RN Hospice Case Manager – Hill Country Memorial Hospital – Fredericksburg, TX

Job Details

Description

  • Initial and ongoing comprehensive assessments of the impact of the terminal disease on the patients physical, functional, psychosocial, and environmental needs as evidenced by documentation, clinical record, IDG, team report, evaluations, and ADLs, (i.e., risk for grief, cultural and spiritual, verbal and non-verbal).
  • Apply specific criteria for admission and re-certification to hospice care to establish appropriate levels of care and the patient’s eligibility. Implement/develop/document the plan of care to ensure quality and continuity of care and recommend revisions to the plan as necessary.
  • Consult with and educate the patient and family regarding disease process, self-care techniques, end-of-life care, nutrition, and dietary needs. Prioritize any needs with the members of the IDG. Provide training to other staff as needed.
  • Determine scope and frequency of services needed based on acuity and patient/family needs. Assess the ability of the caregiver to meet the patient’s immediate needs upon admission and throughout care.
  • Initiate appropriate preventive and rehabilitative nursing procedures.
  • Applies concepts of infection control and standard precautions in coordinating and performing patient care activities to prevent contamination and transmission of disease.
  • Provide clinical directions to the Hospice Aide and LVN to ensure quality and continuity of service provided.
  • Prepare clinical and progress notes that demonstrate progress toward established goals. Ensure continuity of quality patient care delivered with appropriate documentation.
  • Inform physician and other personnel of changes in the patient’s needs and outcomes of the interventions, while evaluating patient and family response to care.
  • Monitor assigned cases to ensure compliance with requirements of third-party payor.
  • Demonstrate commitment, professional growth, and competency.
  • Promote Agency philosophy and administrative policies.
  • Perform on-call responsibilities and provide on-call service to patients and families as assigned.
  • Provide effective communication to patients, families, team members, and other health care professionals.

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