Description

Essential Functions:

1. Is capable of performing all the essential functions of a RN/LPN/LVN.
2. Responsible for implementation and monitoring of the Agency's Quality Improvement program.
   
   • Provides direction and coordination of quality improvement activities utilizing Agency's QA policy.
   • Coordinates activities related to medical record review for data collection.
   • Works collaboratively to assure documentation is complete and consistent with care and reflects legal, regulatory and Agency requirements.
3. Participates in the development, implementation, coordination and maintenance of a program designed to identify problems, opportunities for improvement and resolutions that maximize quality of care rendered to home health care patients.
   • Implements monitoring activities in accordance with the approved quality assessment and improvement plans.
   • Accessible to clinicians and Admin Coordinator on the team throughout the day for any problems, questions, needs either by phone, fax, or in person.
   • Participates in the review of documentation prior to being filed and maintained in the client's record for accuracy, skill and consistency.
   • Implements monitoring activities in accordance with the approved Quality Assessment and Improvement Plan.
   • Assists in the identification and implementation of appropriate measures for correction of identified problems or concerns in the delivery of home care services.
   • Performs reassessment activities designed to ensure that identified problems or concerns have been eliminated or reduced to an acceptable level.
   • Develops data collection tools to document quality assessment and improvement activities.
   • Assists in the development of tools to illustrate pertinent data to the Utilization Review/Quality Assessment and Improvement Committee.
   • Prepares and submits written quality summary reports for the Director of Quality Assurance or Compliance Officer.
   • Audits documentation corrections and monitors the return of documented materials that are incomplete and/or not in compliance with Agency standards, policies and procedures.
   • Analyzes charts for compliance and to facilitate billing process as assigned.
   • Protects and maintains the confidentiality of quality assessment and improvement activities.
4. Responsible for ensuring processes to monitor and evaluate safety, risk management and infection control.
   
   • Educates and implements monitoring activities for safety, risk management and infection control.
   • Acts as resource to staff in identifying safety and risk management issues for patients and staff.
   • Reviews incident reports for completeness, risk, standard of care determination and appropriate follow-up. Maintains a log for trending and makes recommendations related to trends identified.
   • Maintains current knowledge related to home care safety and infection control standards and Agency policy.
5. Monitors Agency compliance with state federal guidelines.
   
   • Maintains current knowledge related to Medicare Conditions of Participation and CHAP and other licensing bodies requirements.
   • Participates in quality assurance activities as directed to monitor Agency compliance with regulations and regulatory bodies.
6. Acts as clinical resource to staff.
   
   • Maintains updated nursing knowledge and skills.
   • Assists with staff education as needed.
   • Assist with communicating information regarding changes in Agency operation.
   • Participates in the development and implementation of quality assessment and improvement programs.
   • Ensures clinicians are following best practice skills, documenting accurately, visiting/treating the patient per approved schedule and time and according to POC (plan of care) signed by physician.
7. Participates in professional growth and development.
   
   • Maintains professional and technical knowledge my attending educational workshops, reviewing professional publications, establishing personal and professional networks and participates in professional organizations or societies.
   • Demonstrates current knowledge of quality assessment and improvement, communication and organizational principles.
   • Maintains current professional licensure.
   • Provides input to the development and revision of Agency clinical and administrative policies and procedures.
8. Fulfills additional performance responsibilities as assigned and as necessary.
   • Performs Medical Records responsibilities as assigned and necessary. 

Medical Records Responsibilities for QA (If Applicable):

1. Handles communications efficiently and responsively.
   
   • Monitors and receives/distributes incoming faxes and mail.
   • Responds to Fieldstaff's inquiries related to the patient's clinical record.
   • Mails out/faxes documents requiring the physician's signature.
   • Tracks/monitors unsigned physician orders to ensure signatures are obtained in a timely manner according to Agency policy.
2. Manages all daily medical records accurately.
   
   • Sets up new patient records and files in the department.
   • Files clinical documentation on a regular basis.
   • Performs other file management tasks as requested.
   • Prepares discharged charts for storage.
3. Audits the end episodes following the patient discharge in compliance with Medicare regulations and Agency policies.
   
   • Maintains comprehensive working knowledge of Medicare documentation guidelines per Agency policy.
   • Reviews the documentation maintained in the client's chart in accordance with Agency policy.
   • Identifies compliance issues and present results to appropriate personnel.
   • Assists QA personnel with concurrent review and end episode chart review.
   • Works collaboratively under supervision to assure documentation is complete and consistent with care and reflects legal, regulatory and Agency requirements.
4. Fulfills additional performance responsibilities as assigned and as necessary.

Requirements

Physical Requirements: Visual/hearing ability sufficient to comprehend written/oral communication. Ability to deal effectively with stress.

Working Conditions: Works in office areas as well as in client homes and in assisted and independent living facilities. Sits, stands, bends, lifts, and moves intermittently during working hours. Interacts with clients, family members, staff, visitors, government agencies/personnel, etc., under all conditions/circumstances. Is subject to hostile and emotionally upset clients, family members, staff, visitors, etc. under all conditions/circumstances. Is involved in community/civic health matters/projects. May be exposed to infectious waste, diseases, conditions, etc., including exposure to HIV and hepatitis viruses. Communicates with the medical staff, nursing staff, and other supervisors. Maintains a liaison with clients, their families, support staff, etc. to assure that the clients' needs are continually met.

Qualifications: Graduate of an accredited school of nursing. Current licensure as a Registered Nurse (RN) or Licensed Practice Nurse (LPN)/Licensed Vocational Nurse (LVN) with appropriate State Agency. Minimum of one (1) year experience in home health care preferred. Basic Knowledge of state, federal, CHAP and other licensing bodies regulations and documentation guidelines. Organizational skills, ability to be flexible yet, set priorities based on changing regulations from Medicare, state and local agencies.

Certification and License Requirements: RN - current and in good standing; LPN/LPN - current and in good standing

Summary

To review, monitor, implement, educate and evaluate clinicians' documentation of treatment or plan of care given to their patients, to ensure the patient is getting the best practice skilled care.
Educate clinicians in understanding and following Medicare guidelines and regulations.
Ability to evaluate reports, survey tools, and other data against predetermined measurable criteria.