A Registered Nurse will provide in-home services to our patients.
- Provide admission, case management and follow-up skilled nursing visits for Home Health patients;
- Administer on-going care and case management for each patient, provide necessary follow-up as directed by the Clinical Manager;
- Provide hands-on care, management and evaluation of the care plan and teaching of the patient in accordance with physician orders, under Clinical Manager's supervision;
- Revise plan in consultation with physician based on ongoing assessments and as required by policy/regulation;
- Coordinate appropriate care, encompassing various healthcare personnel (such as Physical Therapists, Occupational Therapists, Speech Therapists, Social Workers, Home Health Aides and external providers);
- Report and document patient care/condition/progress to patient's physician and Clinical Manager on a continuous basis;
- Implement patient care plan in conjunction with patient and family to assist them in achieving optimal resolution of needs/problems;
- Coordinate/oversee/supervise the work of Home Health Aides and provide written instructions that reflect current plan of care;
- Discharge patients after consultation with the physician and Clinical Manager, preparing and completing needed clinical documentation;
- Prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes;
- Prepare visit/shift reports, updates/summarizes patient records in a timely manner and confers with other health care disciplines in providing optimum patient care.