Admissions RN - Hospice (Sunday to Thursday)

Coordinates patient information and performs comprehensive clinical assessments to determine hospice eligibility. Manages the admission process, including patient education, care planning, and documentation, while ensuring continuity of care with the interdisciplinary team.

About the role

The Admissions RN is responsible for the coordination of patient information in conjunction with the Director of Nursing, Director of Marketing & Business Development, Intake Coordinators, and Community Liaisons. Completes timely and compassionate hospice admissions in both hospital and home settings. Meets directly with referred patients to provide a comprehensive assessment of their clinical findings to the Hospice Medical Director for certification and admission to the hospice program or rejection from the program.

Once a patient receives verbal certification from the Hospice Medical Director, the Admissions RN coordinates all aspects of the patient's admission, including transportation to their home (when necessary), durable medical equipment, and medications related to their hospice prognosis. Inputs data into the patient's hospice medical record and communicates findings to the assigned hospice team for continuity of care.

The role requires strong clinical judgment, excellent communication skills, and the ability to provide emotional support during critical moments in the patient and family journey. The schedule may consist of home hospice admissions, hospital admissions, or a mix of both. Flexibility to assist with either type of admission is expected to meet patient and organizational needs. When available and necessary, the Admissions RN works as part of the clinical team to provide overflow nursing visits, emergency nursing visits, and death calls when other nursing staff is unavailable.

Reports to the Director of Marketing & Business Development and the Director of Nursing or designee. FLSA Status: Exempt/Salary.

Responsibilities

• Adheres to patient rights, abuse reporting, and confidentiality policies.
• Gathers, reports, and analyzes patient care data to create a comprehensive patient assessment and reports findings to the Hospice Medical Director for verbal certification of patient admission or refusal of admission.
• Immediately reports significant condition issues/safety issues to the Admissions Coordinator, Admissions Assistant, Hospice Medical Director, and assigned interdisciplinary team.
• Fosters and maintains effective working relationships between peers, professional staff, and other personnel within the community.
• Explains the hospice benefit to potential patients, their families, and representatives.
• Works with patients and families or caregivers upon admission to create a realistic Plan of Care and set of treatment goals.
• Supervises and delegates duties to Certified Nursing Assistants and Licensed Practical Nurses when needed.
• Anticipates overall care needs of newly admitted patients and coordinates with all hospice disciplines.
• Complies with all documentation policies/procedures for patient admission, including reviewing hospice admission criteria, gathering all patient data, reviewing pertinent H&P, and disseminating this information to the Hospice Medical Director and/or the assigned hospice interdisciplinary team.
• Completes all admission paperwork in the patient’s hospice medical record, same day unless prior approval is given for extenuating circumstances.
• Demonstrates good judgment with proper decision-making abilities.
• Participates in Interdisciplinary Team Meetings and other Performance Improvement Activities as needed.
• With previously established physician orders, may make Pronouncement of Death, call coroner, and complete process related to removal of body from location of death when on call or performing case management.
• Attends scheduled staff meetings and/or in-service training as required.
• Adheres to the departmental dress code requirements related to personal grooming and attire.
• Provides intervention and support as needed related to terminal illness and loss.
• Provides emotional and spiritual support and makes appropriate referrals to other team members.
• Assesses and addresses depression and fear associated with terminal illness.
• Facilitates communication among patient, family, and hospice team.
• Provides referral to community services and resources as needed.
• Identifies caregiver strain which may necessitate respite care relief and/or support.
• Provides personal care as assigned by the Interdisciplinary Team, Physician, Director of Nurses/Supervising RN, which may include:
  • Patient Admissions
  • Nursing Assessment/reassessment
  • Medication management, administration, and teaching
  • Comfort measures
  • Insertion/maintenance/removal of Foley catheters
  • Insertion/maintenance/removal of various IV catheters for pain control/comfort
  • Application/adjustment of oxygen, IV, NG, G-Tube, and other invasive lines as ordered by the physician
  • Vital signs (B/P, T, P, R)
  • Assist with ambulation/transfers
• Follows the State of Nevada Nurse Practice Act during all patient care activities.
• Follows policy and Lippincott Manual of Nursing Practice for clinical care.
• Visits potential patients to review and assess for hospice admission.
• Reports findings of potential patient assessments directly to the Hospice Medical Director for verbal certification of hospice admission or refusal of admission.
• Requests additional H&P when necessary to make final determination.
• Communicates findings to the Medical Director, patient's chosen Attending Physician, and Admissions Coordinator.
• Educates patient about hospice services, assessing needs and preferences, and referring patient for services needed and desired.
• Ensures the initial plan of care (POC) is based on a comprehensive physical, psychosocial, safety, age-related spiritual, financial, environmental, and cultural needs, resources, and preferences assessment.
• Ensures the initial assessment includes assessment of pain and symptoms, history of interventions and response, and pertinent knowledge base of patient/caregiver/family.
• Communicates patient findings to assigned RN Case Manager and interdisciplinary team.
• Works with CNA Coordinator to ensure appropriate aid needs of each patient are met immediately upon admission.
• Ensures all regulatory standards are met, including State, Federal, CHAP, and other regulatory bodies.
• Completes all communications and documentation accurately either electronically, in legible writing, or typewritten.
• Coordinates development of the initial Plan of Care with the Interdisciplinary team (IDT) members.
• Presents new patient admissions for the IDT meeting, when available, or ensures patient data is effectively communicated to assigned RN Case Manager or Director of Nursing.
• Maintains a positive, compassionate, and credible image during patient assessments and with referral sources.
• When available, works with the clinical team and Director of Nursing to assist with overflow patient visits, emergency patient visits, and death calls when no other nursing staff is available.
• Creates opportunities for new referrals when out in the community.
• Supports the philosophy, objectives, and mission of ProCare Hospice of Nevada.
• Maintains professional competency and licensure.
• Stays current with accreditation and both state and federal governmental regulations affecting hospice.
• Works well both independently and within the Interdisciplinary Team structure.
• Promotes a team approach through cooperation, mutual respect, flexibility, and dependability.
• Assists with the training of newly hired Admissions RNs in the department to ensure consistency of care.
• Maintains flexibility to complete after-hours, weekend, and holiday assignments when needed.
• Completes all admission documentation per policy and communicates necessary information to assigned RN Case Manager and interdisciplinary team.
• Must be able to complete three (3) admissions/evaluations per scheduled workday with flexibility to complete additional evaluations as needed and assigned.

Requirements

• Currently licensed as a Registered Nurse by the State Board of Nursing in the State of Nevada and in good standing with the Nevada State Board of Nursing.
• Prefer 1 year of experience as a registered nurse in hospice, home health, or geriatric care.
• Successful completion of a background check pursuant to NRS 449.188 and NRS 179A.100, pre-employment drug screen and physical, TB testing, previous employment and reference checking, and an MVR (may include verification of education).
• Able to read, speak, write, and understand the English language.
• Able to handle frequent interruptions, be flexible with schedule, and effectively manage time.
• Able to cope with emotionally charged situations encompassing patients, families, and other caregivers.
• Availability for prescheduled on-call hours, weekends, and holidays.
• Able to work in varied environments of care including hospitals, skilled nursing facilities, assisted living facilities, group homes, and personal residences.
• Able to utilize usual office equipment including computer, printer, calculator, copy machine, and standard nursing equipment.
• Reliable transportation, a valid driver’s license, and current auto insurance.
• Current CPR/BLS Certification.

Physical/Safety Requirements

• Must have the strength and endurance required for standing, going up and down stairs, walking, bending, and pushing, pulling, and lifting up to 50 lbs., as needed.
• Must utilize appropriate durable medical equipment as needed in a safe manner.
• Must use appropriate body mechanics as needed for safe patient care.
• Category I for potential exposure to blood/body fluids. Requires performance of procedures or other tasks in the work routine that involve an inherent potential for mucous membrane or skin contact with blood, body fluids, or tissues, or a potential for spills or splashes of them. Protective measures should be used while engaged in Category I tasks with exposure potential.
• Utilizes appropriate PPE as needed.
• Follows the designated plan of action in the event of a fire or other emergency/disaster.
• Regularly exposed to fumes or airborne particles, work-related stresses, and driving hazards.
• May be required to drive to meetings with clients, healthcare professionals, or patients' homes.
• The noise level in the work environment is usually minimal.
• In compliance with the Americans with Disabilities Act of 1990, the employer will provide reasonable accommodations to meet the work environmental and physical demands listed above.