There For You Home Care Services is looking to hire compassionate, self-directed Registered Nurses to provide skilled nursing care to patients in their homes. The Home Health RN assesses patient needs, develops and manages individualized care plans, delivers hands-on skilled care, and coordinates with physicians and the interdisciplinary team to help patients recover, manage chronic conditions, and remain safely at home. This role combines clinical expertise with strong documentation and independent judgment in a home-based setting.
Conduct comprehensive in-home patient assessments, including OASIS assessments at start of care, recertification, resumption of care, transfer, and discharge.
Develop, implement, and revise individualized plans of care in collaboration with the physician and interdisciplinary team, ensuring alignment with physician orders.
Provide skilled nursing services such as wound care, medication administration and management, IV therapy, catheter and ostomy care, disease management, and patient monitoring.
Educate patients and caregivers on medications, disease processes, treatment plans, safety, and self-care to support independence and prevent hospital readmission.
Coordinate care with physicians, therapists (PT/OT/ST), social workers, home health aides, and community resources.
Supervise and provide clinical direction to LPNs/LVNs and home health aides, including required supervisory visits.
Document all patient care accurately and timely in the electronic medical record (EMR) in compliance with agency policy and regulatory standards.
Ensure compliance with Medicare/Medicaid Conditions of Participation, PDGM requirements, HIPAA, and applicable state and federal regulations.
Complete accurate and timely OASIS documentation to support proper coding, care planning, and reimbursement.
Participate in case conferences, quality improvement initiatives, and on-call rotation as scheduled.
Manage a caseload independently, planning daily visit schedules efficiently across the service area.
