JobMesh

RN-Home Health and Hospice (H)

SSM Health · Fond Du Lac, Wisconsin, US

It's more than a career, it's a calling. WI-St.

Job description

It's more than a career, it's a calling. WI-St. Agnes Hospital Home Care & Hospice Worker Type: Regular Job Summary: Coordinates, facilitates and performs interdisciplinary plan of care through assessment and evaluation of patient condition and effectiveness of care under the direction of the attending physician by traveling to patient homes, Community-Based Residential Facilities (CBRF), assisted living locations, hospitals or other to meet patient and family/caregivers, assess patient care needs, acuity in relation to policies, procedures and regulations of home care and/or hospice services. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES - Assesses and coordinates patient's discharge planning needs with members of the healthcare team. - May perform point of care testing according to policies and procedures. - Collaborates, consults and communicates with physician regarding the plan of care and changes to patient status. Provides physician with regular updates on progress and recommends revision of plan care, documents status and communication in adherence with regulations. - Coordinates and communicates with multi-disciplinary team members and outside agencies as...