Job Description
REPORTS TO: Clinical Manager
JOB SUMMARY:
Plans, coordinates, provides and documents care for patients in compliance with applicable laws, regulations and standards and Agency policies and procedures. Adheres to Medicare and Medicaid regulations.
DUTIES AND RESPONSIBILITIES:
Performs initial and ongoing patient assessments in response to patients’ needs and in accordance with physician orders.
Initiates a written plan of care, re-evaluates and updates the plan as necessary.
Provides skilled nursing care within the nursing scope of practice.
Documents skilled care and/or services provided in compliance with federal and state laws and regulations, and Agency policies and procedures.
Initiates case conferences to discuss multidisciplinary team responsibilities, patient progress, plans for continued care, to assure patient care needs are met.
Addresses and supports patient/family cultural practices, as long as such practices do not harm others or interfere with the planned course medical therapy.
Promotes and provides patient/family/caregiver education using various verbal and written communication techniques that take into account the patient’s/family’s cultural, ethnic, and/or personal needs or preferences.
Supervises Licensed Practical Nurses at least every 30 days and must include a visit to the patient’s home with or without the LPN present.
Supervises home health aides and ensures supervisory visits are performed every two weeks with or without the aide present, in the patient’s home.
Supervises homemakers and companion as required by state law.
Plans patient discharge appropriately; provides information about community resources to address patient ongoing needs.
Knowledgeable of federal, state regulations and Agency’s policies and procedures regarding patient care.