The care of patients in their homes is an increasingly common service in the health sector, so it has become necessary to assign routes for medical personnel in order to meet the requirements of patients and to reach the promise of service. This problem is known in the literature as the Home Health Care Routing and Scheduling Problem (HHCRSP), which is considered an NP-Hard problem. In this paper we propose a solution with mathematical programming in two stages (based on the problem of traditional assignment and the problem of the traveling agent (TSP)) for a case study, whose restrictions are not found in the literature; that constrains add complexity to the problem, but could be common in the real world. This approach has the potential to become replicable for other similar situations.