Elara Capital

General

• Assess patient needs and gather physical, psychological, social, and spiritual data for the plan of care
• Conduct initial evaluations and re-evaluate patients’ nursing needs during each visit
• Make follow-up visits according to patient, family, and facility needs
• Communicate significant findings, problems, and health, environmental, or facility-condition changes to relevant care personnel
• Revise plans of care in response to patient-care issues and notify the Clinical Supervisor, physician, facility, and team members
• Counsel and instruct patients, facilities, and families on the Interdisciplinary Plan of Care
• Teach hospice philosophy and pain and symptom management to staff in alternate care settings
• Collaborate and communicate with the Medical Director, attending physician, branch leadership, and IDG
• Perform other assigned duties and projects
• Report to the Clinical Team Manager

Hospice RN, PRN

Nurse

• Assess patients to determine their care needs
• Complete initial and ongoing patient assessments
• Protect patient and staff privacy in accordance with HIPAA
• Provide nursing care according to the plan of care and physician orders
• Monitor patient conditions and report changes to the care team
• Educate patients and families on their care and safety
• Take appropriate action when patient conditions change
• Help ensure quality, safe, and continuous patient care
• Travel between patient homes and assigned work locations

Registered Nurse – Home Health

• Assess patients to determine their care needs
• Complete initial and ongoing patient assessments
• Protect patient and staff privacy in accordance with HIPAA
• Provide nursing care according to the plan of care and physician orders
• Monitor patient conditions and report changes to the care team
• Educate patients and families on their care and safety
• Take appropriate action when patient conditions change
• Help ensure quality, safe, and continuous patient care

Manager

• Ensure activities align with Elara Caring’s board, executive team, and Hospice and Skilled Home Health leadership
• Promote the company philosophy, mission, and administrative policies to ensure quality care
• Maintain patient and staff privacy and confidentiality under HIPAA
• Plan, direct, and participate in professional services for patients
• Participate in strategic planning and focus services on diagnosis-specific client care needs
• Develop, implement, and evaluate policies, procedures, clinical protocols, forms, quality improvement monitors, and service programs
• Perform liaison activities with clients and the community
• Maintain staffing levels at branch locations
• Supervise and direct agency personnel and coordinate services with providers, vendors, and facilities
• Provide clinical direction to nursing, spiritual care, therapy, volunteer, and bereavement teams
• Oversee office functions at assigned travel branches
• Ensure compliance with state licensure, Medicare certification, and applicable oversight agencies
• Coordinate staff availability for referrals and assessment visits within 24 hours
• Process patient referrals, physician orders, staff assignments, recertifications, and caregiver communications
• Meet regularly with field staff to provide guidance
• Oversee accurate, complete, and compliant medical records
• Lead Clinical Supervisors, Office, and Field Staff in delivering safe home health services
• Identify and instruct staff on admission criteria and evaluate eligibility for home health and hospice benefits
• Promote compliance with fiscal intermediary and third-party payer requirements
• Monitor Medicare, Medicaid, and reimbursement regulation changes

Clinical Team Manager, RN

Registered Nurse, Home Health

• Provide personal care support, including bathing, grooming, dressing, and hygiene assistance
• Assist clients with mobility, transfers, and daily living activities
• Prepare meals and assist with feeding when needed
• Perform housekeeping, laundry, and household tasks
• Provide companionship and emotional support
• Assist with errands, grocery shopping, and transportation to appointments when applicable
• Promote a safe, comfortable, and respectful environment for each client

Home Health Aide, Personal Care Aide, Homemaker

• Provide skilled nursing care according to the individualized Plan of Care, physician orders, and direction of the RN
• Monitor patient condition and promptly report changes, concerns, or safety issues to the RN Case Manager, physician, and care team
• Collaborate with the RN Case Manager to address patient needs and recommend updates to the Plan of Care when appropriate
• Educate patients and caregivers on self-care techniques to support safety, independence, and overall health
• Document medication regimens and maintain accurate, up-to-date medication profiles
• Help prevent avoidable hospitalizations and emergency room visits through proactive, coordinated patient care
• Provide compassionate, high-quality care while maintaining positive communication with patients, families, physicians, and the care team

Hospice CNA

• Provide personal care support, including bathing, grooming, dressing, and hygiene assistance
• Assist clients with mobility, transfers, and daily living activities
• Prepare meals and assist with feeding when needed
• Perform housekeeping, laundry, and household tasks
• Provide companionship and emotional support to improve quality of life
• Assist with errands, grocery shopping, and transportation to appointments when applicable
• Promote a safe, comfortable, and respectful environment for each client

Caregiver, Personal Care Aide (PCA)

• Provide nursing care in patients’ homes according to their plan of care
• Monitor patients and share changes with the RN Case Manager
• Teach patients and caregivers how to manage care at home
• Document visits, interventions, and medication updates
• Work with the care team to help patients avoid unnecessary hospital visits
• Provide skilled, personal care to patients in the Palmer and Monson area
• Work alongside an RN Case Manager and supportive clinical team

Home Health LPN

• Complete start-of-care visits and comprehensive assessments
• Evaluate clinical needs, medications, home safety, and caregiver support
• Create individualized plans of care with physicians and the clinical team
• Educate patients and families about the care plan
• Document admissions accurately
• Communicate key findings to the care team
• Conduct admissions visits across Newburyport to Haverhill, Greater Boston, and the North Shore
• Use independent clinical judgment to transition patients into ongoing care

Home Health Admissions RN – Full-Time

• Complete admissions, assessments, routine visits, recertifications, and discharges
• Develop and update individualized plans of care
• Monitor patients’ conditions and communicate significant changes
• Coordinate care with physicians, caregivers, and the interdisciplinary team
• Educate patients and families about medications, conditions, safety, and self-care
• Complete accurate and timely clinical documentation
• Help prevent avoidable hospitalizations through proactive nursing care
• Provide skilled nursing care to patients in their homes
• Build meaningful relationships with patients and families

Hospice RN, PRN

Registered Nurse – Home Health

Registered Nurse – Home Health

Registered Nurse – Home Health

Clinical Team Manager, RN

Registered Nurse, Home Health

Home Health Aide, Personal Care Aide, Homemaker

Hospice CNA

Caregiver, Personal Care Aide (PCA)

Home Health Aide, Personal Care Aide, Homemaker

Home Health LPN

Home Health Admissions RN – Full-Time

Home Health RN

Caregiver, Personal Care Aide (PCA)

Caregiver, Personal Care Aide (PCA)