RN-Home Care Skilled Nursing

Job Overview

Overview

The Home Care Registered Nurse (RN) uses clinical nursing knowledge, physical assessment, teaching and procedural skills to deliver high-quality patient care in the patient’s place of residence. The Home Care RN develops and oversees the home health plan of care under the direction of the physician and ensures appropriate interdisciplinary involvement to ensure the best outcome for each patient. The Home Care RN delivers patient care directed by the physician as established in the home health plan of care that is consistent with clinical best practices and results in high quality, improved outcomes and exceptional patient experience.

Why UnityPoint Health?

At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members.

Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.  Here are just a few:    

• Expect paid time off, parental leave, 401K matching and an employee recognition program.

• Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members.

• Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family.

With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together.  

And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.

Find a fulfilling career and make a difference with UnityPoint Health.

Responsibilities

Patient Care/Care Coordination

• Makes visits to the homes of patients requiring home health nursing services and assumes responsibility for an ongoing interdisciplinary assessment of the patient when they are the case manager.
• Performs initial and comprehensive assessments on all patients in accordance with agency policies and procedures.
• Performs nursing assessment at each visit in accordance with agency policies and procedures.
• Ensures quality and safe delivery of services to patients according to the care plan. Uses equipment and supplies safely, effectively, and efficiently.
• Provides the services that are ordered by the physician as indicated in the plan of care.
• Provides patient, caregiver and family counseling and education as indicated in the plan of care. Provides patient and family education using UnityPoint approved patient teaching materials only.
• Develops and continually updates a plan of care that specifies the care and services required to meet patient-specific needs determined during the comprehensive assessment and includes measurable outcomes that will occur as a result of implementing and coordinating the plan of care.
• Develops and updates patient’s discharge plan on every visit ensuring patient and caregiver education and training is facilitating timely discharge and measurable goals and outcomes are attainable, realistic and up-to-date.
• Assesses the need for plan of care updates and every visit and includes the patient and family in care planning decisions and communicates care plan revisions to the patient, representative, caregiver and all physicians issuing orders for the home health plan of care.
• Maintains accurate and timely documentation of clinical records and time/travel entries.Supervises home health aide and licensed practical nurse staff and documents supervision in the patient medical record.
  
• Identifies patient’s risks for hospitalization and/or emergency department use and proactively intervenes to prevent adverse events.
• Communicates with all physicians involved in the plan of care and other health care practitioners related to the current plan of care.
• Is responsible for obtaining physician orders prior to initiation of care and notifying the physician of any changes in the patient’s condition.
• Receives, relays and documents verbal orders in accordance with state and federal regulations and in a timely manner to prevent adverse patient outcomes.

Home Care Performance Criteria

• Delivers quality care and completes clear, concise and accurate clinical documentation of care provision in accordance with home health conditions of participation (CoPs), various payer home health coverage criteria, accreditation standards, professional standards for discipline/credential and the home health plan of care.
• Maintains competence in OASIS data collection and documentation and submits all initial and corrected assessments according to CMS guidance and agency policies and procedures.
• Participates in clinical review of records to monitor quality and accuracy, appropriate utilization, appropriate involvement of interdisciplinary team members, appropriate referrals and coordination of care.
• Participates in peer review and other quality assurance activities, as assigned.
• Uses appropriate infection control procedures and safety measure to protect employees and patients.
• Provides patient and family education using UnityPoint approved patient teaching materials only.
• Participates in case conferences, in-service programs and other meetings required to ensure coordinated and comprehensive care.
• Reviews all patient assignments prior to scheduling first visit and accepts patient assignments only for which qualified and competent in any specific care/technical skill/procedure needed.
• Participates as a member of the interdisciplinary team.
• Participates in quality assurance/performance improvement (QAPI) activities, as assigned.
• Maintains professional knowledge for discipline/credential/license ensuring inclusion of content specific to home and community-based care.
• Communicates professionally, effectively and timely to all team members and co-workers and responds to all communication in a timely manner including, but not limited to e-mails, phone communication and meeting follow-up responsibilities.
• Establishes and maintains positive interpersonal relationships with team members, patients and family members while maintain personal and professional boundaries.
• Assist with new employee orientation when necessary.
• Effectively plans, organizes, sets priorities and completes works assignments with minimum direct supervision per agency policy and within established time frames.
• Maintains productivity standards as defined by home care supervisor.
• Meets or exceeds agency expected outcomes related to patient experience and hospitalization utilization.
• Participates in evening, night and weekend coverage to ensure nursing services are accessible to all patients 24 hours a day, 7 days per week (schedules and rotations determined by region).
• Performs other duties as assigned by home care clinical supervisor and/or administrator.

Qualifications