To address rehospitalization rates and emergency department rates that were above the state and national averages, a quality improvement project was implemented at a midsized home healthcare agency. In order to address these escalating rates, the Home Health Universal Best Practice Protocol was developed and implemented by a home healthcare consultant. The protocol is evidence-based, time-specific, comprehensive, and includes interventions that are linked to reducing avoidable hospital visits. Interventions include risk assessment for rehospitalization, initiation of telehealth, utilization of teach-back method, and timely documentation. The Home Health Universal Best Practice Protocol was effective in not only exceeding objectives regarding decreasing rehospitalization and emergency department rates within a 6-month period but also in improving home healthcare agency referral rates.