Sacred Journey Hospice
The Hospice Nurse Case Manager plans and delivers care to patients utilizing the nursing process of assessment, planning, interventions, implementation and evaluation; and effectively interact with patient, significant other, and other interdisciplinary team members while maintaining standards of professional nursing and clinical competency.
• Operates under the Medical Director’s orders.
• Responsible for identifying and coordinating patient/family care to support terminally ill patients and families in home, skilled nursing facility or residential care facility. Frequency of patient / family contacts will be at the discretion of the Case Manager and his/her assessment of need, but will be a minimum of once per week.
• The Case Manager endeavors to utilize teaching, assessment, and intervention skills to provide comfort care and maximize the quality of life for the patients and families.
• Depending on the acuity of the patient, the Case Manager is expected to make 4-5 visits per day with documentation.
• Case load is approximately 12-15 patients for 40 hours/week
• Assess home care needs, being aware of the physical, emotional, and spiritual aspects and gather data on social, economic and cultural factors which may influence health, well-being and quality of life.
• Assist patients, family members or other clients with concern and empathy; respect confidentially and privacy and communicate in a courteous and respectful manner.
• Provide direct care to patients as prescribed in the Interdisciplinary Plan of Care to maintain the highest level of comfort and quality of life and assuming primary responsibility for case management.
• Evaluate and perform ongoing assessment and revise initial written plan of care with Interdisciplinary collaboration weekly or as the needs and conditions of the patient/family change.
• Authorize, coordinate and supervise care, as prescribed in the Interdisciplinary Plan of Care, with contracted vendors to meet the needs of the patient.
• Attend and participate in weekly Interdisciplinary team (IDT)
• Document accurate and ongoing assessment of patient status via a variety of mediums of communication (verbal, written, email, computer documents and databases). Document patient care reflecting nursing interventions, patient response to care, patient needs, problems, capabilities, limitations, and progress toward goals. Documentation includes evidence of appropriate patient/significant other teaching, and the understanding of these instructions is noted in the medical record. Maintain up-to-date charts and records on patient care and regular communication with the patient’s physician regarding changes in the patient’s plan of care.
• Investigate and follow through on unusual orders or requests for service or information.
• Maintains strict patient confidentiality and protect all patient rights.
• Participate in the agency’s on-call rotation as prescribed by the needs of the agency to provide nursing service to clients when required outside office hours.
• Be available, when possible, to meet a patient/family's need for continuous care in time of crisis.
• Coordinate community resources and other agency disciplines participating in patient care.
• Minimize non-productive time and fill slow periods with activities that will enable you to prepare to meet the future needs of the agency.
• Supervise and maintain ongoing effective communication with other hospice personnel involved with patient care. This may involve formal and informal team meetings in addition to IDT.
• Knowledge of and availability to perform patient intakes and information visits as needed including explanation of the hospice benefit/Medicare, complete physical assessment, completion of all pertinent paperwork, and communication of new patient status to the team.
• Knowledge and availability to handle patient overflow prn calls.
• Provide bereavement resources to the family as appropriate.
• Adheres to all policies, procedures and regulations regarding patient care, conduct, safety, fire, security, and risk management.
• Participation in SJH company functions including attendance at a minimum of one patient related function annually such as memorial service.
• Establish HHA plan of care as well as indirectly and directly supervising the plan of care per regulations.
• Perform as a member of the SJH team and participate in the philosophy of the agency.
• Performs other duties as assigned consistent with skills and training and the mission and goals of the agency.
• Understands and adheres to the Sacred Journey Hospice, Inc. vision and Organizational Philosophy, and advocates its philosophy.
• Follows the guidelines for universal precautions when providing patient care.
• Demonstrates a positive attitude and working relationship with staff members, volunteers, patients and families.
• Carries out duties and responsibilities of position in a manner that exemplifies excellent customer service.
• Consistently represent SJH to all internal and external customers ethically, with integrity and professionalism.
• Addresses patient’s needs by being responsive to phone calls and emails.
• Has a duty to report any potential misconduct or policy violations to supervisor and/or Administrator of SJH
• Has a duty to uphold nursing standards, hospice standards, federal and state laws
• Has a responsibility to participate in staff training and education programs.
• Must be a Registered Nurse licensed to practice in this state who has at least two (2) years healthcare related experience. One (1) year in hospice preferred.
• Must have current Basic Life Support Certification
• Must have reliable transportation and maintain a current driver license in the state and maintain automobile liability insurance.
• Must be able to understand, read, write and speak English.
• Must be able to relate positively and favorably to the patients, families and outside agencies and to work cooperatively with other Employees.
• Must understand and accept hospice philosophy and be knowledgeable of pain and symptom control as related to terminally ill patients.
• Must demonstrate autonomy, organization, assertiveness, flexibility and cooperation in performing job responsibilities.
• Must comply with acceptable professional standards and practice.
BrightSpring Health Services, and our family of brands, provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact the BrightSpring Disabilities Support Team at 1-833-773-7240 or contact us for assistance.
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