Responsible for the overall case management of assigned patient caseload through the coordination of hospice services as determined in the Hospice Plan of Care. Provides patient physical and psychosocial health systems assessments for the purpose of developing the Hospice Plan of Care and "Goals of Care based on the patient's and family's needs and wishes.

BRONX TERRITORY

Qualifications:

Education Graduate from an accredited School of Nursing. BSN preferred.

Experience A minimum of one-year experience in Medical-Surgical nursing, in addition to experience in Community Health.

Hospice or Oncology nursing preferred.

Specialized Knowledge and Skills, License/Certification New York State RN licensure NYS valid driver's license

Responsibility: Manages patient care according to level designation (RHC, GIP, SNF).

Performance Standards:

Makes minimum number of visits as per level of care or arranges alternative coverage with Team Manager

Provide and document ongoing teaching with patient and caregivers, verbally and in writing to include

current list of medications, death and dying process

Provide and document ongoing assessment of safety

Provide and document ongoing teaching regarding changes in patient's ability to perform ADLs, disease

progression

Weekly and as needed review of hospice plan of care with caregivers and emphasis on calling hospice main

phone number for condition changes, questions

Thoroughly documents all medication changes, findings, teaching, and assessments in NetSmart