The Hospice Nurse, RN is responsible for the coordination of all Hospice services in counties assigned in accordance with the Hospice philosophy, Agency goals, objectives, and policies.
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Abides by and supports 3HC's Compliance Program and Code of Ethics. 3HC's Compliance motto is "Compliance for all and all for Compliance". It is the intent of 3HC to comply with all applicable laws and regulations and that spirit is embedded in all aspects of our services and business practices. Our success hinges on doing things ethically and legally, to which, each and every employee plays a critical role.
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Creates positive experiences for internal and external customers that will meet their expectations. (External customers include our patients, families, referral sources, vendors, the community, etc. Internal customers are the people within the agency with whom you work.) Displays a high degree of courtesy, tact, and knowledge of services provided by the agency in all contact with staff, patients, and visitors.
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Provides comfort to patient/family to facilitate quality of life and death with dignity: (a) provides skilled nursing care as outlined in the physician's plan of care, according to 3HC's policies and procedures and as allowed by the Practice Act of the N. C. State Board of Nursing; (b) responsible for completing hospice admissions, educating patients and families on the hospice concept and the hospice benefit. (c) Plans, coordinates, provides and directs the delivery of compassionate, quality patient care. (d) actively participates in the coordination of all aspects of the patient's hospice care, in accordance with current professional standards and practice, including participating in on-going interdisciplinary comprehensive assessments, developing and evaluating the plan of care, and contributing to patient counseling and education. (e) Provides continuity of care to all hospice patients. (f) Assist the interdisciplinary team in the development and implementation of the patient/family care plan (g) Refers hospice patients to other services as needed. (h) Provides end of life care as outlined in plan of care and policy and procedures. Provides ongoing assessment of medicinal, DME needs. (i) Participates in QAPI and QI projects as requested. (j) assists the Social Workers with bereavement counseling as requested. Continuously evaluates the patient’s condition to provide support and nursing visits individualized to the patient need.
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Maintains current electronic documentation and downloads daily: (a) ensures complete documentation on an ongoing basis supporting Hospice guidelines & COPs. (b) assessment information to be entered in EMR and completed in 48 hours
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Ensures that the physician and/or Hospice Medical Director is involved ongoing with the patient's care: (a) reports to the physician/or Hospice Medical Director and other applicable personnel, reactions to treatments, including drugs, and change in the patient's physical or emotional condition and outcomes of intervention, and (b) consults with the attending physician and/or Hospice Medical Director concerning alterations of the plan of treatment and documents appropriate change of orders where necessary. Verifies that physician listed on order/plan of treatment will sign orders.
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Provides regular supervision to the Licensed Practical Nurses and paraprofessionals who are providing services to the patient according to CMS/Hospice guidelines. Ensures task assigned to the LPN: (a) are within the Nurse Practice Act, (b) Supervises LPN on every patient at least every 30 days. Ensures that care is provided by the nursing assistant: (a) provides the certified nursing assistant with a telephonic plan of care and specific duties to be performed (b) supervises and evaluates the care given at least every 14 days, and (c) participates in periodic conferences with supervisor concerning the certified nursing assistant's performance.
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Collaborates with supervisor to meet assigned productivity standard. Rotates weekday, weekend, and holiday "on-call" and "back-up call". During low hospice census: (a) covers visits in other offices as assigned by supervisor (b) makes home health visits, (c) visits referring hospice physicians for marketing, and (d) visits nursing homes and talks with administrators, (e) acts as a resource person for the community on the Hospice Program if needed, and (f) ensures referrals are evaluated timely with a NPU rate of less than 6%.
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Maintains regular communication with supervisor: (a) communicates problems of the patient(s) on a timely basis following chain of command, (b) communicates information using current process and technology available to 3HC, (c) coordinates hospice care with Director of Clinical Practice/Assistant Clinical Director and the IDG team.
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Ensures that 3HC can bill for services appropriately: (a) completes certifications and re-certifications within designated timeframes; (b) obtains verbal orders from Hospital, MD and attending within 48 hours of SOC; and (c) keeps up-to-date on reimbursement criteria and documentation requirements for all patients under his/her care and management, including preauthorization and re-authorizations for insurance.
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Stays abreast of overall patient care and improves nursing care skills: (a) participates in office staff meetings, hospice's quality assessment and performance improvement program, the intra-disciplinary team in the development and implementation of the patient/family care plan, patient care conferences, record audits, utilization reviews, quality improvement activities, and in-services; (b) attends and participates in interdisciplinary team conferences at least 75% of the time; (c) attends agency mandatory in-services, hospice sponsored in-service training/continuing education seminars, IDG and satisfies CEU requirements of the State Board of Nursing; and (d) strives to improve nursing care through continuing education, active participation in professional and related organizations and individual research and readings.
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Notify attending physicians, staff members and family members of patient deaths when they occur.
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Collaborates with contracted pharmacy regarding medication changes, administration, and recommendations. Share pharmacy recommendations with the attending MD.
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Collaborates with supervisor to meet assigned productivity standard. The hospice nurse floater is not required to take on call hours.
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Hospice, RN FLOATERS: On-call for base office per office need/rotation
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HH&HOSPICE NURSE, RN BAYLOR: (a) is responsible for working from 5pm Friday - 8am Monday; (b) provide specialized hospice training to other staff, family members and informal caregivers to insure adequate care; (c) develops and implements the patient care plan in cooperation with other agency professional and paraprofessionals who will be providing care to the patient in EMR (d) ensures complete documentation on an ongoing basis supporting hospice guidelines and COPs; (e) provides regular supervision to Licensed Practical Nurses and paraprofessional who are providing services to the patient according to CMS/HOSPICE guidelines; (f) turns in all paperwork to designated person in the office by 5:00pm on Monday and communicates laptop daily Saturday and Sunday. Makes verbal/written report of new admissions and ER visits to primary nurse Sunday night or Monday morning between 8am-9am; (g) collaborates with supervisor to meet assigned productivity standard; (h) completes scheduled visits after 5pm on Fridays as warranted and (i) works at least one weekend day.
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HH&HOSPICE NURSE, RN EVENING: (a) collaborate with supervisor to meet productivity of 100% for work hours 12pm-11pm Monday-Thursday; (b) covers on-call for clinical office Monday-Thursday and (c) visits done after 11pm will be paid at over quota rate and not considered part of quota.
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Hospice Admissions Nurse: Provide hospice admissions or tuck-ins; (a) develops and implements the patient care plan in cooperation with other agency professional and paraprofessionals who will be providing care to the patient in EMR; (b) ensures complete documentation on an ongoing basis supporting HH/hospice guidelines and COPs; (c) turns in all paperwork to designated person in the office next day as needed and communicates ipad daily. Makes verbal/written report of new admissions and ER visits to primary nurse as needed completed (d) collaborates with supervisor to meet assigned productivity standard; (e) completes scheduled visits as needed per productivity. (f) on-call per needs of the office.
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Demonstrates an interest in personal and professional growth for self and staff: (a) attends and participates in workshops, seminars, webcasts to keep abreast of current changes in rules, regulations, relating to job functions and department; (b) does individual reading and research; and (c) recommends educational opportunities for staff and encourages participation.
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Demonstrates a willingness to be cost effective in the use of agency resources, the monitoring of waste, and the proper and safe use of supplies and equipment.
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Adheres to 3HC's Personnel Policy and performs other appropriate duties as assigned by supervisor to promote the successful operations and future growth of 3HC.
3HC is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex or sexual orientation, age, marital status, gender identity, national veteran or disability status.
