A problem for occupational therapists involved in home-based rehabilitation is the dichotomy between traditional functional status measures, which are commonly reported by therapists to have insufficient flexibility and poor clinical sensitivity, and individualized methods (which do not allow inter-patient comparison for program evaluation). This study used Goal Attainment Scaling (GAS) to evaluate both individual and program change. The study demonstrates that GAS was a simple, clinically meaningful measure of change which evaluated patient-centered outcomes and program effects concurrently. In addition, this measure was applied to a traditionally challenging service, that of a home-based rehabilitation program. Goal Attainment Scaling was demonstrated to be useful as an outcome measure for patients with multiple, complex rehabilitation needs, such as those served by a home-based rehabilitation occupational therapy service. It was able to accurately detect meaningful change (necessary for demonstrating clinically significant improvement at the level of the individual patient), be administered in a time-effective manner, and also allow the clinician to evaluate program effectiveness.