This article describes the development of an assessment inventory to i
dentify home care clients needing skilled management and evaluation se
rvices. Evidence supporting the inventory's content, criterion-related
, and predictive validity is presented. The inventory accurately predi
cted those patients readmitted within 60 days of discharge. Home healt
h care nurses found the inventory easy to use without being time consu
ming. Use of the inventory, by home health care nurses will permit car
e agencies to more easily document the need to continue care and reduc
e recidivism and cost while increasing care quality.