Care Coordinator - LPN

The Care Coordinator - LPN serves as a liaison, promoting coordination, communication, and collaboration among Brookdale teams, residents, families, and healthcare providers within Brookdales HealthPlus communities.

Upholds open and collaborative communication channels, aligning with the changing healthcare needs of the residents.

Works closely with primary and specialty care providers to formulate resident-specific care plans, ensuring that the delivery of medically necessary services aligns with established care plans.

Serving as a resident advocate, they actively contribute to identifying and improving service delivery, closing gaps in care, and understanding key interventions and care protocols relevant to treating residents in place.Reviews the current populations medical diagnoses to identify care needs.

Assists in assessing the health, functional, and psycho-social status of residents.Coordinates services required to enhance optimum wellness and manage chronic conditions.Collaborates with hospice, palliative, and home health services/therapy as indicated.Participates in collaborative care reviews (CCR) and care conferences.Educates and explains Brookdales care pathways as determined by individual diagnosis and healthcare needs and provides advanced care planning education to residents and families/responsible parties.

Helps ensure each resident has a completed Advanced Care Plan, inclusive of goals of care.

Communicate with healthcare providers to ensure care delivery is consistent with the residents Advanced Care Plan(s).Provides resources for residents and families to make informed decisions regarding choices in meeting healthcare needs and effectively champions the benefits of residing and receiving care and services in the community.

This includes informing them about opportunities to enhance care and benefits through specialized plans like the IE-SNP, specifically designed for residents with chronic medical conditions.Applies quality improvement methodology to analyze, enhance, and manage outcomes, striving to achieve quality measure goals.

Collaborates with HWD and/or RN Care Manager to ensure compliance with service plans, while working with providers to attain value-based outcomes for our residents.

This includes coordinating and communicating care for each resident.Communicates information promptly to the appropriate care provider regarding changes in residents health/well-being, personal needs, risk management issues, customer service issues, and family, or outside health care provider concerns.Applies quality performance measures, and assist with training and education of teams to ensure quality outcomes for residents.

This involves effective communication and collaboration with providers and other healthcare entities, such as managed care coordinators, insurance providers, and external healthcare partners responsible for coordinating resources and supplies pertinent to resident needs.Complete documentation as required by Bro...