Health care professionals nationwide are becoming increasingly aware of the high cost of health care as well as the trend to get the patient out of the hospital and back to his/her home environment. One major stumbling block to this concept has historically been the Medicare guidelines, which specifically address the patient's “homebound” status as a prerequisite for home care. Although in recent years, the focus has been on discharge planning well in advance of the actual discharge date, only recently has this emphasis included the care of the I.V. therapy / nutritional support patient. This account, therefore, addresses the actual patient care of this particular patient population as well as the author's role with VNA in developing an I.V. Certification Program.