Careers in Home Care

Advanced Practical Nurse

Advanced Registered Nures Practitioners

Advanced Registered Nurse Practitioners (ARNPs) have obtained advanced education and training enabling them to provide primary care to patients of all ages. When caring for patients, ARNPs may collaborate with physicians and other health professionals or practice independently. ARNPs may specialize in one or more areas, and their responsibilities include performing physical examinations, diagnosing and treating a full range of health problems, ordering and interpreting tests, and prescribing medications.

Education, Training, and Certification
Advanced Registered Nurse Practitioners (LRNPs) must first obtain a M.S. in nursing and hold an RN certification. In New Hampshire, all nurses seeking to practice in an advanced role must hold current certification by a nationally recognized credentialing center in the practice category in which they are licensed. All ARNP programs are graduate level and last from one to three years, offering a master’s degree upon completion. Doctorate programs are also available.

In addition, HCANH periodically offers educational programs with and without CEU credit.

Nursing Schools and Colleges in the Granite State

  • Rivier College, 420 Main Street, Nashua, NH 03060-5086, 603/888-1311,
  • University of New Hampshire, 4 Garrison Avenue, Durham, NH 03824, 603/862-1360,


Registered Nurse

Registered Nurse

Career Profile
Registered Nurses in the home care profession provide patients with treatment and education for health care issues. Responsibilities of a home care RN include observing, assessing, and recording patient symptoms, reactions, and progress; and conducting patient education. Depending on their area of specialization, RNs are responsible for administering treatments, performing therapeutic procedures, conducting health screenings, and supervising other nursing staff such as Licensed Practical Nurses or Licensed Nursing Assistants. Because of the independent nature of the position, most home care agencies prefer that Registered Nurse (RN) staff have at least one-year of medical/surgical experience.

Education, Training, and Certification Registered Nurses (RNs) have to go through one of three types of accredited nursing programs: a diploma, offered by a few hospitals; an associate’s degree, offered through community and liberal arts colleges; or a bachelor’s degree, offered through colleges and universities. After completing education and training, RNs must complete and pass a state board of nursing exam to receive certification to practice nursing in New Hampshire. Thereafter they are required to perform specified continuing education units (CEUs) annually to maintain their licensure. There are no known hospital-based diploma RN programs available in New Hampshire.

In addition, HCANH periodically offers educational programs with and without CEU credit.

Nursing Schools and Colleges in the Granite State

  • Colby Sawyer College, 100 Main Street, New London, NH 03257, 603/526-3700,
  • New Hampshire Community Technical College at Berlin, 2020 Riverside Drive, Berlin, NH 03570, 603/752-1113 or 1-800/445-4525,
  • New Hampshire Community Technical College at Stratham, 277 Portsmouth Avenue, Stratham, NH 03855, 603/772-1194 or 1-800/522-1194,
  • New Hampshire Technical Institute, Concord’s Community College, 31 College Drive, Concord, NH 03301, 603/271-6484 or 1-800/247-0179,
  • Rivier College, 420 Main Street, Nashua, NH 03060-5086, 603/888-1311,
  • Saint Anselm College, 100 Saint Anselm Drive, Manchester, NH 03102-1310, 603/641-7000,
  • University of New Hampshire, 4 Garrison Avenue, Durham, NH 03824, 603/862-1360,


Licensed Practical Nurse

Licensed Practical Nurse

Career Profile of a Licensed Practical Nurse
Licensed Practical Nurses (LPNs) provide routine care for patients of all ages. A LPN’s home care duties may include giving injections, taking, recording, and monitoring patient vital signs; performing diagnostic tests and treatments; changing dressings; and evaluating patient needs or reactions to treatment or medication. LPNs may start and give prescribed medications after completing approved intravenous coursework.

Education, Training, and Certification
Licensed Practical Nurses (LPNs) are required to pass a state licensing examination after completing a year-long LPN program at a vocational or technical college. A high school diploma is usually required prior to enrollment in a LPN program.

In addition, HCANH periodically offers educational programs with and without CEU credit.

Nursing Schools and Colleges in the Granite State

  • New Hampshire Community Technical College, One College Drive, Claremont, NH 03743, 603/542-7744 or 1-800/837-0658,
  • New Hampshire Community Technical College, Prescott Hill, Route 106, Laconia, NH 03246, 603/524-3207 or 1-800/357-2992,
  • New Hampshire Community Technical College, 1066 Front Street, Manchester, NH 03102, 603/668-6706, 1-800/924-3445,
  • New Hampshire Community Technical College at Stratham, 277 Portsmouth Avenue, Stratham, NH 03855, 603/772-1194 or 1-800/522-1194,
  • New Hampshire Technical Institute, Concord’s Community College, 31 College Drive, Concord, NH 03301, 603/271-6484 or 1-800/247-0179,
  • St. Joseph Hospital School of Practical Nursing, 5 Woodward Avenue, Nashua, NH 03061, 603/594-2567 or 1-800/370-3169,


Licensed Nursing Assistant/Personal Care Attendant

Licensed Nursing Assistant/Personal Care Attendant

Licensed Nursing Assistants (LNAs) work under the direction of RNs and LPNs and provide basic patient care and assist with nursing procedures. LNAs care for elderly, newborns, and children with special needs, those recovering from illness, injury or surgery, or individuals with disabilities in their own homes. LNAs typically have a great deal of patient contact as they are responsible for monitoring patient vital signs such as temperature, blood pressure, and pulse. The duties of a LNA often include helping with “activities of daily living,” including personal hygiene, meal preparation, and assistance with self-administration of medicine.

Education, Training, and Certification
In New Hampshire, home health aides must be Licensed Nursing Assistants (LNAs). Licensing is granted upon successful completion of a standardized training program and passage of a written exam. Unlicensed providers of support services include homemakers, companions, and personal care attendants. Many long-term care facilities offer nursing assistant/aide training programs.

LNA Programs in the Granite State

  • American Red Cross–Concord Chapter, 167 North Main Street, Concord, NH 03301, 603/225-6697, or contact your local American Red Cross chapter.
  • St. Joseph Hospital School of Practical Nursing, 5 Woodward Avenue, Nashua, NH 03061, 603/594-2567 or 1-800/370-3169,



Home Health Scope of Practice for Therapists– webinar by HHQI

With the onset of shortened hospital stays and the strong desire by individuals to remain in their homes for as long as possible, many older adults and their families are turning to home care providers to receive rehabilitative services. Home health agencies typically provide the skilled services of registered nurses, social workers, physical and occupational therapists, speech-language pathologists, registered dieticians, and home health aides for their patients (U.S. Department of Health and Human Services, 2009).

Physical Therapy

Physical Therapy offered in home care helps people of all ages who have medical problems, or other health-related conditons that limit their ability to move and perform functional activities in their daily lives.  Therapists implement and monitor exercise programs to promote rehabilitation following stroke, joint replacement surgery, injury or serious illness.  Physical Therapist and Physical Therapy Assistants (PTAs) duties may include instructing patients in exercises, locomotion and regaining functional independence. Home Care Therapists use physical modalities and adaptive equipment in the home; they collect data on the patient’s progress, document and report on the patient’s response, and educating families on adaptive equipment.

Occupational Therapy

Occupational Therapy is used to treat and care for individuals across the lifespan who are impaired in their ability to participate in everyday activities, or occupations, due to neurological, physical, psychological or developmental dysfunctions.  Occupational Therapy is not just getting people back to work– an “occupation” is simply an activity that has meaning or value to an individual as they function in their home, work, school or community. In Home Care an Occupational Therapists and the OT Assistants assess individuals and implement treatment plans that use meaningful activities to improve the emotional, physical, cognitive and social skills of individuals impaired by disability. Occupational Therapy offers creative and adaptive approaches to help individuals mediate, rehabilitate, or compensate for their loss of function and offer a holistic view of individuals to promote the healthy balance of self-care, work, and leisure activities for improved quality of life valued by all individuals. Therapists assess home safety and accessibility, recommending adaptive equipment and home modifications to maximize independence.

Speech Therapy

Speech Therapy in home care is used to evaluate and implement a rehabilitative speech therapy program for patients with musculoskeletal injuries or to patients with other acute or chronic physical disabilities.  Therapists design a program through the use of speech therapy techniques to restore physical functioning and facilitate independence.  The Speech Therapist can provide a wide range of speech therapy services to patients in the home care setting which may include the focus on patient assessment, quality care, and monitoring of patient status and compliance, teaching of patients and caregivers, and discharge planning.  The Speech and Language Pathologist (SLP) delivers care and also provides information regarding evaluation, treatment, and carryover of intervention skills to the home care team.


Home Health Aide, Home Maker and Personal Care Services

Home Health Aide and Personal Care Services

Patients often need extended care and are assigned an individual that is a C.N.A. or Home Health Aide or Home Maker.  These positions work under the direct supervision of a Registered Nurse or therapist, and can provide medically necessary assistance with personal care in accordance with physician order. Home Health Aide may be asked to assess relationships and determine whether goals are being met.   homemaker dues to chronic medical problems such as a stroke, congestive heart failure, emphysema, diabetes, vascular disease and muscle disorder  In many cases this direct care worker keeps the patient from needing admission to a nursing home.  the Home Maker often provides:

  • Personal care, to provide help with activities such as eating, walking, personal hygiene, cooking, and shopping.
  • Homemaking, to help maintain a safe, clean and healthy environment in the home.


Medical Billing Specialist

Medical Billing Specialist

Professional Medical Billing specialists serve as the foundation for the home care financial team. Medical Billing Specialists must have proficiency and confidence in performing administrative responsibilities including electronic, health records, hospital billing, quality assurance, risk management, medical records, practice management, and working with physicians and health care personnel. As a member of the financial team the Medical Billing Specialist must have knowledge of basic financial management, health information administration, ICD-9, CPT, and HCPCS coding, diagnostic related groups, Medicare, Medicaid, and other government/private insurance claims process, managed care systems, medical records legality, with a special emphasis on basic pharmacology, data entry, computer skills, and introduction to ICD-10 coding.

Many, Many More

Truly, Home Care is delivered as a team, and it takes all sorts of people to get the job done.  Speak to the Human Resource specialist at an agency near you to find out more.

A Partial List

Executive Leadership/Management ~ Clinical and Operations
Nursing : Nurse Practitioners, RN’s, ANP Home care nurses, and LNA
Therapies: Speech Therapists, Physical Therapists, Occupational Therapists
Medical Director Jobs, Medical Doctors, Palliative Care Physicians
Accounting and Actuarial
Social Worker LCSW
CNA Jobs, Home Care Aids
Respiratory Therapy
Chaplains and Ethicists
IT and Database Administration
Marketing and Public Relations
Medical Records, Coding and Health Information Specialists
and many, many more

Frequently Asked Questions About Careers in Home Care

Q   What makes home care such an attractive nursing career choice?
A   Home care permits its nurses independence, and offers feelings of fulfillment that challenge other healthcare careers over time. It offers job flexibility and relationship building because home care nurses get to spend more time with clients, and can see their clients’ health outcomes. Home care nurses feel valued and make a difference.

Q   Is there a home care nursing shortage in New Hampshire?
A   The entire healthcare industry faces a challenging nursing shortage in New Hampshire and nationally where the average age of nurses is 47 and 42.5 years, respectively. Several factors contribute to imminent shortages. Over the next four years, New Hampshire is expected to produce 50 percent fewer nursing students than the rest of the country. Forty percent of the current national nursing force will have retired over the next 13 years. By 2020, the state’s population of people 65 and older will double and stretch the limits of the healthcare industry overall. Plus, at the same time the reality of the pending nursing shortage is climaxing, federal and private insurers are relying on less-costly home care services to reduce hospital stays. Unless addressed immediately, these nursing shortage realities are likely to have a detrimental affect on healthcare in the Granite State.

Nursing Shortage Report Jan. 2014

Q   Are home care nurses professionally challenged in the home care setting?
A   Generally, registered nurses are very satisfied with the complexity of their caseloads. As a matter of fact, many registered nurses suggest they are more challenged because they often have to think on their feet and respond quickly to clinical and interpersonal circumstances not usually found in other healthcare settings. They tend to experience more fulfilling and rewarding patient relationships, and often work more closely with physicians. The home care nurse also functions as a member of an interdisciplinary team, and is frequently viewed as the patient’s “care manager.”

Q   Why is home care important to families?
A   Home care helps to lift the burden of worry from family members by helping them to plan and participate as an equal partner in the care of their loved one. It also offers clients feelings of self-reliance and enables them to stay in their homes comforted by familiar surroundings.

Q   What role does technology play in home care?
A   Advances in portable healthcare technology have allowed many chronically ill individuals to receive treatment in their homes. Home care professionals typically educate individuals and their families about equipment use, and monitor the effectiveness of treatment programs.