Essential Duties and Responsibilities include the following. Other duties may be assigned as necessary. Review the home health referral, updating & communicating any changes to other disciplines and to customer service center. Perform assessments within 24-48 hours of receiving a referral. Complete all documentation and forward to the office promptly within 24 hours of completion of in home visit. Develop rapport with the client and family ensuring privacy and confidentiality while obtaining accurate client history. Complete a physical assessment and communicate the findings and plan of care to the physician. Initiate evaluations to other disciplines (PT,OT,SLP,LPN,MHRN,MSW,RD,HHA ) or support services when indicated. Conduct Home health aide supervisory duties as required by internal policy. When appropriate, enter insurance authorization requests within 24 hrs of initial evaluation and continue to enter additional requests at the end of each authorization period. Organize daily assignments, setting priorities based on individual and overall needs of the clients while traveling to each home as scheduled. Ensure the clients have prescribed medications and/or treatment supplies, updating file as changes occur. Identify appropriate actions that will provide for continuity of care, an individualized teaching plan and the involvement of the individual and family/caregiver whenever possible. Formulate a plan of care to achieve expected outcomes through short and long term goals that are realistic and feasible in terms of resources, time, material, people and cultural relevancy. Revise the plan of care in response to changes in the individual's status or to adjust to the individual's response to care, and communicate and update with all disciplines, including PPL. Coordinate discharge planning with direct involvement of client, family/caregiver. Document any communication and/or orders from the physician. Attend PCH/ALF case conferences as scheduled providing weekly client reports to team and provide PCH/ALF monthly educational in-services as requested by facility. Maintain a high level of competency, growth and development, including ensuring license, CPR, TB testing, etc are current and in good standing at all times. Attend nursing staff meetings, quarterly educational in-services and yearly competency day. Perform on-call duties per agency requirements/assignment for non-business hours. Position may require after hours patient visits to achieve positive patient outcomes. Follows agency policies and procedures as per the Policy and Procedures of the company. Adhere/assist with company outcome goals as indicated by QI/home health compare tracking. Follow guidelines as indicated in employee handbook Participate in QA/OBQI initiatives with problem-solving via action items. Coordinate with Corridor to manage alerts and change requests Perform other duties as assigned by management.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree