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VISITING NURSE HOSPICE, Case Manager
1. BASIC INFORMATION
Salary Grade: K
FLSA Status: Exempt
2. WORKING RELATIONSHIPS
Reports to: Clinical Supervisor
Works with: Care management team, internal staff and external customers including clients, physicians and referral sources
3. SUPERVISORY RESPONSIBILITY
4. POSITION DESCRIPTION
Basic Purpose of the Position:
Provides skilled nursing care to hospice clients in their homes or community health settings ensuring the delivery of outcome based, high quality, cost effective care
In general, most of the time will be spent in the following activities:
** Reviews referrals, and initiates contact with client and family
** Conducts a complete nursing assessment based on referral data, client/family interview, and clinical observation of patient health status. Demonstrates clinical expertise in symptom management and end of life issues
** Develops a plan of care in collaboration with client and all disciplines based on assessment data which documents need for services, appropriate discharge planning, short and long term goals, and the utilization of appropriate resources. Facilitates peaceful death and assures appropriate bereavement follow up through timely documentation of bereavement assessment. Modifies plan of care as conditions change
** Demonstrates understanding of payer information in order to maximize care planning. Utilizes Hospice Levels of care appropriately.
Follows IDT process of approving non-formulary medications, treatments and DME
** Initiates and maintains a client record utilizing the Agency's standard for documentation
** Makes follow-up visits to provide skilled care to assess disease progress and evaluates response to treatment so as to promote peaceful death; provides support to client/family utilizing teaching principles to promote and restore health and prevent disease and disability, as possible; coordinates care with providers. Utilizes interdisciplinary team members to support patient/family needs
** Teaches patients and reinforces client/caregiver teaching and education. Prepares/teaches/supports family regarding signs and symptoms of death, as appropriate.
** Refers, collaborates and coordinates all client care services. Consults with physician regarding client needs and plan of care
** Directs LPN s in carrying out the established plan of care. Directs Home Care Aides and supervises plan of care
** Refers client/family to other community resources as needed
** Attends and participates in in-service education program
** Seeks consultation and guidance from supervisor
** Participates in the evaluation of care given by paraprofessional staff
** Participates in health care programs
** Completes reporting requirements on a timely basis
** Participates in client care conferences, staff and group meetings
In addition, the position involves other duties such as:
After hours, weekend coverage and on-call responsibilities may be assigned according to business needs
Assumes the role of team leader on a rotating basis
Attendance at MSW facilitated hospice support group
Will actively participate in the performance improvement process known as H3W.
Performs other duties as assigned
As a Hartford HealthCare Partner, VNA HealthCare s services are based on four core values:
INTEGRITY: We Do the Right Thing
Our actions tell the world what VNA HealthCare (as partner with Hartford HealthCare) is and what we stand for. We act ethically and responsibly in everything we do and hold ourselves accountable for our behavior. We bring respect, openness, and honesty to our encounters with patients, families, and coworkers, and support the well-being of the communities we serve.
CARING: We Do the Kind Thing
Every VNA HealthCare staff member touches the lives of the patients and families in our
care. We treat those we serve and each other with kindness and compassion, and strive to better understand and respond to the needs of a diverse community.
EXCELLENCE: We Do the Best Thing
At VNA HealthCare, only the best will do. We work as a team to bring experience, advanced technology, and best practices to bear in providing the highest-quality care for our patients and families. We devote ourselves to continuous improvement, excellence, professionalism, and innovation in our work.
SAFETY: We Do the Safe Thing
Patients and families have placed their lives and health in our hands. At VNA HealthCare our first priority and the rule of medicine is to protect them from harm. We believe that maintaining the highest safety standards is critical to delivering high-quality care and that a safe workplace protects us all.
Licensure: Registered Nurse with a license to practice in the State of Connecticut
Education: Graduate of an Associate's or diploma program in nursing; graduate of NLN approved BSN program, preferred
Experience: One year nursing experience or one year nursing experience in a specialty; medical/surgery or home care, preferred. Computer skills preferred.