We assessed client satisfaction with the home telemonitoring service provided by 14 home health care agencies in five US states. Clients were randomised to two groups. Telehealth services (health monitoring and patient safety) were provided to 450 experimental subjects. Control subjects (n = 409) received usual care. Clients were asked to rate their satisfaction with their service providers on 25 items, at baseline, 6 months post-discharge (to home) and 12 months post-discharge. The mean age of the clients was 78 years. Out of the initial 859 subjects, 490 had dropped out of the study by the 12-month follow-up, an overall attrition rate of 57%. There were similar proportions of clients reporting high satisfaction with external systems at baseline and at 6 months; at 12 months, there were significantly more clients in the experimental group who reported high satisfaction (P = 0.049). There were similar proportions of clients reporting high satisfaction with internal systems at baseline and at 12 months; at 6 months, there were significantly more clients in the experimental group who reported high satisfaction (P = 0.031). Clients with home monitoring were more satisfied with health-related and medical services post-discharge than those receiving usual care over a 6–12 month period.