Arranges necessary health-care services for patients requiring nursing services in their homes. Evaluates and executes appropriate treatment for referred patients with emphasis on quality of care, continuity of services, and cost-effectiveness. Conducts initial assessment and establishes a plan of care for patients and provides direct patient care. Assumes responsibility for caseloads consisting of patients in specialty areas. Conducts initial assessment to obtain thorough physical, social and environmental data. Establishes the plan of care in accordance with the physician orders and patient needs. Provides direct patient care and adjusts nursing care processes as needed. Identifies problems, modifies nursing care plan, and evaluates outcomes within an appropriate time frame. Advises and consults with family and other personnel, as appropriate. Provides on-going assessment of patient response to treatments and teaching and applies interventions as appropriate. Updates and revises plan of care as indicated. Completes documentation including visit assessment, OASIS, 485 and verbal orders accurately and promptly and within the standards. Communicates with physicians to confirm and update patients' plan of care. Provides status updates and ensures ongoing communication with the physician and other members of the health care team. Facilitates the discharge planning process according to standards and utilizes resources to assure continuity of care after discharge. Participates in developing the discharge plan with the patient/family, physician, social worker, and other staff members as appropriate. Participates in chart audits and continuous quality improvement activities as requested. Identifies, develops and participates in process improvement opportunities that will enhance the quality of the services provided. Maintains and updates accurate clinical and patient records according to agency, state, and federal guidelines. Scheduled Hours M-F 8-430. This is a full time, salaried position providing home care visits in the Burlington/Walworth market. Job hours and FTE are flexible and would consider any FTE .5-1.0 for the right candidate. Minimal call and holiday requirements.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
11-50 employees