Registered Nurse - Home and Community Based Care

Created at: June 28, 2025 00:19

Company: Veterans Health Administration

Location: San Antonio, TX, 78126

Job Description:

Home Based Primary Care (HBPC) provides primary care to complex, chronically ill patients in their 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.
Basic Requirements: English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD). Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification. Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12756407. Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required. Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex. An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required. Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations. An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience. Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience. Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting. MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III. *Note: Foreign education programs/degrees are not creditable as related degrees. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: BSN or higher. Recent (5 years) clinical experience in Home Based Primary Care, Community and Home Based Care, or Hospice. Recent (5 years) clinical experience with geriatric population. Recent (5 years) clinical experience with Alzheimer's/Dementia. Clinical experience in case management/care coordination. Proficiency in EHR and computer software programs (such as MS Word, Excel, Outlook, Explorer); strong writing and verbal communication skills. Nursing Certification Physical Requirements: Lifting up to 35·pounds for 8-12 hours, intermittently, moderate carrying (15-35 pounds) for 8 to 12 hours, intermittently, lifting over 35 pounds with assistive devices in accordance with the Safe Patient Handling Policy except in emergent situations requiring prompt patient care, pulling for 8 to 12 hours intermittently, pushing for 8-12 hours, intermittently, reaching above the shoulders for 8-12 hours, intermittently, both hands required, walking 8-12 hours, intermittently, standing 8-12 hours intermittently, kneeling 8 to 12 hours, intermittently, repeated bending for 8-12 hours, intermittently, climbing and use of both legs and arms for 8-12 hours, intermittently, both legs required, near vision at 13 to 16" Jaeger 1 to 4, far vision correctable in one eye to 20/20 and to 20/40 in the other eye, ability to distinguish basic colors, hearing aid permitted, twisting, simple grasp and fine manipulation.
The HBPC RN functions as a case manager for 25-30 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. Duties of the HBPC RN include, but are not limited to: (1) Assessing potential patients, presenting findings at the Interdisciplinary staff meeting, and recommending a plan of care based on the patients' needs; (2) Assessing and continually reassessing the needs of the veterans and caregivers; (3) Delivering nursing care in the home; (4) Providing care management and care coordination for the HBPC patient; (5) Use of Virtual and Face to Face visits for veterans residing in Del Rio and its surrounding area The HBPC Staff RN must be self-motivated, organized, flexible, responsible, and empathetic. The HBPC RN must possess excellent critical thinking skills, excellent nursing assessment skills and excellent computer skills. Recent case management experience and home health experience is preferred. The ability to work well with different people and personalities is essential. Proficiency in computer skills is beneficial since all the position involves virtual patient care modalities. Travel will be conducted using a government vehicle. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for performance awards Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Full-time, 7:30am-4:00pm or 8:00am-4:30pm Telework: Available; Ad-Hoc only Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized


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