Job Summary: Demonstrate proficient skills using Oasis to admit, transfer, re-certify, and discharge home health patients in regards to physician orders. Coordinate and supervise LPN’ s and HHA’s in the delivery of patient care. Maintain compliance with agency policy and procedures. Follow Medicare and Medicaid regulations.

Qualifications/Educational Requirements:

1. Be a registered nurse (R.N.) with a current license.

2. Minimum of one year of nursing experience as a R.N.

3. Work positively and favorably with patients, families, and staff.

4. Bi-lingual preferred (Portuguese, Cape Verdean Creole and Spanish)

Responsibilities/essential functions: The person in this position must be able to perform the following essential job functions with or without reasonable accommodations.

1. Perform the initial home care patient visit and re-evaluate the patient’s needs and progress on a regular basis. *

2. Initiate the plan of care under doctor’s orders. *

3. Perform admission, transfer, re-certification, resumption of care, and discharge Oasis for the home care patient. *
4. Observe, assess, and document symptoms. *
5. Monitor reactions and patient progress. *

6. Educate patients and caregivers on disease process, medications, plan of care, and individualized treatment plans. *

7. Educate patients and caregiver on techniques for in home health care. *

8. Coordinate patient services. *

9. Supervise LVNs and HHA’s. *

10. Notify the physician and other personnel (Clinical Manager, Therapist, and Case Manager) of change in the patient’s condition. *

11. Perform skill outline in the agency’s approved policy and procedure manual. *

12. Discharge the patient from skilled nursing services when the discharge criteria have been met. *

13. Case conference clinicians providing care to ensure coordination of care. *

14. Update clinical records according to policy and procedures. *

15. Update knowledge and skills by attending in-service programs, continuing education programs, seminars, and self-study programs annually. *

16. Provide onsite supervision of LPN/HHA. *

17. Adhere to Medicaid and Medicare regulations. *

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS

The work environment and physical demands described here are representative of those required by an employee to perform to the essential functions of this job with or without reasonable accommodations.

Physical Elements

• Sufficient clarity of speech and hearing or other communication capabilities, with or without reasonable accommodation, to enable the employee to communicate effectively;
• Sufficient vision or other powers of observation, with or without reasonable accommodation, to enable the employee to review a wide variety of materials in electronic or hard copy form;
• Sufficient manual dexterity, with or without reasonable accommodation, to enable the employee to operate a personal computer, telephone, and other related equipment;
• Sufficient personal mobility and physical reflexes, with or without reasonable accommodation, to enable the employee to safely lift, move, or maneuver whatever may be necessary to successfully perform the duties of their position;
• Sufficient personal mobility and physical reflexes, with or without reasonable accommodation, to enable the employee to efficiently function in a general office environment; and
• Sufficient personal mobility and physical reflexes, with or without reasonable accommodation, to enable the employee to efficiently function in a general office environment, with frequent travel to a variety of field sites.

Environmental Elements

Employee works in an office environment sometimes with moderate noise levels, controlled temperature conditions and sometimes travels to patients homes where they may have direct exposure to hazardous substances. Employees may interact with upset staff and/or public and private representatives in interpreting and enforcing departmental policies and procedures.

Employee will have to travel to a variety of patient homes and perform in conditions that vary greatly depending upon the client’s home environment. Some homes will be clean, neat, and maintained at a comfortable temperature. Other homes may be cluttered, dirty, with an uncomfortable temperature.

The above list reflects the essential functions and other job functions considered necessary of the job identified, and shall not be construed as a detailed description of all work requirements that may be inherent in the job, or assigned by supervisory personnel. This job description is used as a guide only and not inclusive of responsibilities and job duties.

By my signature, I acknowledge that I have read and understand this job description and its requirement and that I am expected to complete all duties as assigned. I understand the job functions may be altered from time to time.