Essential Job Functions
"Conducts an initial patient/family assessment on every inpatient to determine psycho-social needs and discharge plans and completes Care Coordination Assessment within the first 48 hours of admission to determine need for Care Coordination intervention.
"Performs documentation on a weekly basis in patients' medical charts. Documentation shall include significant patient data, problems defined, assessment goals, treatment plans, date and action taken, summary of same and follow-up activities when indicated. Documentation shall occur more frequently if the situation changes.
"Participates as a member of the Multidisciplinary Rounds.
"Performs a consultative role with staff regarding patients/families.
"Communicates clinical status updates to patients/families and other involved individuals.
"Regularly evaluates the appropriateness of the treatment plan in relation to the progress of the patient toward the attainment...