ABSTRACT This study examined the association between the amount of direct care time and total time (direct and administrative) spent by CNSs with families of 39 very low birth weight infants (< or = 1500 grams) and infant outcomes (rehospitalizations and acute care visits). Documentation of the CNSs' time spent with infants and families was recorded during infant hospitalization and for 18 months after infant discharge. The number of infant rehospitalizations and acute care visits was recorded from hospital and physician records. The mean total time the CNS spent per infant for the 18-month period was 27.3 hours. After discharge, there were significant relationships between the amount of CNS direct care time and the number of acute care visits (r = 0.45, p < 0.01) and infant rehospitalizations (r = 0.51, p < 0.01). Although the study findings did not demonstrate improved infant outcomes associated with the amount of time the CNS spent with this high risk population, they document the amount of CNS time spent in intervention and follow-up of these infants. This study provides data for costing home visiting by the CNS in this patient population.