Working as a home health occupational therapist (OT) is one of the most flexible, creative, and rewarding career paths in our field—especially if you value independence, variety, and building strong relationships with families. Whether you’re a new grad or considering a career switch, here’s a real-world breakdown of what it’s like to be a home health OT.

My Daily Schedule as a Home Health OT

One of the biggest perks of home health is managing your own schedule.

I typically start my day around 9 or 10 a.m. and finish by 4:30 or 5 p.m., depending on my caseload. That might sound dreamy—and honestly, it is. I’m not a morning person, so this schedule works really well for me.

I usually see about 4 to 6 kids per day, depending on cancellations and travel time. Unlike a clinic, I’m not in one location all day. I’m out in the community, visiting families in their homes, which keeps the workday fresh and dynamic.

Cancellations and Makeups Are Part of the Job

Home health is flexible, but it does come with some unpredictability—cancellations happen often.

Families might cancel because someone is sick, they’re out of town, or they simply forget. It’s common, and it can affect your schedule and income, especially if you’re paid per visit.

Makeups are a great way to stay on track. I try to reschedule sessions later in the week or even the same day if I have the time and the family is available. Being flexible and proactive is key in this setting.

Per-Visit Pay vs. Salary: What’s the Difference?

There are two common pay structures in home health: per visit and salary.

• Per-Visit Pay: You get paid for each session you complete. This structure usually pays well and often includes mileage reimbursement. The downside is that if a session gets canceled and you can’t make it up, you won’t get paid for it.
  
• Salary Pay: You earn a consistent paycheck, regardless of how many sessions you complete. It’s more stable, especially in weeks with multiple cancellations, but the base pay may be slightly lower than per-visit pay if your caseload is full.
  

A helpful tip is to track your mileage carefully. It adds up quickly, and some companies will reimburse or offer a stipend to help cover those costs.

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Equipment and Working From Your Car

As a home health OT, your car becomes your mobile therapy clinic.

I carry my own therapy bag filled with essentials like fine motor tools, sensory items, adaptive scissors, games, and more. Some companies offer a supply stipend, but others expect you to provide your own materials.

I’ve built my kit using a mix of Amazon finds, Dollar Tree items, and DIY tools. You don’t have to spend a lot—being resourceful is key.

Traits You Need to Succeed in Home Health

Home health isn’t for everyone, but it can be an excellent fit if you have the right mindset and skills. To succeed in this setting, you need to be:

• Independent – You’ll work on your own most of the day
  
• A strong problem solver – Each home and child presents a unique challenge
  
• Flexible – Schedules can shift daily due to cancellations or family needs
  
• Self-motivated – You manage your own time, documentation, and follow-ups
  

If you’re someone who values autonomy and enjoys thinking creatively, this might be your ideal role.

Why I Love Being a Home Health OT

There are so many reasons I enjoy this setting:

• I manage my own schedule
  
• I get to work independently
  
• I’m paid fairly for my time
  
• I can be creative with my treatment sessions
  

As a Latina therapist, I also appreciate the opportunity to connect with families in a culturally responsive way. I often work with Spanish-speaking families and create activities that reflect their daily routines, values, and traditions. That kind of meaningful connection is a big part of why I stay in this setting.

Home health therapy has its challenges, but it’s also one of the most rewarding and empowering areas of occupational therapy I’ve experienced. If you value flexibility, creativity, and building personal connections with families, it might be the right fit for you too.

Are you considering home health OT? I’d love to hear from you—share your thoughts in the comments or reach out to me on Instagram [@the.OTLatina]. For more occupational therapy content, tips for new grads, and insights into pediatric practice, be sure to subscribe to OT Latina on YouTube and follow along for more resources to support your OT journey.