HOME CARE - RN CASE MANAGER

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NURSING SUMMARY/ PURPOSE OF POSITION

The Aultman Registered Nurse (RN) is a professional nurse that provides direct, primary nursing care to patients/residents. The RN delegates and coordinates patient care, based upon a documented assessment of the patient's/resident's needs. The RN supervises the care provided by individuals such as licensed practical nurses, patient care technicians/state tested nursing assistants/nurse aides, medical assistants, and etc., if applicable.

QUALIFICATIONS

• Graduate of an accredited school of nursing; BSN preferred.
• Current, active licensure as a Registered Nurse through the Ohio Board of Nursing.
• Maintain current, active BLS certification through the American Heart Association.
• Certification preferred for RNs meeting applicable certification eligibility requirements.
• Membership in professional nursing organization preferred.

RESPONSIBILITIES & EXPECTATIONS \u2013 colleague must be able to perform the essential functions of this position, with or without reasonable accommodation.

• RN applies the nursing process of assessment, planning interventions, accurately implements and/or delegates patient care, evaluates that care, and accurately communicates patient information in a timely manner.
• RN is a patient/resident advocate in conjunction with the other members of the healthcare team and fosters patient safety, comfort and satisfaction.
• Attains knowledge and competency that reflects current nursing practice.
• Demonstrates quality and effectiveness of nursing practice.
• Adhere to professional standards and guidelines, including ethical actions, relevant statutes, rules and regulations, during nursing practice.
• Collaborates with patient, family, and others in the conduct of nursing practice.
• Exhibits High Reliability Organization (HRO) tools and tones.
• Provides leadership in the professional practice setting and contributes to the professional development of peers, colleagues and students.
• Integrates research findings into practice.
• Responsible for timely review of emails, department communications and applicable learning assignments and completion as applicable.

SKILLS

• Proficient computer skills to complete tasks as required.
• Must be organized, able to effectively prioritize tasks and exhibit appropriate time management skills.
• Must be detail oriented while focusing on safe practices and quality care.
• Demonstrates effective communication.
• Effective appropriate and professional interactions with colleagues/physicians, patients and visitors.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, identity, family status, gender, disability, or veteran status.

Entity/Department/Position Specific Addendum

PHYSICAL REQUIREMENTS

PURPOSE: To identify specific functions job requirements and work environment factors that could affect job performance.

PHYSICAL DEMANDS

Never

Occasional

10-33%

Frequent

34-65%

Continuous

66% of the day

Remarks

Lifting

0-10 lbs

x

10-20 lbs

x

20-35 lbs

x

35-50 lbs

x

50-75 lbs

x

75-100 lbs

x

over 100 lbs

x

Forward

Reaching

x

Overhead

Reaching

x

Standing

x

Walking

x

Sitting

x

Climbing

x

Stairs/Ladder

x

Bending

Stooping

x

Pushing

Pulling

0-10 lbs

x

10-20 lbs

x

20-35 lbs

x

35-50 lbs

x

50-100 lbs

x

over 100 lbs

x

Grasping/repetitive

sustained

Fine motor

coordination

x

Vision: Near/Far

x

Hearing: ordinary

converstation/other

x

HAZARDOUS EXPOSURE CATEGORY \u2013 I

Entity/Department/Position Specific Addendum

Qualifications

• One year nursing experience preferred; home health experience desirable

Responsibilities & Expectations

• Responsible for the continuous review of the care of every patient on his/her caseload (average 20-25 patients) to include: appropriate utilization of services; ensuring continues skilled need and homebound status as required by the payer, review of documentation in the medical record, maintenance of interdisciplinary communication and discharge planning.
• Completes initial and comprehensive assessments of patients to determine home health care needs
• Determines appropriateness for home health and obtains orders for care and referrals for services as needed.
• Accurately complete all assessments, including OASIS assessments, reassessments, transfers, resumptions of care, discharges and significant change in condition in accordance with defined parameters
• Uses assessment data to develop the plan of care, including actual and potential problems
• Establishes long and short term goals based on nursing assessments and incorporates, therapeutic, preventive and rehabilitative nursing actions into the plan of care.
• Includes the patient/family/caregivers in the planning process, goal development and ongoing evaluation of the plan of care.
• Provides care inaccordance with provider orders and the plan of care
• Provides education and counseling to the patient/family/caregivers in meeting patient care needs and to meet established goals
• Documents all observations, interventions, significant findings and communications within agency established timeframes
• Completes assigned responsibilities in required timeframe and accepts additional duties and responsibilities based on the needs of the patient and agency
• Serves as a liaison between the agency, community resources, patients and their families. Manages and directs patients and caregivers toward appropriate and available agencies and community resources needed to ensure implementation of the plan of care
• Communicates with all appropriate providers regarding the patient's needs and reports changes in condition to the appropriate provider timely; obtains and implements orders provided
• Provides care and services in accordance with the requirements of various third party payor sources, Medicare and Medicaid, including the authorization of services
• Identifies and implements discharge planning needs prior to discharge
• Assesses for and initiates interventions to promote a safe environment
• Participates in the Quality Assessment Performance Improvement Program (QAPI)
• Complies with infection control and prevention safety policies
• Attends and participates in case conferences
• Coordinates arrangements for equipment and supplies for patient care
• Meets daily/weekly productivity standards established by the agency
• Completes annual competency and educational requirements within the required timeframes
• Protects patient health information according to the HIPAA privacy rule and Aultman Hospital policies.
• Supports the strategic goals of the organization
• Abides by the Aultman Code of Conduct at all times
• Must have reliable, personal transportation, valid driver's license and automobile insurance

Skills

• Ability to work independently and as part of a team

Working Conditions

• Shifts are scheduled or changed due to the staffing needs of the agency based upon volume and acuity
• Visits may be required during night or evening hours and during periods of inclement weather
• Works weekends and holidays as assigned or as applicable based on department needs
• Participates in on call rotation as assigned to cover departmental needs and schedules
• Travel within the agency designated service areas is required
• Subject to frequent interruptions and changes in priority throughout the assigned shift