Hospice RN Case Manager

Responsibilities

• Completes initial assessment of patient and family to ascertain home care needs, including physical, emotional, spiritual, and mental status.
• Prepares and implements the care plan for the patient/family unit in collaboration with the Interdisciplinary Group.
• Provides direct nursing care to patients to maintain the highest level of care in conjunction with the primary physician.
• Plans and supervises the delivery of care by the HHA.
• Cooperates with the Clinical Manager in utilizing other team members, outside agencies, and community resources. Updates the primary physician and interdisciplinary team as necessary, with regular monthly updates.
• Uses problem‑oriented charting to ensure continuity of care in a home setting, nursing home, inpatient, or respite setting.
• Teaches family members, facility staff, hired caregivers, and patients care skills, including pain control, medication management (RN titrates medication within prescribed range), injections, drawing blood for labs, managing IVs, dressing changes, hygiene, nutrition, checking vital signs per physician orders, and addressing emotional needs.
• Ensures that arrangements for necessary equipment in the facility setting are made available.
• Attends to patient, family, and facility at the time of the patient’s death.
• Documents in the facility chart.
• Maintains positive relationships and open communication with facility staff.
• Reconciles medications against the facility medication list.
• Updates facility staff and family on the visit schedule.
• Attends care‑plan meetings and/or patient‑care rounds for hospice patients within the facility.
• Establishes and maintains professional working relationships with a variety of facility staff, including ED, DON, medical techs, aides, nurses (LPNs and RNs), rehab staff, housekeeping, etc.
• Provides educational in‑services to facility staff, both formally and informally.
• Participates in marketing and customer‑service activities with BDMs.

• Diploma, ADN, and/or BSN from an accredited institution.
• Current Maryland State license as a Registered Nurse.
• Two years of nursing experience, or an equivalent combination of education and experience.
• Knowledgeable of universal precautions for infection control and practices safe nursing standards for self‑protection.
• Strong time‑management skills.
• Excellent interpersonal and communication skills.
• Ability to be patient and family focused.
• Skill in the use of EMR (Electronic Medical Record) and/or willingness to learn.

• Registered Nurse (RN) license.
• ADN.
• BSN.