Hospice Registered Nurse Case Manager

The Registered Nurse Case Manager plans, organizes, and directs care and is experienced in

nursing, with emphasis on community health education/experience. The professional nurse

builds from the resources of the community to plan and direct services to meet the needs of

individuals and families within their homes and communities.

ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES

Patient Care:

1. Completes an initial, comprehensive, and ongoing comprehensive assessment of the patient and family to determine hospice needs. Provides a complete physical assessment and

history of current and previous illness(es).

2. Provides professional nursing care by utilizing all elements of nursing process and as

defined in the state Nurse Practice Act.

3. Assesses and evaluates patient’s status by writing and initiating plan of care.

4.Regularly re-evaluating patient and family/caregiver needs

5.Participating in revising the plan of care as necessary

6.Initiates the plan of care and makes necessary revisions as patient status and needs

change.

7. Uses health assessment data to determine nursing diagnosis.

8. Develops a care plan that establishes goals, based on nursing diagnosis and incorporates

palliative nursing actions. Includes the patient and the family in the planning process.

9. Initiates appropriate preventive and rehabilitative nursing procedures. Administers

medications and treatments as prescribed by the physician in the physician’s plan of care.

10. Counsels the patient and family in meeting nursing and related needs.

11. Provides health care instructions to the patient as appropriate per assessment and plan.

12. Assists the patient with the activities of daily living and facilitates the patient’s efforts

toward self- sufficiency and optional comfort care.

13. Maintain current documentation on EMR system by end of day according to organization

policies/procedures and applicable laws/regulations.

14. The RN Case Manager, when assigned by the Clinical Manager/DPS, assumes

responsibility to coordinate patient care for an assigned case load.

15. The RN Case Manager may act as an Admission Nurse when assigned by Clinical

Manager/DPS and assumes responsibility to coordinate with intake, program staff and

management to complete a patient initial admission/assessment with plan of care.

16. Creates and maintains schedule for nursing and HHA services in accordance with

established plan of care and federal/state regulations.

17. Coordinates with interdisciplinary team regarding visit frequencies for all direct care

personnel.

18. Order medications, DME, medical supplies, and therapies as approved by the

interdisciplinary group.

19. Coordinates with Clinical Manager Medication, DME, supplies, or therapies outside of

formulary.

20. Performs medication reconciliation upon admission and as needed in coordination with

interdisciplinary group.

Communication:

1. Completes, maintains, and submits accurate and relevant clinical notes regarding patient’s

condition and care given in accordance state and federal regulations. Records

pain/symptom management changes/outcomes as appropriate.

2. Communicates with the Hospice Medical Director and attending physician if elected

regarding the patient’s needs and reports changes in the patient’s condition;

obtains/receives physicians’ orders as required.

3. Communicates with community health related persons to coordinate the care plan.

4. Teaches the patient and family/caregiver self-care techniques as appropriate. Provides

medication, diet and other instructions as ordered by the physician and recognizes and

utilizes opportunities for health counseling with patients and families/caregivers. Works

in concert with the interdisciplinary group.

5. Provides and maintains a safe environment for the patient.

6. Assists the patient and family/caregiver and other team members in providing continuity

of care.

7. Works in cooperation with the family/caregiver and hospice interdisciplinary group to

meet the emotional needs of the patient and family/caregiver.

8. Attends interdisciplinary group meetings.

9. Reports any incidents, concerns, or complaints to Director of Patient Services and/or

administrator.

10. Ensures facility binders are up to date in accordance to state, federal, and accrediting

agency regulations or standards.

11. Reviews non-covered items with patient, family, and/or facility as requested.

12. Completes and provides NOMNC to patient and/or family as required by state or federal

regulations.

Additional Duties:

1. Participates in on-call duties as defined by the on-call policy.

2. Ensures that arrangements for equipment and other necessary items and services are

available.

3. Supervises ancillary personnel and delegates responsibilities when required.

4. Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in

continuing education and in-service classes.

5. Fulfills the obligation of requested and/or accepted case assignments.

6. Actively participates in quality assessment performance improvement teams and

activities.

7. Must adhere to the company attendance and reliability guidelines, which are an essential

function of the job to ensure quality and consistent patient care.

The above statements are only meant to be a representative summary of the major duties

and responsibilities performed by incumbent(s) of this job. The incumbent(s) may be

requested to perform job-related tasks other than those stated in the description

POSITION QUALIFICATIONS

• A graduate of a National League of Nursing accredited school of nursing.
• Current licensure in state of practice and current CPR certification.
• Must possess a valid Driver’s License and can show proof of valid auto insurance.

All States (except CA):

• Registered nurses shall have a minimum of (a) one (1) year of experience as a

professional nurse within the last three (3) years OR (b) have a baccalaureate degree in

nursing from a program accredited by the National League for Nursing and a current RN

license. A minimum of two years’ experience, at least one of which is in public health,

home care, or hospice nursing is preferred.

• Must be a licensed driver with an automobile that is insured in accordance with state

and/or organization requirements and is in good working order.

• Management experience not required. Responsible for supervising hospice aides.
• Self-directed and able to work with minimal supervision.
• Excellent observation, verbal and written communication skills, problem solving skills,

basic math skills; nursing skills per competency checklist.

• Prolonged or considerable walking or standing. Able to lift, position and/or transfer

patients. Able to lift supplies and equipment. Considerable reaching, stop bending,

kneeling and/or crouching. Visual acuity and hearing to perform required nursing skills.

PHYSICAL REQUIREMENTS

1. The ability to sit occasionally for 1-3 hours.

2. The ability to frequently stand for 3-6 hours.

3. The ability to occasionally drive/ operate foot control for 1-3 hours

4. The ability to walk intermittently on level and or unlevel surface for less than 1 hour

5. The ability to intermittently bend or climb for less than 1 hour.

6. The ability to occasionally twist, kneel, crouch and crawl for 1-3 hours

7. The ability to lift 50 pounds frequently for 3-6 hours

8. The ability to lift greater than 50 pounds occasionally for 1-3 hours.

9. The ability to carry up to 50 pounds frequently for 3-6 hours.

10. The ability to carry greater than 50 pounds occasionally for 1-3 hours.

11. The ability to push up to 50 pounds frequently for 3-6 hours.

12. The ability to push greater than 50 pounds occasionally for 1-3 hours.

13. The ability to pull up to 50 pounds frequently for 3-6 hours

14. The ability to pull greater than 50 pounds occasionally for 1-3 hours.

Pay: $85,000.00 - $105,000.00 per year

Benefits:

• Health insurance
• Paid time off

Work Location: On the road

Salary : $85,000 - $105,000