Job Description
To review, monitor, implement, educate and evaluate clinicians' documentation of treatment or plan of care given to their patients, to ensure the patient is getting the best practice skilled care. Educate clinicians in understanding and following Medicare guidelines and regulations. Ability to evaluate reports, survey tools, and other data against predetermined measurable criteria. Essential Functions Is capable of performing all the essential functions of a RN/LPN/LVN. Responsible for implementation and monitoring of the Agency's Quality Improvement program. Provides direction and coordination of quality improvement activities utilizing Agency's QA policy. Coordinates activities related to medical record review for data collection. Works collaboratively to assure documentation is complete and consistent with care and reflects legal, regulatory and Agency requirements. Participates in the development, implementation, coordination and maintenance of a program designed to identify problems, opportunities for improvement and resolutions that maximize quality of care rendered to home health care patients. Implements monitoring activities in accordance with the approved quality assessment and improvement plans. Accessible to clinicians and Admin Coordinator on the team throughout the day for any problems, questions, needs either by phone, fax, or in person. Participates in the review of documentation prior to being filed and maintained in the client's record for accuracy, skill and consistency. Implements monitoring activities in accordance with the approved Quality Assessment and Improvement Plan. Assists in the identification and implementation of appropriate measures for correction of identified problems or concerns in the delivery of home care services. Performs reassessment activities designed to ensure that identified problems or concerns have been eliminated or reduced to an acceptable level. Develops data collection tools to document quality assessment and improvement activities. Assists in the development of tools to illustrate pertinent data to the Utilization Review/Quality Assessment and Improvement Committee. Prepares and submits written quality summary reports for the Director of Quality Assurance or Compliance Officer. Audits documentation corrections and monitors the return of documented materials that are incomplete and/or not in compliance with Agency standards, policies and procedures. Analyzes charts for compliance and to facilitate billing process as assigned. Protects and maintains the confidentiality of quality assessment and improvement activities. Responsible for ensuring processes to monitor and evaluate safety, risk management and infection control. Educates and implements monitoring activities for safety, risk management and infection control. Acts as resource to staff in identifying safety and risk management issues for patients and staff. Reviews incident reports for completeness, risk, standard of care determination and appropriate follow-up. Maintains a log for trending and makes recommendations related to trends identified. Maintains current knowledge related to home care safety and infection control standards and Agency policy. Monitors Agency compliance with state federal guidelines. Maintains current knowledge related to Medicare Conditions of Participation and CHAP and other licensing bodies requirements. Participates in quality assurance activities as directed to monitor Agency compliance with regulations and regulatory bodies. Acts as clinical resource to staff. Maintains updated nursing knowledge and skills. Assists with staff education as needed. Assist with communicating information regarding changes in Agency operation. Participates in the development and implementation of quality assessment and improvement programs. Ensures clinicians are following best practice skills, documenting accurately, visiting/treating the patient per approved schedule and time and according to POC (plan of care) signed by physician. Participates in professional growth and development. Maintains professional and technical knowledge my attending educational workshops, reviewing professional publications, establishing personal and professional networks and participates in professional organizations or societies. Demonstrates current knowledge of quality assessment and improvement, communication and organizational principles. Maintains current professional licensure. Provides input to the development and revision of Agency clinical and administrative policies and procedures.