Job Abstract

1. PURPOSE OF JOB:

Facilitates care coordination and discharge planning for the safe transition home with the goal to achieve optimal patient outcomes. Responsible for the development of appropriate, complete and individualized referrals for patients transitioning to home with Doylestown Health Home Health.

II. ESSENTIAL FUNCTIONS:

1. Collaborates with the case management department, physicians, and hospital staff to educate and identify patient home health needs after patient choice obtained by case management. (25%)

2. Assesses patient's home health care needs through review of the patient's medical record and interviews with the patient and/or family (25%)

3. Obtains essential information needed to determine an individual's appropriateness and eligibility for home health services. Acceptance to the program is based on admission criteria, patient needs and the ability for these needs to be met by the agency. (25%)

4. Responsible for running Visiting Nurse Daily patient Activity Distribution' report, fax patient transfer/discharge information and pertinent information as needed. Write coordination note, and notify appropriate staff. (25%)

Environmental Conditions:

Occasional

Frequent

Constant

0-33%

of the shift

34-66%

of the

shift

67-100%

of the

shift

Extreme cold

X

Temperature changes

X

Humid conditions

X

Exposure to blood and body fluids

X

Exposure to chemicals

X

Inclement weather conditions; inside/outside weather conditions

X

Extreme heat

X

Wet conditions

X

Exposure to fumes

X

Noise and vibration

X

Poor ventilation

X

Lifting:

Occasional

Frequent

Constant

0-33%

of the

shift

34-66%

of the

shift

67-100%

of the

shift

Sedentary

(1-10 lbs)

X

Light (11-20 lbs)

X

Medium

(21-50 lbs)

X

Heavy

(51-100 lbs)

X

Very Heavy over 100 lbs)

X

Carrying:

Occasional

Frequent

Constant

0-33%

of the

shift

34-66%

of the

shift

67-100%

of the

shift

Sedentary

(1-10 lbs)

X

Light (11-20 lbs)

X

Medium

(21-50 lbs)

X

Heavy

(51-100 lbs)

X

Very Heavy over 100 lbs)

X

QUALIFICATIONS:

A. Education: Registered Professional Nurse with current license in the Commonwealth of Pennsylvania from the Bureau of

Professional and Occupational Affairs. BSN preferred.

B. Experience: 3 years med-surg experience, home health or hospice preferred.

Other Skills: Ability to manage effectively to meet program goals and objectives. Excellent oral and written communication

skills. Strong organizational, time management and problem solving skills. Good understanding of reimbursement by

Medicare, Medical Assistance and Commercial Insurance.

Must maintain current Pa. driver's license and auto insurance to maintain employment in the VN/HC department.