Registered Nurse - Home Care

Grand Itasca Clinic & Hospital, a part of Fairview Health Services, is currently seeking a dedicated Registered Nurse to join our Home Care team!

About the Position:

• Home Care Registered Nurse
• Part Time .6 FTE (48 hours per pay period)
• Work Schedule: Days
• Internal posting through 6/24/2025

JOB SUMMARY: The Home Care RN plans, organizes, coordinates and provides skilled nursing care to home care patients of all ages according to a plan of care, including advanced nursing interventions related to the patients' needs while following agency, State and Federal regulations through the competent application of primary nursing through a case management model. RN must possess the ability to function independently yet be a team player. Strong communication, organization, documentation and interpersonal skills are required.

Here's what you'll do when you join us:

1. Planning: ongoing development and implementation of the plan of care

• Assesses and continually reassesses the patient's health status, environment, and support system through ongoing comprehensive assessment.
• Develops and maintains an individualized plan of care, related to the patient's needs, in collaboration with the patient/family, provider and interdisciplinary team.
• Evaluates the patient's progress and response to care/services delivered and adjusts the plan accordingly. Continually evaluating whether the patient's clinical needs can be safely met at home, the patient is able to care for themselves or has a primary caregiver and whether the home environment supports home care services.
• Continually reassess resource utilization as patient progresses towards goals. Reviews, prioritizes and implements POC based on patient need taking into consideration payer limitations.
• Completes assignments by managing all anticipated patient's care needs during visit and through next planned nurse visit.

2. Service delivery

• Provides specialized nursing skill in accordance with the plan of care and provider orders.
• Demonstrates competency in all skills required for the agency including but not limited to, wound vacuum, cauterization, TPN, medication management, venipuncture, infusion therapy, CADD pump, infusion therapy device care, wound care and aseptic technique.
• Teaches and supervises LPN, HHA, patients, caregivers and ALF facility staff as needed.

3. Coordination of services

• Communicates consistently and effectively with the patient, caregiver, providers and interdisciplinary (internal and external) team members to assure appropriate implementation and completion of the patient's plan of care.
• Participates in care conferences and communicates any changes in plan of care to the interdisciplinary care team.
• Addresses concerns and makes referrals to other disciplines and community agencies when needed.
• Manages patient expectations.
• Advances the POC with the multidisciplinary team. Consults with the other team members as needed to make modifications in the plan. Decreases utilization of services as patient moves towards goal achievement.
• Communicates/coordinates with the support team; including, but not limited to billing, coding, clinical resource, utilization review and insurance specialists.

4. Control

• Maintains complete, accurate and legible clinical records/ documentation on all patients according to agency policy.
• Meets all compliance measures i.e. provider orders, insurance authorization, patient rights
• Submits all documentation timely.
• Maintains fiscal accountability i.e. good steward of resources, visit utilization, mileage, visits and supplies within payer limits and maintains productivity standards.
• Responsible for completion of record audits and in-home observational audits.

5. On-call as scheduled to make un-planned and short notice home visits and to responds to patient needs.

6. Professional development

• Participates in professional growth and self-development activities to ensure accountability for own professional nursing practice.
• Maintains licensure
• Responsible to maintain OASIS competency to maximize appropriate reimbursement and accurate Home Health Compare scores.