About UR Medicine Home Care

RESPONSIBILITIES:

The registered nurse makes the initial evaluation visit, regularly reevaluates the patient's nursing needs, initiates the plan of care and necessary revisions, furnishes those services requiring substantial and specialized nursing skill, initiates appropriate preventive nursing procedures, prepares clinical and progress notes, coordinates services, informs the physician and other personnel of changes in the patient's condition and needs, counsels the patient and family in meeting nursing and related needs, participates in in-service programs, and supervises and teaches other nursing personnel.

1. Evaluates patient eligibility for Hospice admission and on-going service based on the Conditions of Participation, Conditions of Payment, and Local Coverage Determinant (LCD) guidelines, and recommends acceptance into hospice program as appropriate.
2. Provides an environment, which promotes respect for the patients, their privacy, confidentiality and property.
3. Evaluates and admits cases within 24 hours, or documents reasons for start of care delay. Coordinates all the initial care needs and makes referrals as needed.
4. Develops and revises hospice plan of care in conjunction with patient, family, physician, hospice medical director, Interdisciplinary Group (IDG) and the SNF team, including obtaining medical orders and approval of medical services.  This plan and visit frequency is based on patient and family needs.
5. Works closely with hospice medical director and hospice leadership on issues concerning the evaluation process, admission and patient eligibility criteria. Acts as patient and family advocate regarding end of life care.
6. Ensures comprehensive assessment, coordination and education of end of life care and continually re- evaluates and anticipates the changing patient/family needs.
7. Assures the completion of all appropriate electronic clinical documentation needed for compliance with state and federal regulations and the delivery of seamless service within established timeframes. Laptops must be used in the care setting and the bulk of documentation completed during patient visit.
8. Directs, coordinates, evaluates and supervises the quality of patient care services provided by the Home Health Aides, including clinical supervision. Provides a supportive and inclusive environment for home health aides.
9. Provides in-service education programs and markets the hospice program within the SNF’s and health care systems.
10. Provides supervision of LPN to ensure patient health, safety, and compliance with plan of care.
11. Act as preceptor and works with new staff, students and medical staff as needed.
12. Rotates responsibility for coverage in the community, nursing home and hospital settings as need arises, and participates in appropriate cross-training and competencies to ensure clinical expertise in all settings.
13. Ensures schedules are kept up to date daily and pre-loaded weekly. Demonstrates willingness to flex work hours based on patient need.
14. Will participate in regular on-call scheduling for evenings, nights, weekends and holidays as need arises.
15. Demonstrates flexibility and willingness to visit patients based on need and not geography or time of day.
16. Ensures problem resolution at the point of contact.   
17. Other duties as assigned.

QUALIFICATIONS:

Equal Opportunity Employer