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LHC Group Registered Nurse in Marquette, Michigan

Job Summary The Registered Nurse in Home Health provides and directs provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations and agency policies. Also, coordinates total plan of care with other health care professionals involved in care, and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources. All done within a Point of Care setting. License Requirements liCurrent RN licensure in state of/li liCurrent CPR certification/li liCurrent Driverrsquo;s License, vehicle insurance, and access to a dependable vehicle or public/li /ul Essential Functions liProvides clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team./li liMakes the initial and/or comprehensive nursing evaluation visit, determines primary focus of care, develops the plan of care within State specific guidelines, and submits accurate, complete, and timely documentation, per policy./li liRegularly evaluates and re-evaluates (as warranted by changes in condition but at least every 60 days) the patient's nursing needs./li liPerforms patient comprehensive assessments at designated time points and develops the appropriate POC, in collaboration with physician orders./li liEnsures patients meet home health eligibility and medical necessity guidelines as defined by payer source./li liInitiates, develops, implements and makes necessary revisions to the plan of care in collaboration with the physician and other health care professional's involved in care./li liMakes referrals to other disciplines, as indicated by patient's assessed need./li liResponds to outcome coordinator|coder and Patient Care Manager requests for clarification to OASISassessments on the same day that the request for more information is sent./li liPlots patient encounters for the episode and determines needed RN encounters based on patient's needs and regulations./li liInstructs and supervises the patient's family|caregiver in the care of the patient and maintenance of a healthy environment for the patient./li liActively participates in weekly case conferences./li liMaintains a current and accurate patient medication profile./li liAfter start of care (SOC) assessment, reports the status of the patient, assessed needs, and plan of care overview to the team leader on same day (or by next business day if after hours)./li liObserves, records and reports to the physician and/or team leader the patient's signs and symptoms, response to treatment and changes in the patient's condition, as appropriate. Ensures adequate Team Leader (TL) communication when physician follow-up is needed./li liCommunicates changes in visit assignments, dates of scheduled visits, and schedule changes to scheduler and Patient Care Manger to ensure patient needs are met./li liCommunicates timely and effectively with agency personnel and ordering physician as required to process orders and OASIS data sets, schedule home visits, and deliver services to patient as ordered by physician and in accordance with applicable laws and regulation./li liFacilitates hand-off communication to RN and PCM who will cover patients in their absence, prior to scheduled days off./li liPerforms regular and supervisory visits according to the plan of care and submits complete