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This study is an evaluation of a unique “surveillance nurse” telephone support intervention for community-dwelling elderly individuals in a home care program. A combined propensity-based covariate-matching procedure was used to pair each individual who received the intervention (“treatment” condition, nT = 930) to a similar individual who did not receive the intervention (“control” condition, nC1 = 930) from among a large pool of potential control individuals (nC0 = 4656). The intervention consisted of regularly scheduled telephone calls from a surveillance nurse to proactively assess the individual's well-being, care plan status, use of and need for services (home support, adult day program, physiotherapy, etc.) and home environment (e.g., informal caregiver support). Treatment and control conditions were compared with respect to four service utilization outcomes: (1) rate of survival in the community before institutionalization in an assisted living or nursing home facility or death, (2) rate of emergency room registrations, (3) rate of acute care hospitalizations, and (4) rate of days in hospital, during home care enrollment. Results indicated a beneficial effect of the surveillance nurse intervention on reducing rate of service utilization by increasing the duration of the home care episode.