What are the responsibilities and job description for the Discharge Planner/RN - (Registered Nurse) (2539) position at REGIONAL ONE HEALTH?

JOB SUMMARY

Coordinates the discharge planning functions within Inpatient Rehab Services. This includes needs assessment, assistance in financial resource management, crisis management, service delivery planning and referrals to external agencies/community-based services and programs.

Key Job Responsibilities

Essential Function

Demonstrates knowledge and skills necessary to perform assessment and implement discharge planning services, maintains clinical competency and meets age-specific patient needs in accordance with established protocols, policies and procedures.

Assessment
- Collects key information from patient, family, community agencies, and other professional disciplines as part of medical social work assessment.
- Determines priorities for intervention with special consideration given to discharge planning and the patient's right of self-determination.
- Determines differential treatment needs of patients and families.
- Provides specialized methods of services based upon assessment of needs.
- Documents assessment, including recommendations and professional judgment.
Discharge Planning
- Provides information to patient and families about types and costs of services available to enable them to make informed decisions.
- Completes assessments and plans documenting patient and family's understanding of and input into development of the plan.
- Communicates to appropriate staff information about the patient's discharge plan and schedule multi-disciplinary team conferences for patients/families with complex needs or where complex arrangements are required.
- Collaborates with the multidisciplinary care team to identify patients at risk for readmissions and implements plans of care to reduce risk.
- Initiates referrals to agencies and make a direct referral to enhance service to the patient/family.
- Assists patients in obtaining appropriate services to meet needs such as DME, outpatient therapy, hearing/optical appliances, nursing home, home care and dialysis. Obtains and/or completes required documentation.
- Serves as a resource to multi-disciplinary team in providing information and education about community resources.
- Helps coordinate arrangements for patients with special transportation needs transferring from the hospital.
- Obtains and/or completes required documentation.
- Documents discharge plan in medical record.
- Maintains an effective relationship with collateral agencies and includes them in multi-disciplinary team conferences when this will improve patient care.

Functions as a member of a multi-disciplinary healthcare team. Participates in the patient satisfaction survey.

Essential Function

Provides documentation and utilizes computer to enter and retrieve medical/patient information; generate statistics, computations, tables or charts. Provides clear, concise, timely written documentation and updates information and computer data as required. Maintains confidentiality of all information in accordance with hospital, HIPAA, compliance and other regulatory requirements.

Prepares and maintains required reports, records, and files for operational, administrative and compliance purposes within established timeframes. Utilizes computer and information systems to enter format and retrieve data, generate statistics, computations, tables, charts and graphs.

Maintains professional credentials and education necessary to keep abreast and maintain a current knowledge of social work principles, concepts and techniques, best practices and current trends. Attends continuing education, staff development, and mandatory programs.

Participates in staff training and performance improvement activities and utilizes the results of the quality of care activities to initiate changes in practices. Participates in orientation of medical staff, residents and students to promote an understanding of hospital policies and procedures.

Physical Demands

A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Physical Demand	N/A	Rarely	Occasionally	Frequently	Constantly	Weight
Standing			X
Walking			X
Sitting					X
Lifting		X
Carrying		X
Pushing		X
Pulling		X
Climbing		X
Balancing		X
Stooping		X
Kneeling		X
Crouching		X
Crawling		X
Reaching		X
Handling			X
Grasping			X
Feeling		X
Talking					X
Hearing					X
Repetitive Motions				X
Eye/Hand/Foot Coordination				X

Qualifications:

Education
Education Level	Education Details	Required/ Preferred
	Graduate of a Social Work program	Required	and
Master's Degree		Preferred	and
	Qualified by education, training or experience to work with the adolescent, adult and/or geriatric patient population as specialty assignment dictates	Required

Work Experience

Experience

Experience Details

Required/ Preferred

Minimum 2 years experience

social work experience

Required

and

Experience in an acute hospital setting or direct discharge planning from a medical setting

Preferred

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Discharge Planner/RN - (Registered Nurse) (2539)

What are the responsibilities and job description for the Discharge Planner/RN - (Registered Nurse) (2539) position at REGIONAL ONE HEALTH?

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