The purpose of this study was to explore home health care nurses' attitudes, perceptions, and experiences related to routine collection and documentation of sexual orientation and gender identity data. This was a qualitative descriptive study. Twenty-four nurses from a large home health care agency in the New York metropolitan area were interviewed between November 2014 and December 2015. Three broad categories of themes emerged from the content analysis: (1) current practices that relate to or influence the assessment of sexual orientation or gender identity by home health care nurses, (2) attitudes and perceptions regarding perceived barriers and facilitators to discussing and documenting sexual orientation and gender identity, and (3) training and resources identified as helpful in preparing nurses to discuss sexual orientation and gender identity with their patients. Nurses emphasized wanting to provide everyone with the same quality of care and wanted documentation to inform the care. They felt unprepared to discuss sexual orientation or gender identity with their patients and indicated a need for training and education related to LGBT health disparities. Results from this study can help inform the development of training materials and resources to enable nurses to collect patients' sexual orientation and gender identity data routinely and in a sensitive and culturally competent manner.