Heart failure is a chronic disease marked by variable acute exacerbations. Once hospitalized the decompensated patient may have signs and symptoms only partially reversed, medical therapy only partially optimized and deranged physiology only partially restored. Therefore, the post-acute care period is one of unique vulnerability and merits efforts of careful and comprehensive assessment of patients at risk of recurrent decompensation and rehospitalization. Natriuretic peptide (NP) assessment which has the ability to monitor dynamic changes in a patient's physiology, may play an important role as part of a post-acute care algorithm focused on early detection and prevention of further decompensation and rehospitalization.