The Home Health Nurse provides skilled nursing services to patients recovering from illness, surgery, or managing chronic conditions in their own homes, reporting to the Home Health Director of Clinical Services or Case Manager Supervisor. Home health nursing changes the fundamental dynamic of clinical care: instead of the patient coming to the nurse, the nurse enters the patient's world. You will encounter medication stockpiles, safety hazards, social isolation, inconsistent caregiver support, and economic barriers to adherence that never appear in a hospital chart. Success here is measured by hospitalization prevention, OASIS outcome scores, and the functional gains patients achieve between visits. This role requires strong independent clinical judgment because the physician and the care team are not in the next room.
Conduct OASIS (Outcome and Assessment Information Set) start-of-care, resumption-of-care, and discharge assessments in compliance with CMS requirements and agency timelines.
Perform skilled nursing visits including wound care, IV antibiotic administration, medication management, and post-surgical care per physician plan of care.
Develop and update individualized patient care plans in collaboration with the interdisciplinary team, updating plans within required timeframes following clinical changes.
Assess the home environment for safety hazards, fall risks, and medication storage concerns, documenting and addressing findings in the plan of care.
Educate patients and caregivers on disease management, medication regimens, symptom recognition, and criteria for contacting the agency or seeking emergency care.
Coordinate care with physical therapy, occupational therapy, speech therapy, social work, and home health aides under the umbrella of the patient's plan of care.
Manage IV therapy including PICC line care, port access, and infusion administration for patients requiring home infusion services.
Perform venipuncture and collect laboratory specimens for processing per physician orders, coordinating lab courier pickups.
Recognize and respond to clinical deterioration in the home setting, notifying the physician and coordinating emergency services when indicated.
Complete visit documentation in the home health EHR within agency-required timeframes, maintaining 98%+ documentation compliance.
Manage a caseload of 6-8 patients per day while maintaining accurate scheduling coordination with the staffing office.
Participate in case conference meetings and quality assurance review processes to improve patient outcomes and agency performance metrics.
Active, unrestricted RN license in the state of practice; BSN preferred.
Current BLS certification.
Minimum 1-2 years of clinical nursing experience in an acute care or skilled nursing facility prior to home health practice.
Demonstrated proficiency in wound care, IV management, and medication assessment in a clinical setting.
Valid driver's license, reliable personal vehicle, and adequate automobile insurance coverage.
Ability to function independently with minimal direct supervision in variable home environments.
Familiarity with OASIS documentation requirements and CMS home health conditions of participation.
Proficiency with home health EHR platforms; experience with Homecare Homebase, WellSky, or similar preferred.
HCS-D (Home Care Specialist in ICD-10-CM Coding) or HCS-O (OASIS Specialist) credentials from AHIMA.
Experience managing patients with complex chronic conditions: CHF, COPD, diabetic wounds, post-joint replacement recovery.
IV therapy certification and home infusion administration experience.
Case management experience or familiarity with transitional care coordination models.
Bilingual capability in Spanish or other languages serving the agency's patient population.
OASIS assessment (SOC, ROC, discharge) and CMS compliance documentation
Wound assessment and evidence-based wound care management
IV therapy: PICC line care, port access, home infusion administration
Venipuncture and specimen collection in home settings
Medication reconciliation and polypharmacy management in elderly patients
Home health EHR platforms (Homecare Homebase, WellSky, Kinnser)
Interdisciplinary care coordination in a decentralized team model
Independent clinical judgment without direct supervision
Empathetic engagement in patients' home environments on their terms
Creative problem-solving within resource-limited home settings
Clear patient and caregiver education with high-stakes self-management content
Time management across a geographically distributed daily schedule
Home health nurses earn $72,000 to $94,000 annually across most U.S. markets, consistent with the national RN median of $86,070 (BLS, May 2023). Per-visit compensation models are common in home health, with visit rates ranging from $60 to $110 per visit depending on visit type and geography. Full-time nurses completing 6-8 visits per day can exceed the median in per-visit arrangements. Mileage reimbursement and phone stipends partially offset transportation costs. Source: U.S. Bureau of Labor Statistics, May 2023; PayScale, 2025.
San Francisco Bay Area, CA ($100,000 - $122,000)
New York Metro, NY ($96,000 - $116,000)
Seattle, WA ($94,000 - $114,000)
Boston, MA ($91,000 - $110,000)
Los Angeles, CA ($89,000 - $108,000)
Home health nursing positions commonly include medical, dental, and vision coverage, 401(k) with employer matching, 3-4 weeks PTO, mileage reimbursement, and a company phone or stipend. Many agencies cover professional liability insurance, licensure renewal fees, and continuing education costs. Flexible scheduling is a significant benefit for many nurses attracted to home health.
No prior acute care nursing experience: Home health nurses practice independently without immediate backup. Candidates who come directly from school without hospital experience lack the foundational clinical judgment base to recognize and manage deterioration safely in isolated home environments.
Discomfort with OASIS documentation or unfamiliarity with CMS requirements: OASIS is the backbone of CMS reimbursement and quality reporting. Nurses who view documentation as secondary work will create compliance risk and financial exposure for the agency.
No valid driver's license or reliable transportation: This is a non-negotiable practical requirement. Any candidate who cannot reliably travel between patient homes cannot perform the fundamental function of the role.
Expressed discomfort entering unfamiliar or challenging home environments: Home health nurses work in environments ranging from pristine suburban homes to challenging urban settings. Inflexibility here limits the populations a nurse can safely serve.
Cannot describe how they would handle an at-risk patient without a caregiver present: Social isolation is common in home health patients. Candidates without a framework for this scenario reveal a gap in understanding the realities of independent community-based practice.
Q: What does a home health nurse do?
A home health nurse provides skilled nursing services in patients' homes, including wound care, IV therapy, medication management, OASIS assessments, and caregiver education. They manage a caseload of 6-8 patients daily, operate independently without direct supervision, and coordinate care with interdisciplinary teams to prevent hospitalization and support recovery.
Q: What qualifications do you need to be a home health nurse?
You need an active RN license, BLS certification, a valid driver's license with reliable transportation, and at least 1-2 years of acute care experience. Familiarity with OASIS documentation and CMS home health regulations is strongly preferred. The HCS-D and HCS-O credentials from AHIMA reflect specialty expertise in coding and OASIS documentation.
Q: How much does a home health nurse make?
Home health nurses earn $72,000 to $94,000 annually, consistent with the national RN median of $86,070 (BLS, May 2023). Per-visit rates range from $60 to $110 depending on visit type and market. Nurses completing 6-8 visits per day on per-visit models can exceed the median salary, particularly in high-demand markets.
Q: What skills are required for a home health nurse?
Home health nurses need OASIS documentation competency, wound care, IV therapy, venipuncture, medication reconciliation, and home health EHR proficiency. Equally important are independent clinical judgment without supervision, empathetic patient engagement in home settings, creative problem-solving within resource-limited environments, and disciplined time management.
Q: What is the career path for a home health nurse?
Home health nurses advance to case manager, clinical supervisor, or field educator roles. With additional credentials, paths include Director of Clinical Services, Home Health Administrator, or quality assurance specialist. Some pursue care management roles with insurance payers, particularly in Medicare Advantage markets.
Q: What are the biggest challenges facing home health nurses today?
CMS reimbursement model changes under PDGM (Patient-Driven Groupings Model) have pressured agencies to compress visit utilization, increasing productivity expectations per nurse. Social determinants of health create clinical complexity that is largely invisible in referral paperwork. Workforce shortages are acute, with experienced home health nurses in short supply relative to growing demand driven by aging demographics.