Position : RN Home Health
Develop a plan of care under the direction of patientís physician and in collaboration with the patient, their family and/or the primary care givers upon admission. Periodically reviews the patient care plan and recertifies the patient care plan as appropriate.
Coordinates the patientís care plan through interdisciplinary communication and case conferences, as appropriate. Advises other disciplines of discharges in a timely basis.
Provides ongoing assessment of the patientís clinical, functional, and emotional status to identify problems and/or progress toward desired goals.
Initiates and applies interdisciplinary and therapeutic interventions using appropriate technique; obtains appropriate MD approval. Needs time frame Ė immediately, within 24 hours
Supervises ancillary personnel (HCA and Licensed Practical Nurses) and delegates responsibilities when required. Establishes a care plan for paraprofessional services and revises as needed according to agency policy.
Completes and submits accurate and relevant clinical notes and other required documentation in a timely manner in accordance with expected agency standards, state and federal regulatory compliance i.e., admission papers and OASIS; clinical notes; day sheets; status change; resumption of care; verbal orders/memos; payer source documentation, including management of authorizations; discharge.
Completes all clinical documentation on the laptop and in the home when appropriate and in a timely fashion. Transmits all information twice a day.