RN - Home Healthcare

Provides skilled nursing care services by planning, organizing, directing, coordinating, evaluating, and documenting all aspects of nursing care in accordance with physician/APC plan of care.

Coordinates patients care through collaboration with patient/care giver, multidisciplinary team, and physician/APC.

Intervenes consistently and changes interventions with orders to meet changes with patient/caregiver needs.

Evaluates each visit the effectiveness of interventions and the patients response to intervention.

Provide direct patient care by assessing patient for care needs, resources to meet needs and developing a home care plan of care in conjunction with physician. Assures completion of required OASIS assessments according to regulations for home care and QAPI measures.

Ensures plan of care is followed and that documentation complies with regulatory requirements.

Maintains a department productivity standard for visits and caseload management.

Demonstrates professional accountability for self-scheduling patient case load with appropriate frequency and duration, and concurrently updates schedule throughout the day as needed so that ongoing patient needs can be met.

Assure patients on case load are notified timely of their visits, any unplanned schedule changes, and accommodate patients preferred schedule as available.

Precepts newly hired nurses, students and serves as a resource person and professional role model as needed.

Maintain communication with the multidisciplinary team s and assures that orders for necessary care plan changes are obtained and communicated timely to the team.

Initiates documentation in the home and completely records all care delivery so that receiving staff have record of care delivered in a timely manner per agency policy and procedures.

Oversight and delegation of the plan of care within the care team as appropriate to LPNs and CNAs.

Assumes professional responsibility for current nursing practice and clinical standards of care.

Participates in agency continuous quality improvement and process improvement project (PIP) activities as required.

Assume other leadership roles as required by the department.

Responsible for holiday coverage, select weekend coverage and evening call for agency and patient home visits as required on a rotating basis.

Performs other functions as required.