RN Home Health

Home Health Nurse

Cares for elderly, convalescent, or persons with disabilities in private homes by assessing patient needs by providing care to meet those needs. Being responsible for providing nursing care to individuals or families. Coordination of patient care with other agency provided services in accordance with federal regulations and state and local law.

Patient Care/Skilled Nursing:

• Making the initial assessment visit. Assessing the family and individual needs and re-evaluating the patient's nursing needs at specific time intervals.
• Initiating the plan of care by providing skilled services, including appropriate preventative and rehabilitative nursing care and those services requiring substantial and specialized nursing skill.
• Regularly monitoring and re-evaluating the patient's plan of care by ongoing assessments.
• Coordinating the patient's needs with the family's abilities and resources in an attempt to achieve patient recovery and/or rehabilitation.
• Providing appropriate patient/caregiver education based on the assessed needs.
• Communication with the physician of record in regards to changes in patient status, review/revision of the plan of care, and obtaining supplemental orders as needed and documenting all communication with physicians.
• Responsible for providing patient care in accordance with Serve Link Home Care's approved clinical policies and procedures and accepted standards of practice.
• Providing patient/caregiver with information regarding patient rights and responsibilities, advance directives, home safety measures, who to contact, what to do in an emergency and the on-call procedure.
• Maintaining all patient information as confidential.
• Utilizing appropriate infection control measures in the provision of patient care.
• Preparing and submitting written clinical and progress notes.
• Coordinating services, informing the physician and other personnel of changes in the patient's condition and needs. Participating in case conferences, documenting discussions in the patient's clinical record. Coordinating patient care by personnel within and outside the agency and planning for patient discharge. Making referrals to appropriate and necessary services based upon identified patient care needs.
• Providing and documenting patient discharge instructions.
• Performing the initial and periodical evaluation of the patient's prescribed medication regimen.
• Participating in in-service programs, supervising and teaching other nursing personnel.
• Assigning tasks for the home health aide regarding patient care, then supervises home health aide at least every two weeks.
• Providing regular weekly or monthly visits under the In-Home RN visit program including, but not limited to:
• Medication Set-up
• Skin Care
• Aide supervision and training (Advanced Personal Care)
• Client assessments (generally 2X a year)

Performs related duties as assigned or requested

Possesses adequate knowledge of Medicare/Medicaid and insurance standards to ensure reimbursement for all services rendered

Conforms to all applicable Serve Link Home Care, Inc. policies and procedures

Participates actively in continuing education and in-services

Maintains confidentiality of patient information and business trade practices

Assumes accountability for reporting incidents and complaint according to Serve Link Home Care, Inc. policy

Knowledge / Skills / Abilities:

• Language
  
  Skills:
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to write routine reports and correspondence.
• Ability to speak effectively before groups of customers or employees of organization. Have democratic leadership skills.
• Mathematical
  
  Skills:
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
• Skills necessary to compute care plan frequencies, medication frequencies and scheduling frequencies.
• Ability to determine basic statistical outcomes for patient care and understand basic statistical reports on same.
• Reasoning Ability:
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
• Skills necessary to compute care plan frequencies, medication frequencies and scheduling frequencies.
• Ability to determine basic statistical outcomes for patient care and understand basic statistical reports on same.

Age-Related

Competencies:

Demonstrates the basic knowledge and skills necessary to identify age-specific patient needs appropriate for this position

Information Management:
Treats all information and data within the scope of the position with appropriate confidentiality and security

Risk Management:

Cooperates fully in all risk management activities and investigations

Keeps abreast of changes in health care law

Maintains agency/program compliance with local, state, and…