Job Summary

The Registered Nurse (RN) provides skilled nursing care to patients in their homes or place of residence. The RN is responsible for comprehensive patient assessment, care planning, coordination of services, and ongoing evaluation of patient needs in collaboration with the interdisciplinary team. The RN ensures care is delivered in accordance with physician orders, agency policies, and all applicable state and federal regulations.

Key Responsibilities

Patient Care

• Assesses the home environment and determines needs of patients and caregivers
• Perform initial and ongoing comprehensive assessments of patients’ physical, psychosocial, and environmental needs 
• Develop, implement, and update individualized plans of care 
• Make referrals to other agencies or services as needed  
• Provide skilled nursing services including wound care, medication management, IV therapy, and disease management 
• Deliver end-of-life care focusing on comfort, dignity, and symptom management for hospice patients 
• Educate patients and caregivers on disease processes, medications, and self-care techniques 

Care Coordination

• Collaborate with physicians, nurse practitioners, and the interdisciplinary team (therapy, social work, hospice aides, chaplain) 
• Coordinate care and services to ensure continuity of care across settings 
• Participate in case conferences and interdisciplinary team (IDT) meetings 

Documentation & Compliance

• Complete accurate, timely documentation in accordance with agency policy and regulatory requirements 
• Ensure compliance with Medicare Conditions of Participation, state regulations, and accreditation standards 
• Maintain current and accurate clinical records, including OASIS documentation for home health patients 

Quality & Safety

• Identify changes in patient condition and communicate appropriately to the care team 
• Participate in quality improvement (QAPI) activities 
• Follow infection control and patient safety protocols 
• Report incidents, variances, and patient concerns per agency policy 

Patient & Family Support

• Provide emotional support and guidance to patients and families 
• Support patients and caregivers through end-of-life transitions 
• Promote patient rights, dignity, and cultural sensitivity

Skills & Competencies

• Strong clinical assessment and critical thinking skills 
• Excellent communication and interpersonal skills 
• Ability to work independently and manage time effectively 
• Proficiency with electronic medical records (EMR) systems 
• Knowledge of home health and hospice regulations preferred
• Team-oriented with excellent customer service abilities

The above requirements are representative of minimum knowledge, skills, and abilities.  To perform this job successfully, the individual will possess the ability and aptitude to perform each duty proficiently

Physical Requirements and Working Conditions

The physical requirements represent those that an employee must meet to perform this job’s essential functions successfully. Reasonable accommodation for individuals with disabilities to perform the essential functions may be available. 

• Requires travel within the agency’s service area to provide care in patient homes and community settings. Exposure to varying home environments and conditions
• May require on-call, weekend, or holiday rotation 
• Ability to sit, stand, and walk for extended periods 
• Frequent use of hands for typing and document handling 
• Ability to lift upto50pounds occasionally and carry up to 25 pounds.

Education and Other Requirements

• Graduate of an accredited school of nursing with a current, active Registered Nurse license in the state of Pennsylvania 
• Current CPR certification
• Minimum of one (1) year of nursing experience required. Experience in home health, hospice, or community health preferred
• A valid driver’s license, reliable transportation, proof of auto insurance with acceptable driving history is required.

Core Values

Integrity: We build trust through responsible actions and honest relationships. 
Respect: We value the potential in each individual and treat all with dignity and compassion. 
Teamwork: We work together without barriers and encourage creativity through empowerment. 
Appreciation: We foster a culture that recognizes and rewards the contributions of each employee.