It takes a special person to work in a home setting

Self-motivation, creativity are key skills

You can’t just take clinicians from the inpatient setting and put them in home care and expect them to survive, warns James C. Summerfelt, MS, PT, director of home health and rehabilitation planning operations at the Rehabilitation Institute of Chicago (RIC).

Home health clinicians need special training, as well as some attributes that are not always necessary in the hospital setting, says Summerfelt, who has 20 years of experience in home health care.

Here are some things Summerfelt and other home care managers look for when hiring staff:

Organizational ability.

Home care clinicians must be able to assess patients in the home and take all special situations into consideration. Since no two homes are alike, each home care assessment is different.

Self motivation.

Therapists in the home setting work without supervision. They have to take charge of their schedule and be motivated to keep their productivity at a certain level.


Therapists accustomed to the clinical setting often have to improvise to conduct their training in a patient’s home. The home environment may not be set up in a way the therapist feels is best for the patient, but they can’t just come in and rearrange the family’s home. The supplies and equipment are not readily available like in the clinic. Therapists have to find creative ways to conduct the training using what is at hand.


In a hospital setting, therapists come in, and their schedule is set. In a home care setting, therapists must cope with changes almost daily, Summerfelt explains. Weather, traffic, and transportation are just a few of the variables that can throw off a schedule.

In a managed care environment, home health therapists often have to drop everything to evaluate a new patient. Therapists must be able to shift their schedules to accommodate new cases, Saya says.

Communication skills.

When therapists are on their own, they spend a lot of time communicating by telephone with payers, external case managers, other therapists, and the health care agency. The ability to verbalize what is going on with the patient is extremely important in home health, Saya says.

Therapists often have to initiate contact with other clinicians on progress and planning, as opposed to just showing up for a case conference.

Teaching skills.

Home health therapists must be able to teach the patients and caregivers, as well as treat the patients.

Time management.

It’s easy for therapists to spend more time with patients in the home setting because there’s not another patient waiting right outside the door. Therapists must learn to leave their patients so they can keep up with their productivity demands.

Therapists in home health must be able to manage their time and arrange their schedules so they don’t crisscross geographical areas, and they must keep travel time to a minimum.

The knowledge and ability to order equipment.

Because home health therapists don’t have an equipment closet to choose from, they must have the experience to choose the piece of durable medical equipment that will work best, keeping in mind what the patient can afford. Therapists must work with vendors of equipment, orthotics, and prosthetics and must make sure the equipment gets to the patient quickly.