POSITION SUMMARY:

Under limited supervision provides and documents intermittent therapeutic, palliative, end of life skilled services in the patient’s place of residence.  Patient problems range from simple to very complex. Provides services when ordered by a physician and in accordance with the Medicare Conditions of Participation, California Hospice Standards, standards of The Joint Commission and accepted standards of nursing practice and LMVNA Policies and Procedures.

EDUCATION:

• Current state of California RN license and graduate from accredited nursing school; BSN preferred.
• Current CPR certification.

EXPERIENCE:

• Provides skilled nursing care as required by the plan of care for the patient.

ESSENTIAL JOB FUNCTIONS:

• Conducts and documents the nursing component of the comprehensive assessment on admission, recertification (90, 60 days) and/or when the patient’s condition warrants.
• Determines program eligibility, needed services and verifies payer sources.
• Reviews patient’s medications at every visit, maintains a list of current medications and reconciles the Hospice medication list with medication lists from other providers; e.g. inpatient discharge.
• Collaborates with the interdisciplinary care group (IDG) in developing and maintaining an individualized patient centered plan of care. Evaluates the patient’s response to care, updates the care plan and makes referrals to internal and external resources to meet patient’s needs.
• Develops and implements an individualized teaching plan for the patient and family/ caregiver with a goal of assisting the patient and family in reaching a safe and comfortable death in accordance with the patient’s wishes.
• Timely obtains physician orders for necessary care and services.
• Case manages assigned patients ensuring continuity of care and efficient and effective utilization of resources to ensure patient goals and desired outcomes are met.
• Communicates timely and effectively with physicians, Case Managers, Patient Care Coordinator(s), Senior Case Manager(s), Director(s), and appropriate members of the IDG regarding changes in the patient’s condition, plan of care, needs and goals.
• Ensures clinical documentation is complete, accurate, professional and submitted to LMVNA within 48 hours of the visit, patient/family or interdisciplinary care team interaction.
• Presents assigned patients at weekly care conferences.
• Proactively ensures patients have correct supplies.
• Supervises LVNs and CHHAs. Ensures a current CHHA plan of care is on record and available to the CHHA.  Makes CHHA supervisory visits at least every two weeks.
• Ensures that all required notices are provided to the patient or patient’s legal representative timely and in compliance with regulations.
• In collaboration with designated office staff ensures prior authorization requests are completed in accordance with policy.
• Monitors case communication follow up notes, e-mail and mailbox and takes appropriate action in a timely fashion.
• Meets or exceeds LMVNA productivity expectations.
• Works weekends and holiday rotations as assigned.
• Accurately and timely records and reports hours worked as required by state regulations.
• Identifies health and safety risks and implements risk reduction strategies for self and others according to LMVNA policy and procedure.
• Actively participates in quality improvement, in-services and other activities as requested or required.
• May serve as Preceptor to RNs and/or LVNs.
• Acts as a role model within and outside the agency.
• Maintains a positive and respectful professional attitude.
• Communicates regularly with Director(s) about department issues.
• Demonstrates flexible and efficient time management and ability to prioritize workload.
• Performs other related duties as assigned.

POSITION SUMMARY:

Under limited supervision provides and documents intermittent therapeutic, restorative skilled services in the patient’s place of residence. Patient problems range from simple to very complex. Provides services when ordered by a physician and in accordance with accreditation guidelines, Federal and State Rules and Regulations, accepted standards of nursing practice and LMVNA Policies and Procedures.

EDUCATION:

• Current State of California RN license.
• Current CPR certification.

EXPERIENCE:

• One year prior professional nursing.

ESSENTIAL JOB FUNCTIONS:

• Conducts and documents comprehensive nursing assessments.
• Accurately collects required data (OASIS) as part of the assessment at Start of Care (SOC), Resumption of Care (ROC), transfer, discharge, when there is a significant change in the patient’s condition and every sixty days.
• Determines program eligibility, needed services, and verifies payer sources.
• Reviews patient’s medications at every visit, maintains a list of current medications and reconciles the Home Health medication list with medication lists from other providers; e.g. inpatient discharge.
• Develops and maintains an individualized patient centered plan of care using critical thinking skills. Evaluates the patient’s response to care, updates the care plan and makes referrals to internal and external resources to meet patient’s needs.
• Develops and implements an individualized teaching plan for the patient and family/ caregiver with a goal of assisting the patient in reaching the highest level of independence possible.
• Timely obtains physician orders for necessary care and services.
• Case manages assigned patients ensuring continuity of care and efficient and effective utilization of resources to ensure patient goals and desired outcomes are met.
• Communicates timely and effectively with physicians, Case Managers, Directors, Supervisors and appropriate members of the interdisciplinary team regarding changes in the patient’s condition, plan of care, needs and goals
• Ensures clinical documentation is complete, accurate, professional and submitted to LMVNA within 48 hours of the visit, patient/family or interdisciplinary care team interaction.
• Presents assigned patients at weekly care conferences.
• Proactively ensures patients have correct supplies.
• Supervises LVNs and CHHAs. Ensures a current CHHA plan of care is on record and available to the CHHA.  Makes CHHA supervisory visits at least every two weeks.
• Ensures that all required notices are provided to the patient or patient’s legal representative timely and in compliance with regulations. These include, but are not limited to: Home Health Advance Benefit Notices (HHABN) and Notices of Medicare Non-Coverage (NOMNC).
• In collaboration with Team Coordinators ensures prior authorizations and TARs are completed in accordance with policy
• Monitors case communication follow up notes, e-mail and mailbox and takes appropriate action in a timely fashion.
• Meets or exceeds LMVNA productivity expectations.
• Works weekends and holiday rotations as assigned.
• Accurately and timely records and reports hours worked as required by state regulations.
• Identifies health and safety risks and implements risk reduction strategies for self and others according to LMVNA policy and procedure.
• Actively participates in quality improvement, in-services and other activities as requested or required.
• May serve as Preceptor to RNs and/or LVNs.
• Acts as a role model within and outside the agency.
• Maintains a positive and respectful professional attitude.
• Communicates regularly with supervisor about department issues.
• Demonstrates flexible and efficient time management and ability to prioritize workload.
• Performs other duties as assigned and complies with all policies of the organization

POSITION SUMMARY:

The Home Care Aide is responsible for providing services to clients at home needing care and assistance during the day and/or night under the direction of Livingston CareGivers policies, protocols and procedures.

QUALIFICATIONS & REQUIREMENTS: 

• Current CPR certification
• CA Home Care Aide Registration ID
• Minimum age of 18 years required
• Good verbal, written and reading skills in English
• Be able to drive yourself to and from your assignments
• Previous experience applicable to position

EDUCATION

• High School Diploma or equivalent
• Current CPR credential

ESSENTIAL JOB FUNCTIONS:

• Assists clients with personal hygiene, physical comfort, nutritional needs, and household activities to ensure a safe and clean environment.
• Communicates effectively and efficiently with the client, family, and/or caregiver regarding client’s needs and the services provided.
• Utilizes techniques of positioning, body mechanics and body alignment.
• Understands rationale and principles related to maintenance of skin integrity and need for infection control.
• Ensures client’s rights, including confidentiality of care.
• Conducts services in a caring, professional and ethical manner at all times.
• Assists with performance of procedures to ensure the physical well being and comfort of the client.
• Responds appropriately to emergencies.
• Participates with office schedulers and the Livingston CareGivers Director in a plan for client services and scheduled home visits.
• Submits legible, timely and accurate documentation for billing and payroll purposes.
• Able to work independently including prioritizing schedule of visits with minimum supervision.
• Must be able to work weekend requirements and variable shifts as needed.
• Must be dependable and able to report to assignments on time.
• Communicates in a timely manner with office staff regarding delayed arrivals or absences from assignments.
• Maintains a positive, respectful and professional attitude.
• Participates in process to maintain internal and external customer satisfaction.
• Performs all tasks according to policies regarding Infection Control and Universal Precautions.
• Performs other duties as assigned.

POSITION SUMMARY:

This position provides skilled nursing care to patients at home in accordance with state licensure requirements, Joint Commission guidelines, Title 22 regulations, nursing protocol and the organization’s policies and procedures.

QUALIFICATIONS & REQUIREMENTS:

• Current California LVN license and graduation from an accredited nursing school.
• Current CPR certification.
• One year of home health and/or acute care experience required.

ESSENTIAL JOB FUNCTIONS:

• Provides skilled nursing care as required by the plan of care for the patient.
• Prepares clinical notes and progress notes as required, and submits documentation within 48 hours.
• Documents skilled nursing care appropriate for billing and is aware of reimbursement issues.
• Attends and participates in interdisciplinary team meetings.
• Informs the nursing supervisor, physician and other interdisciplinary team members of changes in the patient’s condition and needs.
• Provides education and information to the patient and family in meeting nursing and related needs.
• Participates in educational programs to maintain skills and knowledge of current nursing practices; in case conference meetings to provide continuity of patient care; and in weekend work as needed.
• Performs other related duties as assigned.

POSITION SUMMARY:

This position provides skilled nursing care to patients at home in accordance with state licensure requirements, JCAHO guidelines, Title 22 licensure regulations, nursing protocol and the organization’s policies and procedures.

QUALIFICATIONS & REQUIREMENTS:

• Current California LVN license and graduation from an accredited nursing school.
• Current CPR certification.
• One year of home health and/or acute care experience required.

ESSENTIAL JOB FUNCTIONS:

• Provides skilled nursing care as required by the plan of care for the patient.
• Prepares clinical notes and progress notes as required and submits documentation within 48 hours.
• Documents skilled nursing care appropriate for billing and is aware of reimbursement issues.
• Attends team case conference meetings.
• Informs the case manager nursing supervisor, physician and other interdisciplinary team members of changes in the patient’s condition and needs
• Provides education and information to the patient and family in meeting nursing and related needs.
• Participates in educational programs to maintain skills and knowledge of current nursing practices; in case conference meetings to provide continuity of patient care; and in weekend work as needed.
• Performs other related duties as assigned

POSITION SUMMARY:

This position works with the Certified Wound Ostomy Continence Nurse Specialist II providing consultation to clinical staff regarding wound management and ostomy care regarding patients on care with home health and hospice.  This person acts as a consultant in a hospital setting in accordance with state licensure requirements, accreditation guidelines, Title 22 regulations, and the organization’s policies and procedures.

EDUCATION:

• Certificate in Enterostomal Therapy from an accredited school of Enterostomal Therapy or CWON Certification Board.
• Current CPR.

REQUIREMENTS:

• Current RN license for the state of California.
• Two years experience in home healthcare or acute care in this specialty.

ESSENTIAL JOB FUNCTIONS:

• Manages Wound Advisor, verifies that each wound type and protocols are appropriate and current. Initiates revisions to plan of treatment as necessary.
• Using Wound Advisor, a software program that allows photographs of patients’ wounds to be uploaded to the e-record, is able to provide consultation to clinicians and physicians regarding wound care.
• Manages Wound Advisor protocols and makes changes as appropriate.
• Mentors staff in use of Wound Advisor.
• Provides educational classes for the staff as needed in coordination with the Director of Education.
• Provides education and instruction to patients and their families.
• Participates and instructs in specialty related inservices for the organization and external professional organizations/associations as appropriate/required.
• Participates in QI process related to specialty services.
• Demonstrates knowledge of OASIS documents, performs OASIS visits as needed on appropriate patients (ostomy or difficult wounds).
• Interacts with insurance coordinator and DME provides as appropriate.
• Acts as a liaison for the agency with hospitals and other referral sources and provides them with specialty (CWON) information and instruction.
• In collaboration with Team Coordinators and Case Manager ensures prior authorizations are completed in accordance with policy.
• Proactively ensures patients have correct supplies.
• Attends and participates in weekly case conferences.
• Identifies health and safety risks and implements risk reduction strategies for self and others according to organization’s policies and procedures.
• Communicates regularly with supervisor about department issues.
• Demonstrates flexible and efficient time management and ability to prioritize workload.
• Monitors case communication follow up notes, e-mail and mailbox and takes appropriate action in a timely fashion.
• Accurately and timely records and reports hours worked as required by state regulations.
• Demonstrates assertiveness, leadership and good interpersonal skills with physicians and clinicians. Maintains good internal and external customer satisfaction.
• Maintains a positive and respectful professional attitude.
• Acts as a positive role model within and outside the agency.
• Performs other related duties as assigned.

POSITION SUMMARY:

This position is responsible for providing para-professional healthcare, nursing, and supportive services in the
Home Health and Hospice Departments under the direction of licensed nursing staff in accordance with state licensure requirements, accreditation guidelines, Title 22 regulations, Medicare Conditions of Participation, California Hospice Standards, and LMVNA’s policies and procedures.

QUALIFICATIONS & REQUIREMENTS:

• Current CPR certification.
• Minimum age of 18 years required.
• Good verbal communication in English.
• Reading and writing skills in English.
• Reliable automobile transportation.
• Bilingual Spanish/English preferred.
• Certification as a Home Health Aide
• Two year certification as a Certified Nursing Assistant from the California Department of Health.
• One year current experience in direct patient care preferred.

ESSENTIAL JOB FUNCTIONS:

• Assists patients to achieve maximum self-reliance.
• Assists patients with personal hygiene, physical comfort, nutritional needs, and household activities to
  ensure a safe and clean environment.
• Ensures patients’ rights, including ethics and confidentiality of care.
• Utilizes proper techniques for positioning and body alignment using safe body mechanics.
• Understands rationale and principles related to maintenance of skin integrity and need for infection
  control.
• Participates in care planning with the interdisciplinary team members.
• Checks equipment and supplies for proper function and maintenance.
• Responds appropriately to emergencies.
• Submits timely and accurate documentation for billing and payroll purposes.
• May assist patients with self-administered medications.
• Works independently, including prioritizing the daily schedule of visits, with minimum supervision.
• Provides proof of participation – a minimum of 12 hours of in-service training during each 12-month
  period.
• Participates in QI process as assigned.
• Works weekends and holidays as required.
• Participates in process to maintain internal and external customer satisfaction.
• Meets LMVNA daily productivity standard.
• Performs other related duties as assigned.
• Maintains a positive, professional and respectful attitude.

POSITION SUMMARY:

The purpose of this position is to assess, monitor, and advance Hospice clinical practices, focusing on compliance, documentation, CMS requirements for quality reporting operational procedures and case management using the processes of Quality Improvement, Utilization Review and critical thinking. This person works in collaboration with the Director of Rehab, Palliative Care, and QAPI/Clinical Manager and Director of Patient Care Services Hospice to assure compliance with licensing and accreditation requirements, Medicare Conditions of Participation, the California Hospice Standards and LMVNA’s policies and procedures.

QUALIFICATIONS & REQUIREMENTS:

• Registered Nurse with current California RN License (BSN preferred)
• Certification in Hospice and Palliative Care preferred
• Two to three years of hospice practice preferred
• Comprehensive knowledge of the Medicare Conditions of Participation for hospice, the California Hospice Standards and The Joint Commission
• Demonstrates collaborative attitude and skill in problem solving
• Proficient computer skill

ESSENTIAL JOB FUNCTIONS:

• Assists with the development and implementation of standards and quality improvement mechanisms that assures safe quality services to patients and their families and to improve clinical outcomes when needed.
• Responsible for communication and being knowledgeable in all regulatory, compliance and CMS updates for the hospice department. Assist in implementing processes to assure compliance with new regulatory changes.
• Act as Hospice Quality Assurance and Performance Improvement Director Designee in the absence of the QAPI Director.
• Monitors quality and completion of documentation by Hospice clinicians and implements strategies to improve clinical documentation and meet the standards of the various accrediting and regulatory bodies.
• Audits for hospice delivery of care via chart review and field visits.
• Effectively utilizes the CMS quality reporting measures and patient/caregiver satisfaction surveys.
• Participates in team-based orientation of new staff. Provides education to new hires for hospice on documentation and delivery of care. When requested, fulfills the role of hospice preceptor.
• Uses data from a variety of internal and external sources to assist in the evaluation of the processes and patient outcomes and in identifying and prioritizing opportunities for improvement.
• Uses available data to track utilization of clinical services and impact outcomes. Create and update the CTI as necessary from a clinical prospective and be a resource to the hospice clerical department for the completion of the CTI. Provides oversight throughout the hospice length of stay for continuity of care, following of the IDG care plan and utilization of appropriate disciplines.
• Exemplifies a collaborative attitude and demonstrates: 1) ability to function as a consultant, 2) ability to role model integrity, compromise, and professional self-confidence.
• Promotes and facilitates understanding of the fiscal impact of all clinical practices and documentation.
• Actively participates as one of the clinical liaisons between electronic medical records, the IT department, and the hospice department.
• Maintains a positive, professional, and respectful attitude.
• Performs other duties assigned and complies with all policies of LMVNA

POSITION SUMMARY:

This position provides bereavement counseling, education and resource referrals to bereaved family and friends of hospice patients as well the community at large. This is in accordance with accreditation guidelines, Medicare and State regulations and Livingston’s policies and procedures.

QUALIFICATIONS & REQUIREMENTS:

• Masters degree in psychology or social work
• Clinical supervision by appropriate personnel for one hour for every 10 hours of patient contact required.

ESSENTIAL JOB FUNCTIONS:

• Facilitates Grief Support Groups for adults and adolescents by assisting survivors in working through issues of grief and loss and helping them access personal and community resources to reach their highest degree of comfort and support after experiencing a loss.
• Provides a setting that promotes comfort, dignity, and empowerment.
• Conveys knowledge of multi-cultural attitudes toward death and dying.
• Identifies manifestations of abnormal bereavement and provides appropriate referrals.
• Provides individual bereavement counseling when requested by supervisor.
• Maintains attendance records of groups and necessary documentation of client contact.
• Maintains confidentiality.
• Educates individuals and community about the hospice philosophy issues of death and dying.
• Maintains a positive, professional, and respectful attitude.

POSITION SUMMARY:

This is an entry level coding position that reviews active patient medical records and assigns applicable ICD codes according to current CMS and NCHO guidelines.

QUALIFICATIONS & REQUIREMENTS:

• Associate Degree or equivalent from an accredited college or technical school.
• Certified but may have no less than one year experience as a coder.
• Acceptable certifications include:
  • Certified Professional Coder (CPC) by the American Academy of Professional Coders.
  • Certified Coding Specialist (CCS) or Registered Health Information Technologist (RHIT) by the American Health Information Management Association.
  • Home Care Coding Specialist — Diagnosis (HCS-D) by the Board of Medical Specialty Coding.

ESSENTIAL JOB FUNCTIONS:

• Reviews the medical record including, but not limited to, assessment, history and physical, discharge summary and clinical notes and completes the appropriate coding sections of clinician’s assessment by assigning and sequencing ICD codes as supported by the patient’s plan of care.
• Ensures the ICD codes accurately reflect the patient’s reasons for home care, recent changes in medical treatment as well as co-morbidities affecting care outcomes.
• Collaborates with Practice Advancement Specialists, Coder II or III as needed to resolve coding and/or documentation issues.
• Maintains current knowledge of home health coding conventions.
• Maintains a positive, professional, and respectful attitude.
• Performs and completes other duties as required.

POSITION SUMMARY:

The Nurse Practitioner works in collaboration with the Medical Director, patient physicians, and team members, in an active practice to deliver and support appropriate clinical care under Hospice federal and state conditions of participation and all LMVNA policies and procedures to ensure excellence involving all aspects of the patient’s clinical care.

The LMVNA Medical Director provides medical supervision, consultation, and guidance regarding the Nurse Practitioners daily clinical patient assignments, i.e., 180 day recertification, patient problem solving, and clinical compliance needs/concerns.

EDUCATION/EXPERIENCE:

• Possession of a current license to practice as a certified Nurse Practitioner in the State of California.
• Minimum of 5 years acute care experience or equivalent in training.
• Minimum of 2 years hospice and/or home health experience preferred.

OTHER REQUIREMENTS AND SKILLS:

• Valid Drug Enforcement Agency registration.
• Current CPR card.
• Demonstrates appropriate patient family assessment, pain management, and critical thinking skills.
• Must have strong computer knowledge, organizational, interpersonal, leadership, and team building skills.
• Must have excellent communication skills, written, verbal, and listening skills, allowing clear and concise communication with staff and patients.
• Must have strong clinical expertise in aggressive comfort care.

ESSENTIAL JOB FUNCTIONS:

• Adheres to the practice of confidentiality regarding patients, families, staff, and LMVNA hospice and palliative care services.
• Functions as an integral part of an interdisciplinary team in order to enhance the mission, policy, and philosophy of LMVNA hospice and palliative care services.
• Available to order and interpret laboratory and radiology tests when requested.
• May prescribe medications, including controlled substances, to the extent delegated and licensed, working hand-in-hand with patient’s primary care physician and LMVNA Hospice Medical Director.
• Orders treatment and durable medical equipment as necessary.
• Consults with referring, and primary care physicians, and designees as needed, providing written documentation on patient contacts and communications.
• Meets with LMVNA Hospice Medical Director weekly, as well as on an as-needed basis.
• Assists in providing training and continuing education for staff when appropriate.
• Conducts assessment, face to face visits on existing hospice patients for the 180 day recertification requirement.
• Works directly with LMVNA committees and teams as a medical liaison and representative – in support of program development and growth opportunities in relationship to CMS/COP’S State guidance, and Nursing licensure – to support and ensure compliance standards with QI and the LMVNA Hospice Nursing Department.
• Assists Medical Director in the research and alignment of patient records prior to LMVNA admission, for the medical review and determination process regarding Medical Director’s decision in relation to appropriateness or diagnosis and (LCD) outlines being satisfied/met for hospice admission criteria.
• Maintains a positive, professional, and respectful attitude.
• Performs other duties as assigned.

POSITION SUMMARY:

This position is responsible for providing assessment, continuity of treatment and instruction of home health care to patients whose abilities to cope with tasks and activities of daily living are threatened or impaired by development deficits, the aging process and physical injury or illness in accordance with accreditation requirements, Title 22, licensure regulations and the organization’s policies and procedures.

EDUCATION/EXPERIENCE:

• Accredited school of occupational therapy, license in California, current certificate of registration AOTA.
• One year of successful experience in health care setting. Prefer at least one year of community health rehabilitation experience or home health.

ESSENTIAL JOB FUNCTIONS:

• Performs occupational therapy assessment and treatment as prescribed by the referring physician and in accordance with the LMVNA procedure manual and revises treatment plan as indicated.
• Instructs, monitors and progresses patient in the use of therapeutic and self-care activities to improve function and increase independence.
• Instructs family members, caregivers and other LMVNA personnel in the treatment program by encouraging them to follow through with those procedures that they can perform safely or supervise.
• Communicates with physician on a regular basis to keep him/her aware of patient’s plan of care, responses and status and ensures physician’s orders are followed.
• Communicates, coordinates and consults with other interdisciplinary team members regarding the patient’s plan of care, responses and status, including case conferences and HHA supervision.
• Demonstrates understanding of LMVNA and third party payor or treatment guidelines and documentation required for payment.
• Instructs LMVNA personnel as needed.
• Attends case conference meetings and prepares clinical and progress notes as required, submitting documentation in a timely manner.
• Participates in QE process as assigned.
• Understands and adheres to all licensing and certification regulations pertinent to job.
• Participates in a process to maintain good internal and external customer satisfaction. Responsible for maintaining integrity of the medical record for each patient whose care they are managing.
• Legibly documents skilled care and other patient-related forms accurately, timely and appropriately for reimbursement, regulatory and compliance mandates.