Fresenius Medical Care North America Holdings Limited Partnership jobs in Southaven, MS - 20 jobs

**PURPOSE AND SCOPE:** The student intern supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. The student intern functions as part of the dialysis health care team in providing medical nutrition therapy for patients under the direct supervision of a registered dietitian in accordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. **DUTIES / ACTIVITIES:** Dietetic Intern: An individual who currently is enrolled in a Dietetic Internship or a university-based Coordinated Program in Dietetics accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND). The dietetic student/intern may under direct guidance of the Renal Dietitian: + Review of Renal Nutrition Basics and other applicable components of the Orientation and Training requirements of staff dietitians + Review the typical workflow for the Renal Dietitian, and/or Role of the RD + Conduct a nutrition interview with a patient + Calculate a diet prescription recommendation + Provide nutrition counseling to patient/designated caregiver on the prescribed renal diet + Collect data for initial, 90 day, semi-annual (if applicable by State), and annual Comprehensive Interdisciplinary Assessments + Assist the registered dietitian in development and implementation of nutrition plan of care + Review monthly nutrition data with patients and/or designated caregivers + Practice writing monthly nutrition progress notes + Provide input to the development and implementation of nutrition plan of care + Create nutrition related projects for patients or staff (such as, bulletin board, patient/staff education handouts, games, lobby activity) + Attend Quality Assessment and Performance Improvement and /or other interdisciplinary team meetings with the registered dietitian, and participate as appropriate **PHYSICAL DEMANDS AND WORKING CONDITIONS:** The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **EDUCATION:** Bachelors or Master's degree in Nutrition or Dietetics; or current enrollment in an accredited Coordinated Program in Dietetics. **EXPERIENCE AND REQUIRED SKILLS:** Preferred outstanding customer service to all external and internal customers. Possess the desire to deliver superior care to our patients and embrace Fresenius' mission and values. **RELATIONSHIPS:** The Intern cannot work under the supervision of a family member. The Intern cannot care for a patient who is a family member. If an Intern's family member is a patient at the facility in which they work, the Intern will be scheduled to work on days the patient is not in the facility or will be assigned to another patient. **SUPERVISION:** The Clinical Manager assigns and closely monitors all Dietetic Intern assignments with direct supervision from a Registered Dietitian based on the agreed education plan. **OTHER:** Performs additional duties as assigned. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: Explores, recommends, and coordinates the insurance and potential financial assistance options available to kidney dialysis patients in a specified geographic area, while maximizing revenue for the company. Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and company policy requirements PRINCIPAL DUTIES AND RESPONSIBILITIES: Meets regularly with dialysis patients at the clinic(s) in the assigned region to educate and coordinate insurance options: + Educates on the availability of alternative insurance options (i.e., Medicare, Medicaid, Medicare Supplement, State Renal programs and COBRA). + Ensures patients have followed through with the application process. + Obtains premium statements and signatures from patients. + Discusses situation and options if employment status changes or other situations change. + Completes and follows up with paperwork when claims are disputed for non-payment. + Collects necessary documents to completed initial and annual indigent waivers. + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include but are not limited to: + Determining Medicare eligibility by meeting with the patients and contacting local Social Security offices to verify eligibility. + Discussing the Medicare application with eligible patients and assisting with the application process. + Acting as liaison between the patient and the local agents for Medicare terminations and re-in statements. + Completing the annual open enrollment and Medicare reinstatement papers with the patients. + Tracking 30-month coordinator period each month for those patients on employer Group Health Plans to ensure Medicare will be in place once coordination ends. + Monitoring and verifying the Medicaid status of each patient on a monthly basis and determining the spend down amounts + Works with patients to evaluate personal financial information and make determination for indigent program. + Completes initial Indigent waiver applications. + Tracks and completes annual indigent waiver applications. + Monitors all patients' insurance information to ensure that it is updated and accurate for the Accounts Receivable Department. + Addresses any identified anomalies or discrepancies, researches and answers questions as needed. + Meets with patients receiving direct payments from insurance companies to ensure payment of dialysis treatments owed to Fresenius. + Prepares, analyzes and reviews monthly reports to track work progress on caseloads; Analyzes patient reports from billing systems as an audit check to ensure the correct insurance information is entered into the billing system and that other changes are not overlooked. Researches and corrects any discrepancies identified. + Provides QA team members with monthly information regarding the details of the patients' primary and secondary insurance status as well as documentation regarding the plans of actions currently in place on a monthly basis as required by QA processes + Completes monthly audit exam to stay current on internal policies. + May present on insurance and financial assistance options to patients as necessary. + Assist with various projects as assigned by direct supervisor. + Other duties as assigned. Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Day to day work includes desk and personal computer work and interaction with patients and facility staff. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Extensive local travel to clinics in a specified geographic area; must have a valid Driver's License. EDUCATION: + Bachelor's Degree required; Social Work or other Healthcare focus preferred. EXPERIENCE AND REQUIRED SKILLS: + 2 - 5 years' related experience; healthcare industry preferred. + Experience with Medicare, Social Security and Medicaid systems a plus. + Past patient interaction a plus. + Excellent written and communication skills. + A strong customer service philosophy. + Strong organizational and time management skills. + Ability to work independently. + Proficient with PCs and Microsoft Office applications. + Valid Driver's License **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP). **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** **Patient Related** Education: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: + Welcome assigned patients and inquire as to their wellbeing since their last treatment. + Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law. + Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient prior to discharge. + Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. + Monitors patients performing self-care under the supervision of RN. **Staff Related** + Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse. **Education/Communication:** + Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. **RECORD KEEPING:** + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. **INFECTION CONTROL:** + Assists in collecting information for infection control audits. + Supports staff and patient Adherence to infection control practices. + Follows infection control Policies and Procedures + Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law. **TRANSITIONAL CARE UNIT:** + Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care + Reinforces all education and care related matters as it relates to the new patient as allowed by state law + Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them. + Sets and preforms a treatment on all machines used in the transitional care unit. + Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up. + Assists with coordination of transition to patient's modality choice. + Assists with supply ordering and inventory for TCU **PHYSICAL** **DEMANDS** **AND** **WORKING** **CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** **AND** **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: This position is for graduates of an accredited school of Nursing working in a state that does not allow graduates to perform nursing duties until licensed. The specific job title used will be determined based on the state where the employee is employed. Functions as part of the hemodialysis health care team providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse while working towards obtaining their nursing license. Employees hired into this position will be required to obtain their nursing license within 90 days of their hire date. PRINCIPAL DUTIES AND RESPONSIBILITIES: Patient Care: + Performs vascular access evaluation pre-treatment. + Performs and records Pre and Post dialysis evaluation, weight and vital signs with initial identification. + Performs vascular access cannulation and reports any difficulties in cannulation or unusual findings to nurse supervisor. + Initiates dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluates intradialytic problems and provides intervention as prescribed by physician order or as directed. + Monitors patients' response to dialysis therapy. + Obtains vital signs prior to reinfusion; performs all relevant functions necessary for the discontinuation of treatment and documents appropriately. + Evaluates patient prior to termination of venous access - standing & sitting blood pressure. + Obtains hemostasis and applies appropriate dressings. + Evaluates the patient prior to discharge. + Documents information related to patient treatment including documentation in the patient health record. + Reports any significant information and/or change in patient condition directly to the nurse supervisor. + Performs and documents interventions for unusual patient status and document patients' response to intervention. + Obtains all prescribed laboratory testing and prepares specimens for collection. Maintenance / Technical: + Conducts all tasks necessary for preparation for dialysis treatment and documents where appropriate. + Maintains environmental integrity and aesthetics - ensures all areas are safe and clean. + Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Performs all required pretreatment dialysis machine set up and testing. + Ensures that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepares, organizes, and efficiently utilizes supplies and equipment to prevent waste. Clerical & Administrative: + Enters all treatment data into the designated clinical application accurately and in a timely manner. + Reviews health care record for completeness and ensures omitted entries are completed or corrected where appropriate. + Prepares lab requisitions for prescribed or stat lab specimens according to laboratory destination. + Collects, labels, appropriately prepares and stores lab samples according required laboratory specifications. + Ensures collection of lab specimens by appropriate lab courier. Other: + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintains regular and punctual attendance. + Performs other related duties as assigned PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Work includes using a desk and personal computer as well as interaction with patients, facility staff and physicians. The position may require travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. SUPERVISION: + None EDUCATION AND REQUIRED CREDENTIALS: + Graduated from an accredited nursing program within the past 12 months EXPERIENCE AND REQUIRED SKILLS: + Previous patient care experience in a hospital setting or a related facility preferred. + Required to obtain nursing license within 90 days of employment Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. **EOE, disability/veterans**

**_Description_** _Provide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own._ **Connect with your goals and change lives** **with Fresenius Medical Care North America.** Here, we make connections that empower patients, their families, and our team members. As the global leader in dialysis healthcare, we form bonds that enable the best possible outcomes and professional satisfaction. While our extensive organization continues to grow, so do opportunities for our professionals to learn, grow, and advance. **Why Join the Fresenius Team?** Passion. Dedication. Knowledge. Motivation. Experience. These are the impressive qualities you'll find in the Fresenius Leadership Team. Our strength in the North American market and extensive global network provide our employees with the best of both worlds-the friendliness of a local organization and the stability of a worldwide organization-for diverse experiences and challenging career opportunities. When you join the Fresenius Medical Care team, you'll be welcomed into a company that is built on the philosophy that our employees are our most important asset. Our career advantages include the following: + Fresenius Medical Care is the nation's largest provider of renal care, meeting the needs of more than 135,000 patients at 1,800 clinics throughout the country. + Our well-established, trusted organization fosters a spirit of camaraderie, emphasizing friendly collaboration, professional support, and career development. + Superior training, UltraCare quality control, and certification procedures ensure your potential to succeed and advance as a professional. + Competitive compensation and exceptional benefits. + Outstanding tuition reimbursement program. + Recognized among Fortune's World's Most Admired Companies in 2011. + National Safety Award from CNA insurance companies for 11 consecutive years. + Opportunities to give back by participating in philanthropy and community outreach programs. **PURPOSE AND SCOPE:** Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and division/company policy requirements. Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for assigned patients under the direct supervision of a registered nurse. Participates in the implementation and evaluation of patient care. Responsible for reporting and documenting all new or unusual incidents, information, complaints, or problems to the supervisor. Promotes and assists in the maintenance of a sage and clean work environment. **DUTIES / ACTIVITIES** : **CUSTOMER SERVICE:** + Responsible for driving the FMCNA culture through values and customer service standards. + Accountable for outstanding customer service to all external and internal customers. + Develops and maintains effective relationships through effective and timely communication. + Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner. **PRINCIPAL RESPONSIBILITIES AND DUTIES:** **Patient Related:** + Provide direct patient care for assigned patient(s). + Perform all technical aspects of dialysis procedures for assigned patients as prescribed. Administer and monitor treatments in accordance with current treatment plan or as directed by the supervisor. + Monitor and document dialysis treatment parameters on dialysis flow sheets. Document other information related to the care of the patient in the individual patient record. + Responsible for reporting any significant information, change in patient condition, or equipment problems to the supervisor. + Assist in developing and following the teaching plan to educate the patient and family regarding end stage renal disease, dialysis therapy, diet and medications. + Assist with all emergency operational procedures. + Administer intravenous medication in accordance with physician orders and state nurse practice laws. + Perform and document pre, interim, and post treatment review of patient condition. + Initiate basic CPR measures in the event of cardiac and/or pulmonary arrest, and respond to emergency situations related to dialysis treatment. **Technical:** + Safely operate all dialysis related equipment according to the proper procedures. + Provide minor troubleshooting when necessary. + Ensure a clean, safe and sanitary environment in the dialysis facility treatment area. + Ensure all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. + Operate all emergency equipment effectively in accordance to the standard operation procedures. **Staff Related:** + Participate in staff meetings as scheduled. + Assist in short term and long term patient care plan meetings. + Acquire information and knowledge in current practice related to dialysis principals and technique by participating in scheduled in-service classes. + Act as a resource person for other staff members. Assist with the coordination of the care plan with Physician, Dietitian and Social Worker. + Other duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS** **:** The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Day to day work includes desk and personal computer work and interaction with patients, facility, staff and physicians. The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment weighing up to 200lbs., and may lift chemical water solutions of up to 30lbs., up as high as 5 feet. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. The work environment is characteristic of a health care facility with air temperature control and moderate noises levels. May be exposed to infectious and contagious diseases/materials. **EDUCATION:** + Graduate of an accredited School of Practical Nursing (LPN, LVN) + Current appropriate State licensure. **EXPERIENCE AND REQUIRED SKILLS:** + One year medical-surgical nursing experience preferred. + Hemodialysis experience preferred but not required. + ICU experience preferred but not required. + Successfully complete a training course in the theory and practice of hemodialysis. + Successfully complete CPR Certification. + Must complete the Nurses Technical Training Program upon hire or soon thereafter. + Ability to provide coverage at area facilities during times of short-staffing or as required. + Employees must meet the necessary requirements of Ishihara's Color Blindness test as a condition of employment. + Good communication skills, both verbal and written. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory requirements and programs. Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of care and patient and staff safety **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Manages the tactical execution of short- and long-term objectives through the coordination of activities with a direct responsibility for results, including costs, methods, and staffing. + Provides leadership, coaching and development plans for all direct reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters. + Technically proficient in the specific department and knowledge of industry practice and business principles. Works on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends. Has a larger range within the department. + Responsible for supporting and driving FMS quality standards through meeting all ESRD regulatory requirements and the practice of Quality Assessment and Improvement (QAI), including use of FMS QAI tools. + Responsible for addressing and acting on adverse events and action thresholds. + Oversees facility's Home Therapies Program if applicable. + Accountable for compliance with all applicable federal, state and local laws and regulations. + Ensures all FMS Clinical Quality policies and procedures are communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with all data collections and auditing activities. + Maintains facility environmental integrity, including safety. + Experienced leadership required for multi-faceted environment; role primarily focuses on tactical execution. Receives assignments in the form of objectives and determines how to use resources to meet schedules and goals. + An individual contributor will have significant project/process responsibilities. Program or project responsibility generally within the function. + Follows processes and operational policies in selecting methods and techniques for obtaining solutions. Interprets and recommends change to policies and establishes procedures that effect immediate organization(s). + Decisions have an impact on work processes and outcomes. Erroneous decisions or failure to achieve results will add costs and may impact the short-term goals of the organization. + Frequently interacts with subordinate supervisors, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers. + Participates and presents at meetings with internal and external representatives. Often leading a cooperative effort among members of a project team. + Interacts with internal departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. + Responsible for hiring, coaching and counseling employees, including performance reviews, disciplinary action and terminations. + Provides technical guidance. + Performs other related duties as assigned. **PATIENT CARE:** + Coordinates all aspects of patient care with the appropriate staff members, from admission through discharge of the patient. + Ensure education of the patient regarding quality measures, transplant options, modality awareness, and access care, including catheter reduction and adherence to treatment regime. + Acts as a resource for the patient to address patient concerns and questions. + Accountable for timely completion of patient care assessments and care plans by organizing meetings of the facility's Interdisciplinary Team to discuss patient care plans and to resolve patient problems. + Directs initiation, maintenance and communication of efficient and timely patient schedules to ensure maximization of the facility station efficiency. + Is aware of and develops a mechanism or process for knowing the specific situation of each patient, including hospitalizations, no- shows, catheter use, and any significant change in patient care status. + Develops action plans for unexcused and missed treatments in collaboration with the Director. + Plans, coordinates and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely workup of patients for access management, dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination of care with the multidisciplinary renal team. Communicates changes in patient status regarding clinical, insurance, travel and transportation issues to the disease management company. Maintains current knowledge of disease management software and systems as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. + Participates in the recruitment and interview process, and decision to hire new personnel. + Ensures completion of new hiring orientation and training including mandatory in-services and ICD code training when applicable. Ensures documentation completed for annual in service training, and policy and procedure in service updates. + Responsible for all patient care employees receiving appropriate training according to FMS policy, including training to ensure ongoing compliance with all FMS risk management initiatives. + Provides opportunities for professional growth, and training to ensure clinical competence and the ability for licensed staff to assume Team Leader responsibilities + Responsible for overseeing performance of all licensed personnel, direct patient care staff, reporting indirect patient care personnel as assigned, and when necessary, technical staff. Provides employee education and guidance, and feedback related to performance. + Maintains current knowledge regarding FMCNA benefits, Human Resources policies, procedures, and processes, and acts as a resource to facility staff. + Provides counseling for all clinical staff members at regular intervals offering support and encouraging professional growth. + Completes timely employee evaluations and establishes annual goals for staff. + Provides written documentation of all disciplinary conferences in accordance with the established personnel policies, and confers with the Director and Human Resources regarding the nature of the disciplinary decisions. + Participates in Corporate and Business Unit specific employee recognition and satisfaction programs. + Creates, maintains, and communicates efficient and timely employee schedules according to the needs of the facility. + Creates and implements a Continuous Quality Improvement (CQI) Process Improvement Team that involves staff in problem solving. **PHYSICIANS:** + Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. + Responsible for strong Director and physician relationships and facilitating staff relationships with physicians. + Ensures regular and effective communication with all physicians, through regular meetings with Directors. + Participates in Governing Body. + Schedules and coordinates CQI meetings with physicians. **MAINTENANCE/TECHNICAL:** + Responsible for the integrity and safety of the facility water system. + Must be knowledgeable in the operation of all facility equipment and technology. **ADMINISTRATIVE:** + Responsible for maintaining and updating all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, and responds as appropriate. + Directs information gathering as required supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve supply cost goals following all guidelines established in FMS formularies + Participates in the completion and interpretation of the Pl-17 inventory supply use analysis. + Reviews and approves facility payroll. + Reviews profit and loss statements with Director + Responsible for participating in all required Network reporting and on-site state or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians + Position may require travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **SUPERVISION:** + Responsible for the direct supervision of various levels of staff as designated by region. **EDUCATION AND REQUIRED CREDENTIALS:** + Bachelor's Degree; Advanced Degree desirable or an equivalent combination of education and experience + Graduate of an accredited School of Nursing (RN). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + 6 - 8 years' related experience or an equivalent combination of education and experience. + 3+ years' supervisory or project/program management experience preferred. + Minimum of 12 months experience in clinical nursing is required. Experience in med/surg or ICU/CCU is preferred. + Minimum of 6 months chronic or acute dialysis nursing experience is required. + Must be available as a full-time employee and provide on-call coverage when necessary. + Demonstrated leadership competencies and skills for the position, including excellent communication, customer service, continuous quality improvement, relationship development, results orientation, team building, motivating employees, performance management, and decision making. + Demonstrated management skills necessary to provide leadership in the supervision of dialysis personnel and to ensure the delivery of maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

*Full-time position at 30 hours per week* **PURPOSE AND SCOPE:** Provides nutritional services for the facility's in-center and home patients as applicable in order to maximize the patient's nutritional status and improve clinical outcomes. Functions as a member of the interdisciplinary healthcare team, supporting the FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) activities. Actively participates in process improvement activities that enhance the likelihood that patients will achieve their individualized patient-specific goals as determined by the patient's physician. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Assesses patient's knowledge of diet and kidney disease and provides education appropriate to patient's learning needs regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides patient specific detailed education to patient/family/caregiver regarding nutritional status, adequacy measures and results, fluid status, and all nutrition related lab parameters pertaining to their disease process. + Completes nutritional assessment and participates in the interdisciplinary comprehensive assessments. + Participates with the interdisciplinary team in the development of a written, individualized comprehensive plan of care that specifies the services necessary to address the patient's needs, in accordance with established Federal and, where applicable, state licensure guidelines. + Calculates diet prescription according to standard of practice. + Completes progress notes on all chronic dialysis patients according to established FMCNA guidelines. Maintains complete and accurate documentation of all appropriate information in medical record according to established FMCNA policies and Federal and state regulations. + Provides patient with ongoing nutrition assessment and outcome-oriented nutrition counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished patients as well as patients at risk for malnutrition and works collaboratively with interdisciplinary team to identify appropriate interventions, resources or solutions. Reviews each patient's albumin level and body weight at least monthly. Implements plan of care with involvement of patient/family/caregiver. + Monitors adherence and response to nutrition therapy, adjusts therapy as needed to achieve and sustain an effective nutritional status, documents why the patient was unable to achieve the goals and implements the plan of care to address issues impacting the patient's ability to achieve the goals. + Collaborates with the interdisciplinary team on Urea Kinetic Modeling recommendations to achieve the physician's prescription of Kt/V. + Collaborates with the interdisciplinary team on management and recommendations for mineral metabolism and renal bone disease, anemia and iron status, nutritional status, psychosocial status, vascular access, modality, rehabilitation status and sodium/volume control. + Adheres to FMCNA algorithm and medical record policies. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Collaborates and coordinates with team members in provision of Pre-ESRD education as appropriate. + When appropriate, works with Case Manager to coordinate plan of care for patient education and identifies candidates to refer to physician for nutritional supplements, as per disease management agreements. + Reviews nutrition related lab results: + Counsels patient and/or caregiver and formulates appropriate action. + Recommends treatment changes to the interdisciplinary team as appropriate. + Communicates with physician and/or facility staff regarding lab results as appropriate. + Communicates lab results and recommended treatment changes to providers of patient care in nursing facilities (i.e., hospitals, short term and long-term care facilities). + Participates in pertinent staff meetings (i.e., general staff, quality improvement), Care plan meetings, and others as applicable. + Consults with FMS Corporate Dietitian regarding nutrition concerns as needed. + Maintains and improves knowledge and skills for a competent and innovative practice. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. + Collaborates with interdisciplinary team, ensuring that all work areas are safe and clean. + Other nutrition management duties as assigned. + Performs other related duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS** **:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. + The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. **SUPERVISION:** + None **EDUCATION AND REQUIRED CREDENTIALS** **:** + Registered Dietitian as per Commission on Dietetic Registration + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND SKILLS** **:** + Minimum of 1-year professional work experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. + Demonstrated leadership competencies and skills for the position, including ability to teach, strong organizational skills, excellent communication, customer service, relationship development, results orientation, team building and decision making. + Able to perform responsibilities with minimum supervision. + Basic computer skills required. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMC Quality Enhancement Goals (QEP). **DUTIES / ACTIVITIES:** CUSTOMER SERVICE: + Responsible for driving the FMS culture through values and customer service standards. + Accountable for outstanding customer service to all external and internal customers. + Develops and maintains effective relationships through effective and timely communication. + Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner. **PRINCIPAL RESPONSIBILITIES AND DUTIES** PATIENT CARE: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. + Welcome assigned patients and inquire as to their well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual findings to nurse supervisor. + Obtain necessary pre and post treatment vital signs and weight. Report unusual findings to nurse supervisor. + Perform vascular access evaluation pre-treatment and report unusual findings to nurse supervisor. + Perform vascular access cannulation and report any difficulties in cannulation or unusual findings to nurse supervisor. + Perform administration of Heparin as delegated or as allowed by state law. + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy and report any unusual findings to nurse supervisor. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures, + Evaluate patient prior to termination of venous access - standing & sitting blood pressure. + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient for prior to discharge and report any unusual findings to nurse supervisor. + Perform and record Pre and Post dialysis evaluation, weight and vital signs with initial identification. + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; Sodium (Na) modeling; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification. + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the nurse supervisor. + Observe patient, and conduct machine safety checks according to facility policy. Report any change or unusual findings to the nurse supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the nurse supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. MAINTENANCE/TECHNICAL: + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate. + Perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. CLERICAL & ADMINISTRATIVE: + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application accurately and in a timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected where appropriate. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. OTHER: + Perform additional duties as assigned. **ADDENDUM FOR PATIENT CARE TECHNICIANS WORKING IN THE HOME PROGRAMS (NOT HOME ASSIST):** Assisting the HT RN: + May assist HT RN on Home Visit as directed + Reinforces PD / HHD education under supervision of qualified HT RN + Schedules and contacts patients regarding appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning and prepping treatment room; prep charts + Preparing lab tubes and requisitions & assisting with lab draw days both pre and post draw (PCT certified phlebotomy or per state regulations) + Clerical duties as assigned (faxing, mailing to physician offices etc.) + Obtain home hemo water sampling as directed by the HT RN + Set-up of the home hemo machine and PD Cycler. + Assist with exit site care when directed by HT RN. + Warm dialysate solution when directed by the HT RN + Draw dialysate solution for testing as directed by the HT RN + Creates and sends patient reminders (supply inventory for order, Kt/V collection, bringing meds to clinic visit for review) + Assembles/breaks down charts/thins charts + Maintains logs as directed and applicable + Inventory of Home Program + Maintains par levels of home department supplies + Files home patient packing slips/invoices + Inventory for Patients + Assists patient with supply management and contacting customer service **PHYSICAL DEMANDS AND WORKING CONDITIONS:** The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** + Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification or High School diploma or G.E.D. and must meet certification requirements within the required state or CMS timeline. + All appropriate state licensure, education and training (if any) required. **EXPERIENCE AND REQUIRED SKILLS** + Previous patient care experience in a hospital setting or related facility preferred. + Continued employment is dependent on successful completion of the FMCNA dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations. PRINCIPAL DUTIES AND RESPONSIBILITIES: All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations. · Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. · Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. · Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. · Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. · Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. · Initiates or assists with emergency response measures. · Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. · Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. · Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. · Ensures patient awareness related to transplant and treatment modality options. · Required to complete CAP requirements to advance. · Performs all other duties as assigned by Supervisor. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. · This position requires frequent, prolonged periods of standing and the employee must be able to bend over. · The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. · The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. · May be exposed to infectious and contagious diseases/materials. · Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. · The position may require travel to training sites or other facilities. · May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. SUPERVISION: Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: · Successful completion of all FKC education and training requirements for new employees. · Must have a minimum of 9 months experience as a RN. · Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN. EDUCATION and LICENSURE: · Graduate of an accredited School of Nursing. · Current appropriate state licensure. · Current or successful completion of CPR BLS Certification. · Must meet the practice requirements in the state in which he or she is employed. EXPERIENCE AND REQUIRED SKILLS: · Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse. · Chronic/acute hemodialysis experience (preferred). **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP). **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** **Patient Related** Education: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: + Welcome assigned patients and inquire as to their wellbeing since their last treatment. + Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law. + Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient prior to discharge. + Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. + Monitors patients performing self-care under the supervision of RN. **Staff Related** + Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse. Education/Communication: + Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. **RECORD KEEPING:** + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. **INFECTION CONTROL:** + Assists in collecting information for infection control audits. + Supports staff and patient Adherence to infection control practices. + Follows infection control Policies and Procedures + Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law. **TRANSITIONAL CARE UNIT:** + Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care + Reinforces all education and care related matters as it relates to the new patient as allowed by state law + Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them. + Sets and preforms a treatment on all machines used in the transitional care unit. + Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up. + Assists with coordination of transition to patient's modality choice. + Assists with supply ordering and inventory for TCU **PHYSICAL** **DEMANDS** **AND** **WORKING** **CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** **AND** **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: This position is for graduates of an accredited school of Nursing working in a state that does not allow graduates to perform nursing duties until licensed. The specific job title used will be determined based on the state where the employee is employed. Functions as part of the hemodialysis health care team providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse while working towards obtaining their nursing license. Employees hired into this position will be required to obtain their nursing license within 90 days of their hire date. PRINCIPAL DUTIES AND RESPONSIBILITIES: Patient Care: + Performs vascular access evaluation pre-treatment. + Performs and records Pre and Post dialysis evaluation, weight and vital signs with initial identification. + Performs vascular access cannulation and reports any difficulties in cannulation or unusual findings to nurse supervisor. + Initiates dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluates intradialytic problems and provides intervention as prescribed by physician order or as directed. + Monitors patients' response to dialysis therapy. + Obtains vital signs prior to reinfusion; performs all relevant functions necessary for the discontinuation of treatment and documents appropriately. + Evaluates patient prior to termination of venous access - standing & sitting blood pressure. + Obtains hemostasis and applies appropriate dressings. + Evaluates the patient prior to discharge. + Documents information related to patient treatment including documentation in the patient health record. + Reports any significant information and/or change in patient condition directly to the nurse supervisor. + Performs and documents interventions for unusual patient status and document patients' response to intervention. + Obtains all prescribed laboratory testing and prepares specimens for collection. Maintenance / Technical: + Conducts all tasks necessary for preparation for dialysis treatment and documents where appropriate. + Maintains environmental integrity and aesthetics - ensures all areas are safe and clean. + Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Performs all required pretreatment dialysis machine set up and testing. + Ensures that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepares, organizes, and efficiently utilizes supplies and equipment to prevent waste. Clerical & Administrative: + Enters all treatment data into the designated clinical application accurately and in a timely manner. + Reviews health care record for completeness and ensures omitted entries are completed or corrected where appropriate. + Prepares lab requisitions for prescribed or stat lab specimens according to laboratory destination. + Collects, labels, appropriately prepares and stores lab samples according required laboratory specifications. + Ensures collection of lab specimens by appropriate lab courier. Other: + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintains regular and punctual attendance. + Performs other related duties as assigned PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Work includes using a desk and personal computer as well as interaction with patients, facility staff and physicians. The position may require travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. SUPERVISION: + None EDUCATION AND REQUIRED CREDENTIALS: + Graduated from an accredited nursing program within the past 12 months EXPERIENCE AND REQUIRED SKILLS: + Previous patient care experience in a hospital setting or a related facility preferred. + Required to obtain nursing license within 90 days of employment Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP). **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** **Patient Related** Education: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: + Welcome assigned patients and inquire as to their wellbeing since their last treatment. + Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law. + Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient prior to discharge. + Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. + Monitors patients performing self-care under the supervision of RN. **Staff Related** + Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse. **Education/Communication:** + Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. **RECORD KEEPING:** + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. **INFECTION CONTROL:** + Assists in collecting information for infection control audits. + Supports staff and patient Adherence to infection control practices. + Follows infection control Policies and Procedures + Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law. **TRANSITIONAL CARE UNIT:** + Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care + Reinforces all education and care related matters as it relates to the new patient as allowed by state law + Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them. + Sets and preforms a treatment on all machines used in the transitional care unit. + Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up. + Assists with coordination of transition to patient's modality choice. + Assists with supply ordering and inventory for TCU **PHYSICAL** **DEMANDS** **AND** **WORKING** **CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** **AND** **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: The professional registered nurse Inpatient Services RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the kidney disease health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and program operations. PRINCIPAL DUTIES AND RESPONSIBILITIES: All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care, policy, procedures, standards of nursing practice, applicable contractual service agreements, state and federal regulations. · Performs all essential functions under the direction of the Supervisor and with guidance from the Educator, Preceptor or in collaboration with another Registered Nurse. · Performs ongoing, systematic collection and analysis of patient data pre - during - post treatment for assigned patients and documents in the patient medical record, makes adjustments and modifications to treatment plan as indicated and notifies Supervisor, Physician, patient's primary nurse and others as may be indicated. · Assesses, collaborates and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. · Recognizes aspects and implications of patient status that vary from normal and reports to or collaborates with appropriate health team members for input including but not limited to Supervisor, appropriate physician, and the contracted facility primary Nurse. · Directs and provides safe effective patient care for assigned patients as prescribed for all modality specific treatment procedures. · Assesses daily assigned patient care needs and collaborates with direct and ancillary patient care staff as needed. · Initiates and coordinates communication with FKC and Non-FKC dialysis providers and appropriate contracted facility personnel as needed to provide continuity of patient care. · Performs the implementation, administration, monitoring, and documentation of patient's response to prescribed intradialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. · Administers medications as prescribed and documents appropriate medical justification and effectiveness. · Initiates and assists with emergency response measures. · Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. · May be asked to provide specialized nursing care instruction to hospital/facility staff as stipulated contractually. · May be assigned to assist in an Outpatient facility on an as needed basis. · Required to complete CAP requirements to advance. · Performs all other duties as assigned by Supervisor. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. · This position requires frequent, prolonged periods of standing and the employee must be able to bend over. · The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. · The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. · May be exposed to infectious and contagious diseases/materials. · May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. · Day to day work includes, desk work, computer work, interaction with patients, facility/hospital staff and physicians. · The position requires travel to training/meeting sites and between assigned facilities. · Position requires participation in on-call rotation, night, weekend, holiday or as defined by individual program needs. SUPERVISION: Assigned oversight of Patient Care Technicians/LVN/LPNs/RNs as a designated Nurse in Charge, after meeting all the following: · Successful completion of all FKC education and modality specific training requirements for new employees. · Must have a minimum of 9 months experience as a RN. · 6 months experience in acute dialysis as a RN. EDUCATION and LICENSURE: · Graduate of an accredited School of Nursing. · Current appropriate state licensure. · Current or successful completion of CPR BLS Certification · Must meet the practice requirements in all states in which he or she is employed. EXPERIENCE AND REQUIRED SKILLS: · Entry level for RNs with less than 2 years of Nephrology Nursing experience as an RN · Minimum 9 months experience as a Registered Nurse, 12 months (preferred). · 6 months acute dialysis experience (preferred) · Hemodialysis and/or ICU experience (preferred). ACKNOWLEDGEMENT: I acknowledge that I have read and accepted this . I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate Supervisor or my Human Resources representative **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations. PRINCIPAL DUTIES AND RESPONSIBILITIES: All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations. · Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. · Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. · Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. · Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. · Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. · Initiates or assists with emergency response measures. · Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. · Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. · Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. · Ensures patient awareness related to transplant and treatment modality options. · Required to complete CAP requirements to advance. · Performs all other duties as assigned by Supervisor. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. · This position requires frequent, prolonged periods of standing and the employee must be able to bend over. · The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. · The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. · May be exposed to infectious and contagious diseases/materials. · Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. · The position may require travel to training sites or other facilities. · May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. SUPERVISION: Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: · Successful completion of all FKC education and training requirements for new employees. · Must have a minimum of 9 months experience as a RN. · Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN. EDUCATION and LICENSURE: · Graduate of an accredited School of Nursing. · Current appropriate state licensure. · Current or successful completion of CPR BLS Certification. · Must meet the practice requirements in the state in which he or she is employed. EXPERIENCE AND REQUIRED SKILLS: · Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse. · Chronic/acute hemodialysis experience (preferred). **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Functions as the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Provides day to day direction and supervision to assigned direct patient care staff. Communicates with the physician and other members of the healthcare team to interpret, adjust, and complete patient care plans. Provides safe, effective delivery of patient care in compliance with standards outlined in the facility procedure manual, as well as regulations set forth by the company, state, and federal agencies. Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** General and Staff Related: + Provide day to day guidance, support and direction to direct patient care staff, providing informal feedback on an ongoing basis and formal feedback input for the annual performance evaluation. Participate in the department staffing and the appropriate hiring, firing and disciplinary actions. Recommend disciplinary action to Clinical Manager and initiate as appropriate. + Ensure compliance with all company and facility approved procedures and policies as well as regulations set forth by state and federal agencies in clinics with more than 100 patients. + Approve or disapprove time or personnel schedule changes in the absence on the Clinical Manager ensuring compliance with applicable regulations, policies and procedures for documenting time of work hours for staff members on assigned shift. + Participate in patient care plan meetings. + Maintain knowledge in the current practices related to the principles and techniques of dialysis by participating in all scheduled in-services. + Train and orient staff as necessary. + Routinely observe and guide direct patient care staff for appropriate technique and adherence to facility policies and procedures. + Promote and assist with compliance to OSHA programs in order to maintain a safe and clean working environment. + Maintain overall shift operation in a safe, efficient, and effective matter. + With Clinical Manager conduct staff meetings at least monthly or as needed to keep patient care staff informed of changes in patient care needs or operations to improve delivery of care. + Meet routinely with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Supervise all documentation of patient information. + Coordinate Charge Nurse duties with Staff RNs acting in the relief charge capacity. Patient Care: + Assess daily patient care needs and develop and distribute patient care assignments appropriately. + Assume primary responsibility in an emergency situation. + Assess patient needs, respond to dialysis treatments, and communicate concerns to rounding physician. Implement changes in patient care/treatment as directed. + Monitor and supervise all patient care activity during dialysis and assist as necessary. + Collaborate with direct patient care team in making decisions to benefit patient care. + Continuously monitor patient's condition with regards to problems and potential complications associated with dialysis. + Administer medications to patients per physician's orders. + Act as the subject matter expert and as a resource for staff members. + Supervise and participate in completion of short- and long-term care plans. + Admit new patients according to facility procedure. + Ensure educational needs of patients are met and educate the patient and family about End Stage Renal Disease, dialysis therapy, diet and medication. Technical: + Supervise the safe and effective use of all equipment involved in direct patient care. + Operate all dialysis related and emergency equipment safely and efficiently when needed. + Perform required testing and verification and initial the checklist for start-up and shut-down procedures as outlined in the Technical Services Manual. + Complete Nurse's Technical Training Program/Water Quality Facility Training. Other: + Assist with special projects or other duties as assigned by the Clinical Manager + Assist with the interviewing of potential direct patient care staff as requested. + Promote efficient use of medical supplies. + Attend and participate in monthly Quality Assurance meetings. + Other duties as assigned. Relationships: + Internal Contacts: Direct Patient Care Staff, Facility support staff, management teams (Clinical Manager, Area Manager, RVP) + External Contacts: Physicians, Back-up Hospitals **Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.** The duties listed in this job description are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. + The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **SUPERVISION:** + Direct Patient Care Staff, Ward Clerk as assigned. **EDUCATION** **:** + Graduate of an accredited school of Nursing (R.N.) + Current appropriate state licensure. **EXPERIENCE AND REQUIRED SKILLS:** + Minimum of 9 months of nursing experience and an additional 3 months of clinical experience in dialysis + RN charge nurses assuming responsibility for nursing and patient servicesin the absence of the Clinical Managermust have one-yearclinical experience and six months dialysis experience. + Supervisory or management experience preferred. + Successfully completea training course in the theory and practice of hemodialysis. + Good communication skills - verbal and written. + Must meet appropriate state requirements (if any). **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment planning intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team this position participates in decision-making teaching leadership functions and quality improvement activities that enhance patient care outcomes and facility operations. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy procedures standards of nursing practice state and federal regulations. + Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator Preceptor or in collaboration with other Registered Nurses. + Performs ongoing systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record makes adjustments or modifications to treatment plan as indicated and notifies Team Leader Charge Nurse Supervisor or Physician as needed. + Assesses collaborates and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. + Directs and provides in collaboration with direct and ancillary patient care staff all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. + Administers medications as prescribed or in accordance with approved algorithm(s) and documents appropriate medical justification and effectiveness. + Initiates or assists with emergency response measures. + Serves as a resource for health care team participates in staff training and orientation of new staff as assigned. + Ensures correct laboratory collection processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. + Identifies expected outcomes documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. + Ensures patient awareness related to transplant and treatment modality options. + Required to complete CAP requirements to advance. + Performs all other duties as assigned by Supervisor. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. + This position requires frequent prolonged periods of standing and the employee must be able to bend over. + The employee may occasionally be required to move with assistance machines and equipment of up to 200 lbs. and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. + May be exposed to infectious and contagious diseases/materials. + Day to day work includes desk work computer work interaction with patients facility/hospital staff and physicians. + The position may require travel to training sites or other facilities. + May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. **SUPERVISION:** Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge after meeting all the following: + Successful completion of all FKC education and training requirements for new employees. + Must have a minimum of 9 months experience as a RN. + Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN. **EDUCATION and LICENSURE:** + Graduate of an accredited School of Nursing. + Current appropriate state licensure. + Current or successful completion of CPR BLS Certification. + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND REQUIRED SKILLS:** + Entry level for RNs with less than 1 year of Nephrology Nursing experience in the last two years as a RN. + Minimum of 9 months experience as a Registered Nurse (preferred). + Chronic/acute hemodialysis experience (preferred). **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** " **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Functions as the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Provides day to day direction and supervision to assigned direct patient care staff. Communicates with the physician and other members of the healthcare team to interpret, adjust, and complete patient care plans. Provides safe, effective delivery of patient care in compliance with standards outlined in the facility procedure manual, as well as regulations set forth by the company, state, and federal agencies. Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** General and Staff Related: + Provide day to day guidance, support and direction to direct patient care staff, providing informal feedback on an ongoing basis and formal feedback input for the annual performance evaluation. Participate in the department staffing and the appropriate hiring, firing and disciplinary actions. Recommend disciplinary action to Clinical Manager and initiate as appropriate. + Ensure compliance with all company and facility approved procedures and policies as well as regulations set forth by state and federal agencies in clinics with more than 100 patients. + Approve or disapprove time or personnel schedule changes in the absence on the Clinical Manager ensuring compliance with applicable regulations, policies and procedures for documenting time of work hours for staff members on assigned shift. + Participate in patient care plan meetings. + Maintain knowledge in the current practices related to the principles and techniques of dialysis by participating in all scheduled in-services. + Train and orient staff as necessary. + Routinely observe and guide direct patient care staff for appropriate technique and adherence to facility policies and procedures. + Promote and assist with compliance to OSHA programs in order to maintain a safe and clean working environment. + Maintain overall shift operation in a safe, efficient, and effective matter. + With Clinical Manager conduct staff meetings at least monthly or as needed to keep patient care staff informed of changes in patient care needs or operations to improve delivery of care. + Meet routinely with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Supervise all documentation of patient information. + Coordinate Charge Nurse duties with Staff RNs acting in the relief charge capacity. Patient Care: + Assess daily patient care needs and develop and distribute patient care assignments appropriately. + Assume primary responsibility in an emergency situation. + Assess patient needs, respond to dialysis treatments, and communicate concerns to rounding physician. Implement changes in patient care/treatment as directed. + Monitor and supervise all patient care activity during dialysis and assist as necessary. + Collaborate with direct patient care team in making decisions to benefit patient care. + Continuously monitor patient's condition with regards to problems and potential complications associated with dialysis. + Administer medications to patients per physician's orders. + Act as the subject matter expert and as a resource for staff members. + Supervise and participate in completion of short- and long-term care plans. + Admit new patients according to facility procedure. + Ensure educational needs of patients are met and educate the patient and family about End Stage Renal Disease, dialysis therapy, diet and medication. Technical: + Supervise the safe and effective use of all equipment involved in direct patient care. + Operate all dialysis related and emergency equipment safely and efficiently when needed. + Perform required testing and verification and initial the checklist for start-up and shut-down procedures as outlined in the Technical Services Manual. + Complete Nurse's Technical Training Program/Water Quality Facility Training. Other: + Assist with special projects or other duties as assigned by the Clinical Manager + Assist with the interviewing of potential direct patient care staff as requested. + Promote efficient use of medical supplies. + Attend and participate in monthly Quality Assurance meetings. + Other duties as assigned. Relationships: + Internal Contacts: Direct Patient Care Staff, Facility support staff, management teams (Clinical Manager, Area Manager, RVP) + External Contacts: Physicians, Back-up Hospitals **Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.** The duties listed in this job description are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. + The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **SUPERVISION:** + Direct Patient Care Staff, Ward Clerk as assigned. **EDUCATION:** + Graduate of an accredited school of Nursing (R.N.) + Current appropriate state licensure. **EXPERIENCE AND REQUIRED SKILLS:** + Minimum of 9 months of nursing experience and an additional 3 months of clinical experience in dialysis + RN charge nurses assuming responsibility for nursing and patient servicesin the absence of the Clinical Managermust have one-yearclinical experience and six months dialysis experience. + Supervisory or management experience preferred. + Successfully completea training course in the theory and practice of hemodialysis. + Good communication skills - verbal and written. + Must meet appropriate state requirements (if any). **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations. PRINCIPAL DUTIES AND RESPONSIBILITIES: All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations. · Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. · Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. · Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. · Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. · Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. · Initiates or assists with emergency response measures. · Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. · Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. · Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. · Ensures patient awareness related to transplant and treatment modality options. · Required to complete CAP requirements to advance. · Performs all other duties as assigned by Supervisor. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. · This position requires frequent, prolonged periods of standing and the employee must be able to bend over. · The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. · The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. · May be exposed to infectious and contagious diseases/materials. · Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. · The position may require travel to training sites or other facilities. · May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. SUPERVISION: Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: · Successful completion of all FKC education and training requirements for new employees. · Must have a minimum of 9 months experience as a RN. · Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN. EDUCATION and LICENSURE: · Graduate of an accredited School of Nursing. · Current appropriate state licensure. · Current or successful completion of CPR BLS Certification. · Must meet the practice requirements in the state in which he or she is employed. EXPERIENCE AND REQUIRED SKILLS: · Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse. · Chronic/acute hemodialysis experience (preferred). **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: This position is for graduates of an accredited school of Nursing working in a state that does not allow graduates to perform nursing duties until licensed. The specific job title used will be determined based on the state where the employee is employed. Functions as part of the hemodialysis health care team providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse while working towards obtaining their nursing license. Employees hired into this position will be required to obtain their nursing license within 90 days of their hire date. PRINCIPAL DUTIES AND RESPONSIBILITIES: Patient Care: + Performs vascular access evaluation pre-treatment. + Performs and records Pre and Post dialysis evaluation, weight and vital signs with initial identification. + Performs vascular access cannulation and reports any difficulties in cannulation or unusual findings to nurse supervisor. + Initiates dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluates intradialytic problems and provides intervention as prescribed by physician order or as directed. + Monitors patients' response to dialysis therapy. + Obtains vital signs prior to reinfusion; performs all relevant functions necessary for the discontinuation of treatment and documents appropriately. + Evaluates patient prior to termination of venous access - standing & sitting blood pressure. + Obtains hemostasis and applies appropriate dressings. + Evaluates the patient prior to discharge. + Documents information related to patient treatment including documentation in the patient health record. + Reports any significant information and/or change in patient condition directly to the nurse supervisor. + Performs and documents interventions for unusual patient status and document patients' response to intervention. + Obtains all prescribed laboratory testing and prepares specimens for collection. Maintenance / Technical: + Conducts all tasks necessary for preparation for dialysis treatment and documents where appropriate. + Maintains environmental integrity and aesthetics - ensures all areas are safe and clean. + Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Performs all required pretreatment dialysis machine set up and testing. + Ensures that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepares, organizes, and efficiently utilizes supplies and equipment to prevent waste. Clerical & Administrative: + Enters all treatment data into the designated clinical application accurately and in a timely manner. + Reviews health care record for completeness and ensures omitted entries are completed or corrected where appropriate. + Prepares lab requisitions for prescribed or stat lab specimens according to laboratory destination. + Collects, labels, appropriately prepares and stores lab samples according required laboratory specifications. + Ensures collection of lab specimens by appropriate lab courier. Other: + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintains regular and punctual attendance. + Performs other related duties as assigned PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Work includes using a desk and personal computer as well as interaction with patients, facility staff and physicians. The position may require travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + The position provides direct patient care that regularly involves heavy lifting and moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. SUPERVISION: + None EDUCATION AND REQUIRED CREDENTIALS: + Graduated from an accredited nursing program within the past 12 months EXPERIENCE AND REQUIRED SKILLS: + Previous patient care experience in a hospital setting or a related facility preferred. + Required to obtain nursing license within 90 days of employment Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. **EOE, disability/veterans**