Field Nurse Supervisors

  1. Wondering what the responsibilities of some of the FNS are. We are struggling at our agency. Expected to review and audit all new admits (usually about 60 pages), all recert and dc paperwork. Some doc is in the computer, some on paper. Do in-field sup. visits with all nurses 4 times a year, all yearly PAs and evals. Carry caseload if a nurse quits, orient new staff (this is ongoing since we can't seem to keep staff), run the staff meetings, do overflow visits when short staffed, cover intake if intake nurse is out, and attend anywhere from 2-5 meetings a week. There are 2 FNS and 11 nurses, and 1 HCA. Therapies are contracted so we don't sup. them. We just can't seem to keep up. All that plus the dozens of questions and problems that staff have everyday. Let me know how some of your agencies structure their management and what the job respons are. Thanks
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  2. 9 Comments

  3. by   renerian
    I am confused by your post. Are you FNS for the unskilled patients? I cannot say I have heard of supervising/I am assuming your meaning evaluation/competency sup visits four times per year?

    ARe you only doing skilled or unskilled or both? Are you using FNS as the same term as case manager?

    Just trying to clarify so I can help you more.

    renerian
  4. by   Ruth1201
    Quote from renerian
    I am confused by your post. Are you FNS for the unskilled patients? I cannot say I have heard of supervising/I am assuming your meaning evaluation/competency sup visits four times per year?

    ARe you only doing skilled or unskilled or both? Are you using FNS as the same term as case manager?

    Just trying to clarify so I can help you more.

    renerian
    We do only intermittant skilled nursing. The FNS has to do joint sup. visits with each nurse 4 times a year to assess their job performance. We are not casemanagers but have to do casemanagement and ct visits if a CM quits, until we can hire someone else. Wanting to know job description of other supervisors in home care. Thanks
  5. by   renerian
    I have seen some common and some uncommon duties listed on JDs in home care supervisor roles depending on the following:

    patient population
    company structure
    acceditation
    certification
    licensure
    skilled
    unskilled
    private pay
    insurance contracts

    Similar duties are on call

    some QI duties

    Coverage for unfilled visits

    Sup visits with skilled staff/competency (have never seen it more than 2 times per year and that is for an accedited agency) 4 seems excessive

    HR coaching and counseling

    hiring/firing

    orientation

    staff education/inservices

    competency training for staff at hire and other required intervals

    policy and procedures

    committee involvement

    community involvement

    OASIS training or other paperwork "stuff"

    coding

    customer service triage

    disaster drills,coverage, documentation

    Training of other managers

    utilization studies

    case mix studies to evaluate loss/profit etc.

    staff meetings

    meetings at client's home for problem solving

    select errands for patients

    triage dr orders etc.

    purchase and pricing of equipment

    assistance with regulatory compliance

    productivity reports for yourself and those who report to you

    and the infamous "other duties as assigned "

    LOL.

    Does this help at all,

    renerian
  6. by   Ruth1201
    Quote from renerian
    I have seen some common and some uncommon duties listed on JDs in home care supervisor roles depending on the following:

    patient population
    company structure
    acceditation
    certification
    licensure
    skilled
    unskilled
    private pay
    insurance contracts

    Similar duties are on call

    some QI duties

    Coverage for unfilled visits

    Sup visits with skilled staff/competency (have never seen it more than 2 times per year and that is for an accedited agency) 4 seems excessive

    HR coaching and counseling

    hiring/firing

    orientation

    staff education/inservices

    competency training for staff at hire and other required intervals

    policy and procedures

    committee involvement

    community involvement

    OASIS training or other paperwork "stuff"

    coding

    customer service triage

    disaster drills,coverage, documentation

    Training of other managers

    utilization studies

    case mix studies to evaluate loss/profit etc.

    staff meetings

    meetings at client's home for problem solving

    select errands for patients

    triage dr orders etc.

    purchase and pricing of equipment

    assistance with regulatory compliance

    productivity reports for yourself and those who report to you

    and the infamous "other duties as assigned "

    LOL.

    Does this help at all,

    renerian
    Thanks, sounds like pretty much what we do. The biggest problem is that the auditing seems to take up about 70% of the day. Doing anywhere from 5-12 packets a day. Freq. interrupted while trying to get a picture of what is going on with the new cts. We don't feel that we are much help to the staff out in the field.
  7. by   renerian
    May I ask a roundabout number of clients you have? Is your agency accredited? I assume your certified? If you can let me know. I am asking to try to sort out your jobs and the auditing/OBQI, adverse events, best practice development, etc.

    May I ask your company structure? ie) do you have a DON, OBQI person, Educator etc.

    Helps me give more specified assistance.

    renerian
  8. by   NRSKarenRN
    Renerian gave you great info!

    Don't see the need for more than yearly field eval visit of nursing staff unless:
    a. part of corrective action plan with the state
    b. part of contract for office of aging/medicaid services.

    I feel your pain working in a small agency...been there before. You do wear many hats. Do you have a clerk to assist you? Who gets authorizations?
    We've shifted many of our clinical managers responsibilites since our nursing staff are now on laptop to the clerks. Nurses/therapists are now using a form to document auths and clerk is able to submit them online for our biggest payers: Blue cross and Keystone Mercy health plan. This has freed up time to concentrate on those OASIS and admit packets. Having a dedicated clerk also has give supervisors time to go to a quiet room with closed door WITHOUT INTERRUPTION ---clerk takes messges and only interrupts for irrate client/family. This way each supervisor able to go thorough admissions more quickly and avoid interruption.

    Another supervisor prefers to come in one hour prior to agency start time to peace and quiet and prioritize her day as she has 20+ nurses and 300 patients--she refuses to have a second manager be hired for the branch and leaves 30 minutes before doors closing with QI RN in charge end of day. Staff don't come to her at end of day with last minute concerns that SHOULD have been addressed earlier; they've adapted to HER time. One of her RN's does weekend admits only, 6 each day Fri/Sat/Sun--prefers it that way. She averages 20-25 new admit packages every Monday AM to face.

    Hope these have given you some ideas.
  9. by   renerian
    Thanks Karen. Like I said before, if I lived near you I would come and apply! Your excellent!

    renerian
  10. by   Ruth1201
    Quote from renerian
    May I ask a roundabout number of clients you have? Is your agency accredited? I assume your certified? If you can let me know. I am asking to try to sort out your jobs and the auditing/OBQI, adverse events, best practice development, etc.

    May I ask your company structure? ie) do you have a DON, OBQI person, Educator etc.

    Helps me give more specified assistance.

    renerian
    We are MCA certified, dropped our Joint Comm a while back to cut costs. We have a DOPS, FNS, a PI person who does OBQI along with the OBQI committees, team assisstants who enter orders, 485's, etc ( this will be done by the casemanagers soon) and answer phones. The intake nurse does the insurance auths. I have heard that some agencies use team leaders instead of supervisors, don't know what the differences are. I just know that we would like to do more to help the staff that sit and audit all day. We have approx 300-350 ct. Thanks for all of the replys, every bit helps. It's great support.
  11. by   renerian
    I love doing OBQI. Been downsized several times in that role thought from people spending to much on maintaining JCAHO LOL. I don't blame you for dropping it.

    renerian

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