidson College employee facing prior charges of secret peeping has been charged with two additional felony counts in Charlotte. Jeremy Whitworth, 49, is accused of secretly recording women on campus and in public areas over several years; he is scheduled to appear in Mecklenburg County court in May. (WBTV)
Mecklenburg Democrats elect new leader: Former state representative Wesley Harris was elected chair of the Mecklenburg County Democratic Party on Saturday, succeeding Drew Kromer. Harris, who won 76% of the vote, pledged to unite the party and rebuild trust following internal divisions over voter outreach efforts, particularly in Black communities. (Observer)
Nonprofit to pay penalty: A nonprofit called Balanced Nutrition run by former Lt. Gov. Mark Robinson’s wife, Yolanda Hill, must repay more than $101,000 to the N.C. Department of Health and Human Services after an administrative judge found it violated federal rules, kept poor records and claimed unallowable costs. Hill, who did not appeal the decision, had argued the investigation was politically motivated. (The Assembly)
Lounge plate problem: American Airlines lounges have upgraded their food but are still handing out plates that are too small, according to travel blogger Gary Leff. A photo shows a full-size brat at the Charlotte Admirals Club hanging off both sides of a tiny plate. (View from the Wing)
Secret menu items: Optimist Hall food hall features a hidden bevvy of secret menu items at spots like Papi Queso, Harriet’s Hamburgers, and Suárez Bakery, which offer exclusive dishes like the spaghetti melt, Juicy Lucy hamburger and tres leches french toast. Chefs say secret menu items allow them to test new offerings with minimal risk and make regulars feel special. (Charlotte magazine)
No more pretzels: Legion Brewing took pretzels off its menu for economic reasons and replaced them with buttermilk beer bread. (Axios Charlotte)
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Whew! All caught up for today!