Open Letter · October 2026
Continuity Is Care
An open letter to Ontario Health atHome on how a revolving door of care providers erodes the gains of care recipients, and what the evidence shows
October 20, 2026
Ms. Anna Greenberg, Chief Executive Officer, and Ms. Carol Annett, Board Chair
Ontario Health atHome
Dear Ms. Greenberg and Ms. Annett,
Thank you for the care that Ontario Health atHome and its personal support workers, nurses and care coordinators bring into homes across the province every day. We write on behalf of the families who receive it.
A revolving door of care providers erodes the gains of care recipients. Here is the evidence.
Function. Patients served by many different aides were 14 to 15 per cent less likely to improve in daily activities than those served by the same aide.1
Safety and well-being. Higher home care worker continuity is associated with fewer falls, fewer depressive symptoms and better function.2
Hospital readmission. Older adults with dementia who had lower nurse continuity in home care were 30 to 33 per cent more likely to return to hospital.3
Continuity protects the gains that care is meant to achieve. In practice, it is built through a small, stable care team for each patient; clear communication and complete, accurate notes from every provider; time for providers to review the care plan and previous notes before each visit, so that no family repeats its story and no assessment is duplicated; and regular measurement.
Thank you for your leadership and for your consideration of this evidence-based research.
Respectfully,
Saron Gebresellassi, J.D., M.Ed., B.A., N.P.
Principal, Gebresellassi Private Office
cc: Deputy Premier and Minister of Health, Government of Ontario; CNIB Foundation; CBI Health
Sources
1 Russell et al., Home Health Care Management & Practice, 2013
2 Reckrey et al., Innovation in Aging, 2024
3 Ma et al., Medical Care, 2021