A Masterclass on the Medicare GUIDE Program for Home Care (Jenna Morgenstern-Gaines)

You’ve probably heard about the Medicare GUIDE program—but you may still be wondering: Is my agency a fit? And how do we actually participate? PocketRN Co-Founder and CEO Jenna Morgenstern-Gaines delivers one of the clearest breakdowns I’ve heard on how GUIDE really works. We unpack the program model, the difference between participants and partner organizations, patient eligibility and enrollment, what services are actually included, and how home care agencies can use GUIDE to strengthen and differentiate their dementia care. If dementia is part of your caseload, this is an episode you can’t afford to miss. GUIDE isn’t just another program—it’s an early signal of where dementia care, reimbursement, and home care integration are heading.

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min

Feb 25, 2026

A Masterclass on the Medicare GUIDE Program for Home Care (Jenna Morgenstern-Gaines)

Miriam Allred (00:11)
Hey everyone, welcome back to the Home Care Strategy Lab. I'm your host Miriam Allred. It's great to be back with you. Today in the lab, I am joined by Jenna Morgenstern-Gaines, the co-founder and CEO of PocketRN I hope all of you have had the opportunity to meet her, rub shoulders with her at conferences, catch her on a webinar or a podcast. Jenna, welcome to the show.

Jenna Morgenstern-Gaines (00:32)
Thank you so much for having me, Miriam and thank you for everything that you do for the home care industry. I'm super, super excited to be here.

Miriam Allred (00:39)
⁓ sheesh. The pleasure is mine. I feel like we've kind of been on parallel journeys. We have both been in the industry for five or six years. Maybe you've been in it longer than I have, but I just feel like PocketRN and my journey have been kind of on this parallel track and we've known each other for a few years. So I'm excited to learn more. I think it's been a big couple of years for you and for your company. And I have people coming to me with questions about GUIDE And so I'm like, who better to have on the show than yourself? So we're going to unpack the GUIDE program. And you and I were talking before the conversation.

My audience is sophisticated. There's been a lot of awareness brought to this program over the last 12, 24 months. And so we're actually gonna unpack the common misunderstandings, the enrollment process, the market, the landscape. Like we're gonna give a couple layers deeper here, which I'm excited about. Before we do that, let's have you tell your story. For those that don't know you or know your background, kind of pre-home care, pre-pocket PocketRN, let's start there. Tell us your story.

Jenna Morgenstern-Gaines (01:34)
Fantastic. I'm excited. Thank you, Miriam. So just to briefly introduce myself, I'm Jenna, CEO, co-founder of PocketRN. And my background is mostly in the healthcare strategy and policy world. I started off my career here in DC trying to form public-private partnerships between policymakers and healthcare providers and Fortune 500 companies to support the sandwich generation of women, family caregivers who are caring for their aging adult parents as

as their young kids. And I love that work. And it became quite personal for me too around the same time, about 10 years ago or so now when I started to become a family caregiver to my mom. And I still am. And we've been through a journey together. And one thing that we've found, we've relied on over the course of her journey is really the amazing nurses in our family. So my aunt is nurse, my cousin's a nurse, my next door neighbor's a nurse.

and out of the goodness of their hearts, they just proactively check in on her on a regular basis. They're there at 11 p.m. on a Friday night when something comes up and we have questions. And they also have the most longitudinal data on her over time and the best relationship to help actually make change and support us through those moments. And so I've been very lucky, our family has been very lucky to have that kind of support from amazing nurses around us throughout this whole journey. And not to mention,

Mom also, we from time to time get amazing in-home care and services in the home that we need. And ⁓ that combination has been so helpful. And so, you know, when I left my previous job and life and went off to get my MBA at Stanford, I was part of the bio design program there. it's amazing program that brings together folks from across the university to try and address unmet medical needs. And I met my co-founder.

my co-founder, Dr. Sam Thomas, he's a doctor, but before he was a doctor, he was actually a home health aide living in the home of a man who needed overnight, round the clock care. And so the two of us were both very professionally and personally passionate about trying to help older adults and their families get the care that they need where they need it. And so, you we ultimately banded together to start PocketRN and to democratize what in many ways

family was very fortunate to have access to, which is what we call the nurse for life model. So all of our patients or clients and families on own placket are and get a dedicated specialized nurse who really becomes a care partner to them throughout their throughout their journey. And we work very closely and we've always worked very closely since our inception with home care to partner together to deliver the kind of services that families actually need in order to be able to stay healthy at home.

the support for activities of daily living, plus that kind of clinical wraparound nurse for life support. So that's a little bit about me and my background and sort of the journey that led us ultimately to PocketRN.

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Miriam Allred (04:45)
I love it.

When you say you've been working on advocating and supporting the sandwich generation for the last 10 years, I'm curious where you think we are today. The sandwich generation, how far have we come? How far do we have to go? Are we doing better for this key sandwich generation right now?

Jenna Morgenstern-Gaines (04:55)
Yeah, great. ⁓

Yes. Great question. 10 years ago, and I owe a debt of gratitude to folks who have been working on these issues for decades. But even 10 years ago, I think of Andrea Cohen, is one of the leaders of daughterhood and family caregiving policy writ large. I think of folks who have been trying to put family caregiving on the map, archangels, for years and decades now.

And, but even 10 years ago, it wasn't, it was, it wasn't sexy yet in the way that I think it is now today, at least kind of in the lexicon of, of most folks in the, in the healthcare world. And, you know, 10 years ago, we were all still working and I would say we are still working on ⁓ helping caregivers identify and see themselves as caregivers. I think you, if you look at any of the, of the studies and the research that groups like Archangels and others have done, you know, most often people, people will identify themselves not as a caregiver.

but as a daughter or as a spouse or as a neighbor and just doing what neighbors do for the people who are around them that need help. And so it's definitely been a journey, I would say, over the last 10 years to a point where now I think people understand more what that role means, where they understand what the role of being a parent means. But being a caregiver is something that is, I think, now finally sinking in for people. But policy and reimbursement

instructors and everything that kind of follows behind that is still playing catch up. That being said, the GUIDE program is really the first that we've seen that puts a specific focus on supporting the family caregiver. And I'm so grateful and so glad to see that Medicare is leading the way and recognizing that. often when Medicare takes the lead on things, others follow. So I think we're making progress, but there's definitely

there's still quite a bit of room to go.

Miriam Allred (07:08)
Yeah, that's a perfect transition into this GUIDE program. Let's do kind of a quick timeline of the history of events that have gotten us to where we are, because it's been a couple of years. When did the GUIDE program first launch? And talk a little bit about the early days, the evolution, the early adopters, what the program looked like, and then we'll kind of follow up to where we are today. But talk about kind of the early, when it started, what the early days were.

Jenna Morgenstern-Gaines (07:13)

That's right. Yes. Perfect. That sounds great. So we are in early 2026 now and the GUIDE program, the first sort of swirlings around the GUIDE program emerged in, in 2023. And those of us who were sort of following along, we're waiting for that application to come out. And it came out late 2023. You had to apply by early 2024, January, 2024. And it was a one and done application process. So if you applied and you got in,

you're in, if you missed the application process, and you know, you can no longer become a participant in the GUIDE program, you can become a partner organization, but there are only a set number of participants that were selected for the program in early 2024, those announcements went out and the very first track, the established track under GUIDE went live actually in July of 2024. This was mostly for organizations that

were little bit older, more established, hospices, any hospitals that participated in the program. Those were the main.

types of organizations that went live in that first track for everyone else who was in the new track like PocketRN, we were in an implementation year. And so we were essentially running a pilot from July 2024 through to July 2025, which is when we PocketRN and everybody else in the new track officially went live and spent a lot of time preparing a lot of time and setting up partnerships and testing the models to make sure that the workflows worked and then officially went live.

in July 2025, which means that we're in about month eight or so officially of GUIDE and the uptake has been tremendous in just a very short amount of time. Now this is an eight year program total. So it will run now for an additional six-ish years. we are right at the beginning, but it feels like we've been a part of it for almost decades now. So that's a bit of the timeline just to level set, Miriam, for everyone.

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