Start of Care (SOC) Registered Nurse
MUST HAVE HOME HEALTH START OF CARE / OASIS EXPERIENCE
$200 PER START OF CARE X ROUGHLY 10 ADMISSIONS PER WEEK
Department: Clinical Services
Reports To: Director of Nursing / Clinical Director
Position Type: RN – Full-Time, Part-Time, PRN, or Contract
Primary Function: Home Health Admissions / Start of Care
Agency: We Care at Home Healthcare
Position Summary
The Start of Care (SOC) Registered Nurse is responsible for completing timely, accurate, and comprehensive initial assessments for patients admitted to the home health agency.
The SOC Nurse manages the clinical admission process from the initial home visit through completion of all required admission documentation. The nurse ensures that each patient's assessment, medication reconciliation, plan of care information, physician/provider orders, and other required clinical documentation are completed accurately and submitted within agency-established timeframes.
This position is designed to support an efficient admission process and prevent delays in patient care, quality review, authorization, and billing.
Essential Job DutiesStart of Care Visits
- Complete Start of Care visits for newly admitted home health patients.
- Perform comprehensive head-to-toe nursing assessments.
- Evaluate the patient's current medical condition, functional abilities, home environment, safety risks, caregiver support, and skilled care needs.
- Verify diagnoses and relevant medical history.
- Review available referral and hospital/physician documentation before the visit.
- Identify immediate clinical concerns and communicate them promptly to the Director of Nursing.
OASIS & Clinical Documentation
When applicable to the patient and payer:
- Complete the OASIS Start of Care assessment accurately.
- Complete all required SOC assessment sections in the agency's EMR.
- Ensure documentation supports the patient's clinical condition and ordered services.
- Document functional limitations, risks, patient goals, interventions, and care needs.
- Ensure documentation is internally consistent throughout the SOC.
- Correct documentation deficiencies identified during QA review within the required timeframe.
Medication Reconciliation
- Obtain and document a complete medication profile.
- Compare medications in the home with available referral, discharge, and physician/provider records.
- Identify potential medication discrepancies.
- Contact the appropriate provider or clinical supervisor when clarification is required.
- Document medication reconciliation and follow-up appropriately.
Orders & Plan of Care
- Review referral orders and supporting documentation.
- Confirm that ordered services and frequencies are consistent with the patient's assessed needs.
- Collaborate with the DON/Clinical Director regarding the initial plan of care.
- Identify when additional or clarified orders are needed.
- Communicate significant findings or changes requiring physician/provider notification.
- Ensure required documentation is available to support the patient's admission.
Patient & Caregiver Education
Provide and document education regarding:
- Patient rights and responsibilities
- Agency contact information
- Emergency preparedness
- Medication management
- Fall and safety precautions
- Disease-specific education as appropriate
- Infection prevention
- When to contact the agency, physician/provider, or emergency services
- The patient's individualized plan of care
Admission Documentation & Timeliness
The SOC Nurse is responsible for ensuring the admission is completed—not simply performing the home visit.
The nurse must:
- Complete the SOC visit on the scheduled date unless a documented patient, provider, or agency-approved circumstance prevents completion.
- Submit the initial SOC documentation within 24 hours of the SOC visit, unless agency policy requires a shorter timeframe.
- Complete outstanding corrections or QA requests promptly.
- Communicate missing orders, records, medication information, or other barriers immediately rather than allowing the chart to remain incomplete.
- Maintain an organized workload to support the agency's weekly admission goals.
Agency Performance Standard: SOC documentation should be substantially complete and ready for QA review within 24 hours of the visit.
Communication & Coordination
- Communicate completed admissions to the DON/Clinical Director and appropriate office staff.
- Coordinate with Intake regarding missing referral documentation.
- Communicate patient scheduling and service needs to the appropriate clinical team.
- Notify leadership immediately of hospitalization, unsafe conditions, suspected abuse/neglect, significant medication issues, or other serious clinical concerns.
- Participate in clinical meetings and admission-review meetings as requested.
Productivity Expectations
The SOC Nurse must be able to manage an admission-focused caseload and meet productivity expectations established by the agency.
For an agency targeting approximately 10 admissions per week, the SOC Nurse may be expected to complete approximately 2 SOC admissions per working day, depending on patient acuity, travel distance, payer requirements, and documentation complexity.
Productivity will be evaluated based on:
- SOC visits completed
- SOC documentation completed within required timeframe
- QA accuracy
- Number of charts returned for corrections
- Timeliness of corrections
- Communication of admission barriers
- Ability to maintain the admission schedule
Quality and regulatory compliance take priority over volume.
Qualifications
Required:
- Current unrestricted Registered Nurse (RN) license applicable to the state in which services are provided
- Current CPR/BLS certification
- Valid driver's license and reliable transportation
- Ability to travel to patient homes
- Strong nursing assessment and documentation skills
- Ability to work independently in the home setting
- Ability to use electronic medical record systems
Preferred:
- Previous Medicare-certified home health experience
- Start of Care/admissions experience
- OASIS experience
- Experience using Axxess or similar home health EMR
- Experience with Medicaid and managed-care home health patients
- Knowledge of home health Conditions of Participation and agency clinical policies
Skills & Competencies
The ideal SOC Nurse demonstrates:
- Strong clinical assessment skills
- Excellent time management
- Accurate and timely documentation
- Strong understanding of medication reconciliation
- Ability to recognize changes in condition
- Strong communication with physicians/providers and clinical leadership
- Attention to regulatory and documentation requirements
- Ability to receive and promptly correct QA feedback
- Reliability and accountability
- Ability to manage multiple admissions without allowing documentation to accumulate
Quality Expectations
The SOC Nurse is expected to maintain documentation that is:
- Complete
- Accurate
- Timely
- Consistent
- Clinically supported
- Patient-specific
- Ready for QA review
- Supportive of the ordered plan of care
Repeated late SOC documentation, incomplete assessments, unresolved QA corrections, or failure to communicate barriers may result in additional training, performance improvement measures, or reassignment of admission responsibilities.
Physical Requirements
The employee must be able to perform the physical functions necessary to provide nursing assessment services in patients' homes, including walking, standing, bending, reaching, carrying clinical supplies, and assisting with patient assessment activities as appropriate.
Pay: $50.00 - $55.00 per hour
Expected hours: 20.0 – 40.0 per week
Benefits:
- Dental insurance
- Health insurance
Work Location: In person