Changes in reimbursement and advances in technology have resulted in a decreased hospital stay for patients undergoing cardiac surgery. These patients are being discharged into the community setting earlier, resulting in an increased demand for transitional specialty home care. This article relates the experience of a Midwest home care agency charged with the development of specialty home care for these complex patients. It offers a new practice model for professional nursing staff delivering this level of care. This model challenges traditional beliefs that cardiac specialty home care can best be provided by nurses with critical care or acute care cardiology background. This agency was successfully able to use the specialty roles of generalist home care as a foundation for advanced cardiovascular practice in the home care setting due to the agency’s commitment to support this process with an on-site advanced practice nurse skilled in both cardiovascular nursing and home health care.