The Registered Nurse (RN) in Home Health provides and directs provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies.

• Coordinates total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources. All done within a Point of Care setting.

• Makes the initial and/or comprehensive nursing evaluation visit, determines primary focus of care, develops the plan of care within state specific guidelines, and submits accurate, complete, and timely documentation in collaboration with physician orders.

• Performs patient comprehensive assessments at designated time points and develops the appropriate plan of care.

• Ensures patients meet home health eligibility and medical necessity guidelines as defined by payer source.