In a recent episode of Health Futures: Taking Stock in You, host Bob Roth welcomed Bianca Fabbo, MSN, Ed., RN, founder of Prata Health, for a conversation about concierge nursing, navigating an increasingly fragmented healthcare system, aging in place and how her experiences as a nurse became the foundation for a new approach to care at home.
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Fabbo’s path to founding Prata Health began long before she became an entrepreneur. After earning her nursing degree, she worked across a range of healthcare settings, from skilled nursing and medical-surgical care to neurology, trauma and postoperative recovery. Those experiences taught her not only the clinical side of nursing, but also the importance of advocating for patients and helping them understand what is happening with their own care.
One of the most formative experiences of her career came while working at Hospital for Special Surgery in New York City during the COVID-19 pandemic. As hospitals across the city became overwhelmed, the elective orthopedic hospital became an overflow site for critically ill COVID patients, with operating rooms converted into ICU rooms. Families could not visit, leaving nurses to care for patients through some of the most frightening and isolating moments of their lives.
Fabbo recalled walking home after late-night shifts through nearly empty New York City streets and FaceTiming families who could not be at the hospital with their loved ones. She saw patients die without their families physically beside them and watched fellow healthcare workers become sick as nurses tried to navigate a disease they were still learning how to treat.
“It really changed who I am as a person and as a nurse,” Fabbo said.
The experience eventually inspired Fabbo to earn a master’s degree in nursing education and move into leadership and teaching. After relocating to Arizona in 2023, however, she began noticing a different problem. While accompanying nursing students in hospitals and long-term care settings around the Valley, Fabbo said she repeatedly encountered situations where important pieces of patient care appeared to be falling through the cracks.
She found herself advocating for patients even when she was there primarily to support her students. Those experiences reinforced something she had learned early in her career: nursing should be about more than completing a list of medical tasks. Nurses are often the people who see how the different pieces of a patient’s care fit together and can recognize when something does not seem right.
“The nurses are supposed to be the ones that are connecting all the care,” Fabbo said.
That idea ultimately became the foundation for Prata Health.
Healthcare can become especially complicated for older adults who may be seeing multiple specialists, taking numerous medications and receiving services from different providers. Each physician may be focused on one specific condition or part of the body, while family members are left trying to understand how all of those recommendations, medications and appointments fit together.
Fabbo saw an opportunity for nurses to help fill that gap. Prata Health provides concierge nursing designed around the entire person rather than an individual medical task. A dedicated nurse can help coordinate physician appointments, medications and treatment plans while also understanding what is happening in a client’s everyday life at home.
“It’s the whole person, not a task,” Fabbo said.
The name Prata Health is also deeply personal. Fabbo’s father grew up in Prata, a small town outside Naples, Italy, where she said caring for aging relatives was simply part of family life. Growing up, Fabbo saw that same philosophy within her own family and wanted to build a company where clients received that level of personal attention.
“We care for our families like family,” Fabbo said.
That approach can be particularly valuable for older adults who are aging alone or whose children live in another state. Fabbo described recently speaking with a woman who lived out of state while her mother, who was experiencing cognitive decline, remained in an independent living community. Although her mother had housing and support, the family still needed someone who could understand the broader picture of her health, daily routine and quality of life.
For Prata Health, that process begins with getting to know far more than a client’s medical chart. Fabbo said the company conducts an extensive assessment that examines medical and surgical history, medications and previous healthcare experiences, but the team also asks about hobbies, favorite foods, routines and what a person enjoyed doing earlier in life. From there, Prata Health works with the client and family to determine what they want life and care to look like moving forward.
“What’s going to bring you joy to make sure that you’re living to your fullest potential?” Fabbo said.
That same level of coordination extends to physician appointments. Fabbo said her team prepares questions in advance, accompanies clients to visits, takes notes and then reviews what happened with the patient and family afterward. Just as importantly, they help make sure the physician’s treatment plan is actually carried out once the patient returns home.
Medication management is another major part of that work. Fabbo said she frequently encounters patients who know they were told to take a particular medication but cannot explain why they are taking it. The problem can become even more complicated for older adults receiving prescriptions from multiple physicians.
Fabbo believes patients should understand what each medication is for, how and when to take it and what they should be monitoring. Prata Health also works with other healthcare professionals, including pharmacists and dietitians, to create a broader team around each client rather than treating every healthcare need separately.
“We have to work together as a team,” Fabbo said.
Roth and Fabbo also discussed the growing importance of aging in place as America’s older population continues to increase. Advances in home-based healthcare mean services that once required a trip to a hospital, physician’s office or diagnostic center can increasingly come directly to the patient, making it possible for more care to revolve around where people actually live.
“I see a world where home has to be the center of care,” Roth said.
Fabbo agreed, arguing that even some people with complex health conditions can remain at home when the proper support is in place. She described a Prata Health client diagnosed with Lewy body dementia whose family was advised to consider moving her into memory care. But that was not what the client wanted, and Fabbo did not believe a difficult diagnosis alone meant she had to leave her home.
For Fabbo, that is part of the larger promise of concierge nursing. With appropriately trained professionals, families can have someone who understands the patient’s health, communicates with providers, notices changes and helps coordinate the services necessary to keep the person safe and supported.
“We are the point guards. We are the quarterbacks of people’s healthcare,” Fabbo said.
The conversation also explored Fabbo’s transition from nurse to entrepreneur, a role she acknowledged required an entirely different set of skills. Nursing school had prepared her to care for patients, not to market a business, build a company or operate as a CEO. Learning how to balance her instinct to remain directly involved in patient care with the responsibilities of leading a growing organization has been one of the biggest adjustments.
“I think it’s probably been the most difficult thing I’ve done in my life,” Fabbo said.
Still, entrepreneurship gave Fabbo the opportunity to build the kind of healthcare model she believed was missing. Prata Health has since grown to a team of about 20 people, but Fabbo said she is deliberately approaching that growth carefully. Her goal is not to build the largest organization possible, but to preserve the personalized model that led her to start the company in the first place.
“Prata Health will always be a boutique company,” Fabbo said. “The goals for the business is not to be the biggest; it’s to be the best and the highest quality.”
That means being selective about the nurses and other professionals who join the company. Fabbo said being a concierge nurse requires more than having the right degree or clinical experience. She looks for nurses who genuinely want to become involved in their clients’ lives, build relationships with families and care for people with the same attention they would give their own loved ones.
The episode also touched on how technology is changing healthcare. Fabbo said she uses artificial intelligence and believes it can be a valuable tool, but she worries about losing some of the interpersonal skills that are essential to caring for people. While teaching, she said she encountered nursing students who struggled with something as basic as walking into a patient’s room, starting a conversation and learning about the person behind the medical chart.
For Fabbo, those relationships remain essential regardless of how much healthcare technology advances. Her vision for Prata Health reflects that philosophy: healthcare that is coordinated, personal and centered around the individual rather than a series of disconnected appointments, medications and tasks.
And as more healthcare moves into the home, Fabbo believes nurses may be uniquely positioned to help families connect those pieces and make sure someone is looking at the whole picture.
🎧 Listen to the full episode of Health Futures: Taking Stock in You to hear Bob Roth and Bianca Fabbo discuss concierge nursing, navigating the healthcare system, medication management, aging in place, entrepreneurship and the growing role of nurses in coordinating care at home.
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