Abstrak: Along with the worldwide demographic change in the increased number of population aged over 65, Indonesia was no exception. Consequences of the prolonged life-expectancy and changes in disease pattern care recipients with chronic diseases have increased, but no sufficient home-health care yet. The objective was to develop a home-health care model with the concept of Coordination Unit, which possibly solved problematic issues under the current home-health care services. The qualitative research design was applied with the mix-method approach of the exploratory research approach and applied policy research approach was used with the exploratory approach were applied The purposive sampling technic was applied for data collection through interviews, and analyzed by the framework and thematic analysis. The result found the care recipients satisfaction was not high, and found problematic issues relating to quality of care and the lack of integration and coordination. Based on the Indonesian health system, the home-health care model with care coordination units was proposed with the concept that the Puskesmas possibly play roles as the coordination unit functioning as the center of coordinating home-health care services by a Care Manager who is in responsibilities of developing care plans, coordinating care providers and care service quality assurance