Primary Responsibilities: Develops, implements, and updates patient plans of care in collaboration with physicians and the interdisciplinary team; ensures home‑health eligibility and completes comprehensive nursing assessments (including OASIS and medication reconciliation). The Registered Nurse coordinates total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.