Coordinates, facilitates and performs interdisciplinary plan of care through assessment and evaluation of patient condition and effectiveness of care under the direction of the attending physician by traveling to patient homes, Community-Based Residential Facilities (CBRF), assisted living locations, hospitals or other to meet patient and family/caregivers, assess patient care needs, acuity in relation to policies, procedures and regulations of home care and/or hospice services. Territories include: Arlington, Portage, Rio, Wyocena, Dane, Deforest, Doylestown, East/North Bristol, Lodi, Morrisonville, Windsor, Briggsville, Cambria, Dalton, Endeavor, Fox Lake, Kingston, Lewiston, Marquette, Montello, Oxford, Packwaukee, Pardeeville, Plainville, Westfield, Lake Mills, Lowell, Reesville, Waterloo, Beaver Dam, Columbus.