Home Health as a New OT Grad: Should You Do It?
Home health as a new grad occupational therapist: Should you do it?
I first published this article with the answer to this question wayyy back in 2016 (my, how time flies) and I still haven’t changed my stance on the issue.
While there is always a great need for quality home health therapists, since more and more patients are getting pushed from the hospital straight to home instead of rehab, I will still tell you that this OT setting isn’t the best choice for new graduates.
Why I Don’t Recommend Home Health as a New Grad
Home health occupational therapists are amazing and so many of my acute care patients benefit greatly from home health services once they leave the hospital. Personally, my mom got discharged home way too soon from rehab (after only one day due to insurance issues!) after breaking her hip, and her home health OT was truly a godsend while I was still out of state.
I absolutely don’t want to discount the benefits home health occupational therapists provide their patients, but as a new grad, it’s still the one setting I don’t recommend.
Mentorship as a new OT or COTA is SO important for growth as a therapist. When you’re practicing in home health, you really lose out on that crucial mentorship that new grads need their first year.
When you’re around other therapists every day, you learn new ideas and can expand your toolbox. You also aren’t totally alone if your patient becomes unstable or if you’re in a bind due to a fall or any other issues.
Some home health companies may provide you with some mentorship off the clock, but finding true mentorship in this setting is hard to come by. Even if you have a mentor you can call in the evenings, it benefits you more to be practicing around other therapists during the day as well.
“But I Heard Home Health Pays the Best!”
Choosing the highest paying job may be a tempting choice when you’re strapped with student loans, but know that you can always transition to this setting once you’ve gotten a few years of experience in places like hospitals, rehab, or an outpatient setting, as examples.
I’ve heard many therapists tell me that it’s harder to go from home health to another rehab setting after doing home health for a few years. Therapists say that they feel embarrassed asking questions to other rehab OTs after coming from working in the home health setting for a few years; they feel like the questions they have are for things they should already know from experience.
It isn’t their fault, they just didn’t get to be around other OTs to learn a lot of the essentials. If this is your situation, please never be embarrassed to ask questions!
So When Should You Start Your Home Health Career?
I recommend waiting to become a home health occupational therapist after getting at least 1 year of other OT experience after fieldwork.
You’ll have more of an understanding of occupational therapy interventions, medical conditions, transfer techniques, and everything in between. With that experience, you will feel much more prepared than if you started fresh out of fieldwork.
A Few Other Things
Other things to keep in mind even as a seasoned OT interested in home health is that you will more than likely get paid per visit, not hourly. You likely will not get paid for drive time.
If your client doesn’t come to the door, cancels last minute or refuses, you’re usually out of luck for getting paid for not only that visit but the time you spent driving to and from.
In addition, there will be a hefty amount of paperwork per visit with its own set of rules and regulations. There is a combined stress that comes from being a new grad in a new environment and having to figure out the extensive paperwork on top of it. Keep in mind, you don’t get paid for extra documentation time.
Notes can take 2-3x as long to complete than in an inpatient or outpatient setting. Adding in extensive drive time to different counties with the increased paperwork (and minimal experience) can be a recipe for burnout.
Save Home Health for Later if Possible
This article isn’t meant to discourage you from ever going into home health OT.
It’s certainly different from working in a hospital or outpatient setting, but certainly home health is not a “bad” setting! Several of my PRN coworkers that work in home health as well love it for the flexibility and true occupation-based nature of working in patients’ natural environments.
But save home health for when you’re ready! Get a bit of experience under your belt. There will always be jobs in home health, especially with the continuous Medicare changes and the constant push for home health instead of rehab.
What are your thoughts about new occupational therapy grads working in home health for their first job? Have you started out in home health yourself? We’d love to hear about your experiences and advice in the comments below!
This post was originally published on May 1, 2016 and last updated on October 27, 2023.