Advanced practice registered nurses (APRNs) provide high-quality primary care on a daily basis in communities across the nation, particularly in rural and underserved areas. APRNs also play a vital role in providing care coordination for people with multiple diseases and chronic conditions. Their advanced education and training equips APRNs with the knowledge and experience to refer patients for home health and hospice services. Despite this, Medicare rules and regulations keep ARPNs from signing forms to allow consumers to receive these needed services.    This paper expands on the Institute of Medicine (IOM) report The Future of Nursing: Leading Change, Advancing Health recommendation that APRNs be authorized to certify eligible patients for home health and hospice services. Allowing APRNs to certify home health and hospice services can potentially decrease costs, expedite treatment by eliminating the need for physician sign-off, and allow patient-centered health care teams to practice more efficiently.