Affinity Hospice

Registered Nurse Case Manager


Birmingham, AL


Full Time

Affinity Hospice

Job Title: Registered Nurse

Division: Hospice

Report to: Clinical Director

Classification: Non-Exempt


Position Overview

The registered nurse plans, organizes and directs hospice services and is experienced in nursing, with emphasis on community health education/experience.  The professional nurse builds from the resources of the community to plan and direct services to meet the needs of individuals and families within their homes and communities.


Essential Job Functions

  • Must be able to read, write, speak, and understand the English language
  • Must have reliable transportation to travel to patient homes per patient schedule and agency needs, as appropriate
  • Using effective body mechanics, must be able to lift 20 lbs. floor to waist; lift 10 lbs. waist to shoulder; lift and carry 20 lbs. and push/pull 40 lbs.
  • Must be able to ensure agency is in compliance with all applicable federal, state, and local regulatory agencies
  • Must practice regular and dependable attendance per company policy and procedure  
  • Must be able to ensure qualified staffing is appropriate to meet the needs of the patients served
  • Must be able to interview, hire, train, evaluate, counsel, and supervise agency staff
  • Must be able to meet budgeted goals in all areas, including admissions, revenue, cost, and profitability
  • Must be able to develop and implement the Performance Improvement program, including the agency annual evaluation for the global region
  • Must be able to effectively implement all company programs
  • Must be able to develop a business plan to address opportunities for improvement, growth, and expansion, including staff for expansion
  • Must be able to sit, stand, bend, lift, and move intermittently throughout the work day
  • Must be able to communicate and function in an interdisciplinary team
  • Must be able to document and chart appropriately and within specific time frames
  • Must be able to follow physician orders and nursing treatment plans for patients
  • Must be able to (or assist with) lift, turn, move and position patients
  • Must be able to knowledgeably and competently deliver nursing care to patients
  • Must be able to evaluate patient needs through ongoing assessment and revise care plans based on changes in patient condition
  • Must be able to oversee and evaluate care given by LPN and HA


Specific Requirements

  • Must be able to read, write, speak, and understand the English language
  • Must have excellent verbal and written communication, organizational, problem solving, and basic math skills
  • Must be competent in standard Microsoft Office applications
  • Must comply with accepted professional standards and practice
  • Must have excellent observation and good nursing judgment
  • Must be able to concentrate and use reasoning skills
  • Must be able to interact professionally with the community
  • Must possess the ability to work harmoniously with professional and non-professional personnel
  • Must be knowledgeable of nursing practices and procedures based on state practice acts
  • Must be self-directed and possess leadership and supervisory skills
  • Must understand and follow company policies and procedures
  • Must possess the ability to make independent decisions when circumstances warrant such actions
  • Must have a valid driver’s license and auto liability insurance with automobile being in good working condition
  • Must be able to multi-task and accept additional duties as assigned
  • Must present a professional image
  • Must practice regular and dependable attendance


Education and Experience

  • Graduate of an accredited school of nursing. One (1) to two (2) years of recent acute care experience in an institutional setting
  • Current licensure in state and CPR certification
  • Bachelor’s degree, with one (1) year of hospice experience preferred
  • Management experience not required. Responsible for supervising hospice aides
  • Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist
  • Prolonged or considerable walking or standing. Able to lift, position or transfer patients.  Able to lift supplies and equipment.  Considerable reaching, stooping, bending, kneeling or crouching.  Visual acuity and hearing to perform required nursing skills
  • Licensed driver with automobile that is in good working order and insured in accordance with the organization requirements


Working Conditions

  • Will work in and travel to patient homes as well as agency office
  • Sits, stands, bends, lifts, and moves intermittently during working hours
  • Subject to frequent interruptions
  • Attends and participates in continuing education programs
  • Possible exposure to infectious waste, diseases, conditions, etc. including exposure to the AIDS and Hepatitis B viruses
  • Subject to hostile and emotionally upset patients, family members, caregivers, etc.
  • May work beyond normal working hours, weekends, and holidays as needed and in other positions temporarily as necessary
  • Involved with patients, associates, caregivers, government agencies/personnel, etc. under various circumstances


General Responsibilities

  • Completes an initial, comprehensive and ongoing comprehensive assessment of patient and family to determine hospice needs. Provides a complete physical assessment and history of current and previous illness(es)
  • Provides professional nursing care by utilizing all elements of nursing process and as defined in the state Nurse Practice Act
  • Assesses and evaluates patient’s status by:
  • Writing and initiating plan of care
  • Regularly re-evaluating patient and family/caregiver needs
  • Participating in revising the plan of care as necessary
  • Initiates the plan of care and makes necessary revisions as patient status and needs change
  • Uses health assessment data to determine nursing diagnosis
  • Develops a care plan that establishes goals, based on nursing diagnosis and incorporates palliative nursing actions. Includes the patient and the family in the planning process
  • Initiates appropriate preventive and rehabilitative nursing procedures. Administers medications and treatments as prescribed by the physician in the physician’s plan of care
  • Counsels the patient and family in meeting nursing and related need
  • Provides health care instructions to the patient as appropriate per assessment and plan
  • Assists the patient with the activities of daily living and facilitates the patient’s efforts toward self-sufficiency and optional comfort care
  • Acts as Case Manager when assigned by Clinical Director and assumes responsibility to coordinate patient care for assigned caseload
  • Completes, maintains and submits accurate and relevant clinical notes regarding patient’s condition and care given. Records pain/symptom management changes/outcomes as appropriate
  • Communicates with the physician regarding the patient’s needs and reports changes in the patient’s condition; obtains/receives physicians’ orders as required
  • Communicates with community health related persons to coordinate the care plan
  • Teaches the patient and family/caregiver self-care techniques as appropriate. Provides medication, diet and other instructions as ordered by the physician and recognizes and utilizes opportunities for health counseling with patients and families/caregivers.  Works in concert with the interdisciplinary group
  • Provides and maintains a safe environment for the patient
  • Assists the patient and family/caregiver and other team members in providing continuity of care
  • Works in cooperation with the family/caregiver and hospice interdisciplinary group to meet the emotional needs of the patient and family/caregiver
  • Attends interdisciplinary group meetings
  • Participates in on-call duties as defined by the on-call policy
  • Ensures that arrangements for equipment and other necessary items and services

are available

  • Supervises ancillary associate and delegates responsibilities when required
  • Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and in-service classes
  • Fulfills the obligation of requested and/or accepted case assignments
  • Actively participates in quality assessment performance improvement teams and activities
  • Instructs, supervises and evaluates hospice aide care provided every two (2) weeks
  • Performs comprehensive physical and psychosocial assessment on patients accurately and completely, including OASIS assessment, according to direction. Utilizes assessment information to establish appropriate plan of care, clinical goals and discharge plans for patients in collaboration with physician and patient/family/caregiver
  • Reassesses patient status and revises plan of care as indicated throughout episode.
  • Performs admission visit and completes all associated paperwork accurately and completely. Explains all patient rights and responsibilities to patients/families/caregivers per regulatory requirements. Verifies payer and advance directive information on admission visit. Coordinates necessary activity to satisfy Medicare and other payer regulations. Submits admission paperwork within 48 hours
  • Regularly promotes interdisciplinary communication and coordination of care by communicating and documenting pertinent findings to Clinical Director, care team members and physician. Requests changes in physician orders and adds disciplines as needed
  • Accurately and safely performs all infection control procedures and adheres to standard precautions and principles of safe body mechanics
  • Performs nursing interventions, including technical skills, wound care management, pain management and clinical program management accurately as ordered
  • Performs and documents routine daily visits, transfers of care, resumptions of care, recertification, discipline discharges and agency discharges according to regulatory/payer requirements and agency policy
  • Regularly re-evaluates patients to identify progress toward goal achievement. Reviews OASIS answers, coding and sequencing of diagnoses to ensure accuracy. Obtains orders and updates plans of care as needed throughout the episode of care
  • Participates in care conferences and mandatory staff meetings. Initiates conferences with patient/family/caregivers and physician as needed to ensure effective coordination of care provided
  • Identifies and documents changes in patient needs throughout episode of care. Communicates with physician and patient/family/caregivers. Provides written Notice of Medicare Non-Coverage and Hospice Advance Beneficiary Notice per regulatory requirements
  • Supervises care provided to assigned patients by LPN/LVNs and hospice aides. Provides accurate and complete written instructions and care plans as required. Ensures appropriate assignment and instruction of paraprofessionals by skill level and patient need
  • Performs supervisory visits for hospice aides per regulation to ensure safe and appropriate care (at least every 14 days for Medicare)
  • Handles patient complaints as appropriate and/or refers complaint to supervisor for appropriate resolution
  • Maintains knowledge of community resources and appropriately refers patients to resources as needed
  • Identifies medical supply needs of patient and ensures patient has adequate supplies to meet care needs without wasting resources
  • Submits DARS, clinical notes, reassessment visit forms as indicated by payer, and OASIS documents timely and per agency requirements
  • Meets productivity expectations and communicates change in schedule to Clinical Director /office
  • Participates in on call, holiday, weekend rotation as assigned

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

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