Home Based Primary Care (HBPC) provides primary care to complex, chronically ill patients in their own homes. The patients are managed by a physician-led interdisciplinary team. HBPC's goal is to decrease unnecessary hospitalizations, and triage visits, and assist with preventing nursing home placement. The HBPC RN functions as a case manager for 21-25 assigned patients and is responsible for assessing and continually reassessing the needs of the veterans and caregivers, delivering nursing care in the home, and keeping physicians and interdisciplinary team members aware of changes in the patients' conditions. The HBPC RN is also responsible for assessing potential patients, presenting findings at the Interdisciplinary staff meeting, and recommending a plan of care based on the patients' needs. The case manager must be self-motivated, organized, flexible, responsible, and empathetic. The HBPC nurse must possess excellent critical thinking skills and excellent nursing assessment skills. Recent geriatric medicine and recent home health experience are preferred. Experience in case management is preferred. The ability to work well with different people and personalities is essential. Proficiency in computer skills is beneficial since all documentation is completed through a computerized patient record system. The position requires traveling in a 70-mile radius area from the Kerrville Medical Center using a government vehicle. Work Schedule: Monday-Friday, 07:30am-04:00pm or 08:00am-04:30pm Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Auhtorized Financial Disclosure Report: Not required
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.