Meet A Home Health Nurse

The share of patients discharged from short-term acute care hospitals to home health care jumped from 11% in 2019 to 19% in 2020. That spike came during the COVID-19 pandemic, and the trend has had staying power: home health is more cost-effective for insurers and families, and it lets seniors keep their independence instead of moving into a residential facility.

Home health nursing is a nontraditional way to make a real impact. Below, a home health nurse describes the work, followed by what the job involves, what it pays, and how to get into it.

Q&A With Lizeth Ramirez, a Home Health Nurse

I'm Lizeth Ramirez, born in Los Angeles to Guatemalan immigrants. I have been drawn to medicine for as long as I can remember. As a child I watched the hustle of the hospital and saw how much pride everyone took in their work and how much respect they earned for helping people.

After high school I started the RN program at community college but had to pause it. I became pregnant and started a family with my high school sweetheart. I didn't want to give up on my goals, so with my family's support I went to private school and earned my licensed vocational nurse license in 1996. I worked with children in an outpatient setting, aiming for a children's hospital, and got there in 2002. Once my kids were older, I went back to college and graduated as an RN in 2018. I couldn't keep working at the children's hospital because it was too heartbreaking, and I knew I didn't want the long hours of a hospital setting at my age. I'm grateful for the chance I was given to start my home health journey, and I feel truly blessed to do what I enjoy most.

Why did you choose nursing?

I grew up around hospitals with my grandmother being sick, and I was always in awe of how the nurses cared for everyone.

What led you to home health specifically?

I had never heard of home health until a former coworker brought it up. I didn't realize how perfect it would be for me: time to spend with a patient, no rushing, and the chance to educate them so they can prevent rehospitalizations. I was amazed at how much we can offer from the comfort of their home. Being in the hospital alone can be overwhelming. At home, patients are in a more comfortable environment, and we can continue care at a slower pace where they're more receptive.

How does home health differ from hospital nursing?

The hospital can be stressful and overwhelming. The patient load doesn't always leave the time you need to educate patients and families. It's unfortunate that home health isn't more visible as a career path.

How has home health changed since COVID-19?

Unlike in the hospital, these patients aren't isolated in a special room with all the equipment on hand. We take extra precautions, because when we visit we're not only seeing the patient, we're in the home with the whole family. And in California, we deal with the heat, the Santa Ana winds, and the rain on top of it.

What are the biggest challenges?

Early on, my biggest challenge was not having another nurse to ask for help or advice while out in the field. That forced me to learn a lot fast. I've since had the privilege of working with a great team. The other challenge is the tedious charting home health requires.

And the greatest rewards?

The flexibility. I can adjust my schedule to take my mom to her doctor's appointments. But mostly it's the patients. Many are so appreciative, and it amazes me how the education and tools we provide, big or small, make such a difference.

What advice would you give someone considering home health?

Do it. We need more home health nurses. If you're passionate about nursing and making a difference, this is the way to go. You may drive around a lot, but the satisfaction of changing a family's life is worth it.

What Does a Home Health Nurse Do?

A home health nurse cares for patients in their own homes, which means being self-directed and able to work independently. Care usually starts with an assessment of the home environment and recommendations to reduce fall risks and other hazards.

The home health nurse is the link between the patient and their physician, therapists, and the rest of the care team, and stays in constant communication to improve outcomes. They also support the patient and family through recovery. Core responsibilities include:

• Assess the home for safety issues and recommend changes
• Assess health needs and build a plan of care with the patient's provider
• Pain assessment and management
• Monitor the patient's response to treatment and adjust interventions
• Oversee case management
• Administer medications and IV infusions, and assess the IV site
• Assist with activities of daily living, including grooming, toileting, bathing, and mobility
• Assess and treat wounds and build a wound care plan
• Take vital signs, draw labs, and start IVs
• Document the patient's physical, psychological, and emotional status
• Detect early symptoms that could lead to rehospitalization
• Teach patients and families proper home care
• Supervise nurse aides

How to Become a Home Health RN

Home health nurses hold either an associate degree in nursing (ADN) or a BSN from an accredited program. After graduating, you pass the NCLEX, which every state requires for licensure; the rest of the requirements vary by state.

Because the role is fairly autonomous, you need a strong foundation first. Most home health nurses come in with at least two to three years of medical-surgical or critical care experience, which builds confidence in your assessment and intervention skills.

There's no certification specific to home health nursing. The American Nurses Credentialing Center once offered one and currently only renews existing credentials. Home health nurses can still earn specialty certifications to support independent practice, such as certified pediatric nurse, wound care certification, oncology certified nurse, or maternal newborn nursing.

How Much Do Home Health Nurses Make?

Home health offers more flexibility and independence than most nursing roles, and the chance to build long-term relationships with patients. Most home health nurses work standard business hours, roughly 8 a.m. to 5 p.m. As of 2025, the average annual salary runs around $82,000, though figures vary by source, with the BLS reporting higher averages.

Several factors raise your value to an agency. BSN-prepared nurses generally earn more than ADN nurses, and more hospital or home care experience commands a higher salary. Although there's no home health certification, optional specialty certifications show your commitment to quality care, improve patient outcomes, and can increase your compensation.