Home health speech-language pathologist job description
A home health speech-language pathologist treats swallowing, speech, language and thinking problems at home, often after a stroke or a hospital stay. They watch patients eat their usual meals and suggest safer textures to the physician. They also teach families and aides the steps that keep meals safe.
By the HireBus team · Updated · Pay data: BLS, May 2025
Median pay, home health care agencies · BLS, May 2025
We're hiring a Speech-Language Pathologist to treat home health patients with swallowing, speech, language, and thinking problems, often after a stroke or a hospital stay. You'll evaluate patients at home, recommend safe foods and liquids to the physician, teach patients and families, and help patients communicate their needs. On therapy-only cases, you may open the case with the start of care OASIS.
2. Essential Duties and Responsibilities
Evaluate swallowing at home, and recommend a modified barium swallow study or FEES when the bedside exam can't answer the question.
Recommend food textures and liquid thickness to the physician or allowed practitioner, using IDDSI levels if your agency uses them.
Treat aphasia, slurred speech, and trouble with memory or problem solving after a stroke, a brain injury, or with dementia.
Teach patients and caregivers safe swallowing steps, such as posture, small bites, and mixing thickened liquids correctly.
Set up communication tools, such as picture boards or [speech-generating devices], for patients who can't speak clearly.
Complete the start of care OASIS when speech therapy is the only service ordered, and write aide instructions on those cases.
Report coughing or choking at meals, weight loss, or new chest congestion to the RN Case Manager and physician the same day.
3. Key Tasks / Daily Activities
See [4–5] patients across your area, starting with new swallow evaluations.
Watch patients eat and drink their usual foods, and adjust strategies to what you see.
Call physicians' offices for diet order changes after you make a recommendation.
Update nurses, aides, and family caregivers on each patient's current diet and swallow precautions.
Document visits and diet recommendations in [your EMR] the same day.
4. Key Performance Indicators (KPIs)
Swallow evaluations completed within policy: [your target].
Diet change orders requested the same day: [your target].
Speech therapy notes completed on time: [your target].
Patients meeting speech or swallow goals by discharge: [your target].
5. Required Qualifications and Skills
Master's degree in speech-language pathology from a program accredited by ASHA's Council on Academic Accreditation (CAA).
Active [State] speech-language pathology license.
ASHA Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP).
Current BLS certification, or able to earn it during orientation.
Valid driver's license, car insurance, and reliable transportation for visits across [your service area].
Passes required background checks and follows HIPAA in homes, cars, and on the phone.
6. Preferred Experience
Dysphagia experience in home health, skilled nursing, or acute care.
Board Certified Specialist in Swallowing and Swallowing Disorders (BCS-S).
Experience with aphasia, dementia, or head and neck cancer patients.
Has opened therapy-only cases with the start of care OASIS.
7. Physical Requirements
Sitting, kneeling, and leaning close to patients during swallow exams and therapy.
Driving between homes and climbing stairs into homes of all layouts.
With or without reasonable accommodation.
8. Work Environment and Schedule
Mostly in patients' homes and assisted living apartments across [your service area].
Exposure to saliva, coughing, and body fluids during swallow work, with gloves and masks provided.
A weekday schedule built around your caseload: [your hours].
Mileage paid per [your mileage policy].
9. Compensation and Benefits
Pay: [range and hourly or salary basis].
Additional pay: [overtime, bonus or incentive terms, or none].
Benefits: [health, dental, vision, retirement, paid time off, and when they start].
10. Company Culture and Overview
[Two or three sentences on what your company does, the area you serve, and the support a new speech-language pathologist gets in the first 90 days.]
11. How to Apply
[Apply link or email]. Our process: [phone interview, in-person interview, and next steps]. Contact [hiring contact] if you need an accommodation during the application process.
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What makes home health speech-language pathology different
In a hospital, an SLP can send a patient down the hall for a swallow study. In home health the first look happens at the kitchen table, and there is no speech assistant to share the visits.
Some swallow questions need a study
At home, the SLP does a clinical swallow exam while the patient eats and drinks. When that can't answer the question, the SLP recommends an instrumental study to the physician, and the agency helps the patient get one. A modified barium swallow study is an X-ray procedure. FEES uses a scope instead, and ASHA notes it is portable enough for a clinic room or the bedside. Source: ASHA Practice Portal: Adult dysphagia.
A diet change needs an order
The SLP recommends food textures and liquid thickness, then calls the physician's office. The change itself has to be ordered by the physician or allowed practitioner and recorded in the plan of care, where nutrition needs are listed too. Once the order is in, nurses, aides and family all need the new diet the same day. Source: 42 CFR 484.60: Care planning, coordination of services, and quality of care (Cornell LII).
No assistant to share the caseload
Home health PTs and OTs can hand some visits to assistants. ASHA says Medicare policy doesn't recognize speech-language pathology assistants, whatever the level of supervision, and doesn't pay for their services. So on Medicare cases, a licensed SLP makes every speech visit. Plan coverage for vacations and sick days with that in mind. Source: ASHA: Frequently asked questions about speech-language pathology assistants.
Aides and family carry the practice
Medicare's aide rules let home health aides help with repetitive practice of communication skills that support speech therapy. Family members mix thickened drinks and set up meals. So the SLP's teaching has to work for whoever will be there at dinner, not only for the patient during the visit. Source: 42 CFR 409.45: Dependent services requirements (Cornell LII).
How much home health speech-language pathologists make
Speech-Language pathologists who work for home health care agencies earned a median of $56.43 an hour ($117,370 a year) in May 2025, according to the Bureau of Labor Statistics. That’s above the $97,870 median for Speech-Language pathologists in all industries. About 6,350 of the 183,390 Speech-Language pathologists in that survey work for home health care agencies.
Many agencies pay SLPs by the visit, with a separate swallow evaluation rate, since they don't have enough speech orders for a full-time role. A larger agency may salary one SLP who covers every branch.
Home health care agencies
$117,370$117,370 median Middle half $99,060–$145,030 10th–90th $77,100–$175,690
All industries
$97,870$97,870 median Middle half $77,730–$114,570 10th–90th $62,900–$134,160
$50k$75k$100k$125k$150k$175k$200k
10th–90th percentileMiddle halfMedianAnnual pay, May 2025. Source: BLS Occupational Employment and Wage Statistics.
Annual pay by percentile
Group
10th
25th
Median
75th
90th
Home health care agencies
$77,100
$99,060
$117,370
$145,030
$175,690
All industries
$62,900
$77,730
$97,870
$114,570
$134,160
Skills to hire for, and what you can teach
Hire for these
Runs a clinical swallow exam at a kitchen table and knows when to ask for an instrumental study
Explains a texture or liquid change so a tired caregiver gets it right
Treats aphasia and memory problems with tasks from the patient's own day
Gets diet orders updated through busy physicians' offices
Works alone across a wide territory and keeps notes current
Teach these on the job
Your agency's texture and liquid labels, such as IDDSI levels
Start of care OASIS on speech-only cases
Which nearby hospitals and clinics do swallow studies, and how to refer
Your EMR's speech evaluation and diet recommendation steps
The communication boards and devices your agency stocks
SLPs bring a penlight, gloves, thickener samples, measured cups and spoons, and picture boards, and a tablet that runs the EMR and, at times, communication apps. Before you hire, list the hospitals and clinics nearby that do swallow studies, since the SLP will send patients there.
Home health speech-language pathologist interview questions
They have their own page: 6 questions that test this job, what strong and weak answers sound like, and a work exercise to run with your finalists.
Speech cases are fewer than PT cases, so judge targets over a longer stretch. Set them from your own recent quarters of data.
Swallow evaluations completed within policy
Days from each swallow evaluation order to the visit, with overdue ones listed daily. Put these first, since the patient's diet may be on hold until the SLP sees them.
Diet change orders requested the same day
For each diet recommendation in a note, check the time the request went to the physician's office. Count same-day requests against all recommendations.
Speech therapy notes completed on time
Speech notes signed inside the window your policy sets, divided by all speech visits, from the EMR. When diet details sit in a late note, aides learn about them late too.
Patients meeting speech or swallow goals by discharge
At discharge, mark each goal as met, partly met or not met in the note. Report by diagnosis group, since stroke and dementia cases move differently.
Career path
Clinical fellow in a hospital or skilled nursing facilityCompletes the supervised clinical fellowship ASHA requires for the CCC.
Speech-Language PathologistTreats swallowing and communication at home and opens speech-only cases.
Dysphagia leadTrains nurses and aides on swallow safety and takes the hardest swallow cases.
Board certified specialist in swallowingEarns the BCS-S and consults on complex swallow cases across branches.
Medicare doesn't require it. ASHA says the federal Medicare law asks for a license in states that license SLPs and doesn't require the CCC. ASHA also calls the CCC voluntary and says licensure is meant to protect the public, and it notes that every state and DC now licenses SLPs. Many agencies ask for the CCC anyway, and this template lists it as required. That is your call.
How much does a home health speech-language pathologist make?
Speech-Language pathologists who work for home health care agencies earned a median of $56.43 an hour ($117,370 a year) in May 2025, according to the Bureau of Labor Statistics. The middle half earned between $99,060 and $145,030 a year. Pay also depends on your local market, experience and overtime.
Can an SLP be the only clinician on a home health case?
Yes. On a case where speech is the only ordered service, the SLP may handle the first visit and the comprehensive assessment, including OASIS. With Medicare patients, the SLP also checks eligibility for the home health benefit, homebound status included. The template also has the SLP write the aide's care instructions on those cases.
What do home health SLPs treat besides swallowing?
Medicare's manual names helping patients with aphasia rebuild speech and language, and helping patients with voice disorders control their voice. It also covers work on speech production after an illness or injury. Trouble with memory, attention and problem solving after a stroke or brain injury is common too. So is setting up a picture board or device for a patient who can't speak clearly.
Which settings prepare an SLP for home health?
The template prefers dysphagia experience in acute care, skilled nursing or home health. Those settings teach the bedside swallow exam and working with frail patients. Ask the candidate to describe a time a bedside exam wasn't enough, what they recommended, and how they got the order.
