Furnishes those services requiring substantial and specialized nursing skill. 

Initiates appropriate preventative and rehab nursing procedures. 

Prepares & submits timely, clinical and progress notes. 

Oversees coordination of client services. 

Informs MD and other staff of changes in PT situation or needs. 

Completes medical history/home safety check/environmental assessments. 

Performs socio-psychological evaluation. 

Performs assessment visit and documents timely. (i.e., OASIS/ Skilled Nursing Note etc.). 

Performs physical examination and review of all body systems and documents accordingly. 

Develops individualized Plan of Care (POC) to be submitted to the physician for approval and implementation and performs necessary revisions based upon client needs. 

Determines medical necessity for other services. 

Regularly re-evaluates the client’s nursing needs. 

Evaluates the client’s ADL and iADL abilities and need for home health aide. 

Develops and implements the HHA plan of care when HHA services are ordered. Revises and signs this care plan at the beginning of each certification period. 

Supervises HHA in accordance with state/federal requirements and documents the supervision. 

Orders “other” professional services that may be appropriate to the needs. 

Reviews billing processes with client and/or family advising client and/or family when co-pay or Medicare is not likely to pay for services.  

Effectively communicates ongoing with client and family progression/changes in POC.  

Effectively communicates with Supervisor/Supervising nurse/other disciplines in the case. 

Communication with the client’s MD (verbally and/or in writing) to obtain effective treatment modalities and/or rehabilitative therapy modalities. 

Actively communicates in the case conferencing sessions to establish best practices. 

Submits requests for re-authorization of “more visits needed” to payers timely. 

Coordinates Community Services for the client to assist in safe home care needs. 

Participates in the QAPI Committee process. 

Performs timely CRR per Agency policy in collaboration with the Nursing Supervisor.  

Participates in ongoing staff meetings/in-services.  

Participates in the growth of office by being a willing preceptor for same discipline employees. 

Participates in the planning, operation, and evaluation of the nursing services of the organization. 

Maintains professional licensure per state requirements. 

Notifies the Agency of emergencies, sickness, and other imminent occurrences that may affect the client caseload as quickly as possible relative to the event’s occurrence. 

Submits written time requests 2 weeks or more in advance of planned time off. 

Other duties as assigned. 

An active license to practice professional nursing in Texas.  

Preferably completed a BA degree program. 

A minimum of two (2) years of experience as a professional nurse, with at least (1) year of experience, preferably in community/home healthcare. 

Will pass a criminal background check and any other required checks. 

Must have current CPR certification.