Home Care Nurse

Supervising Registered Nurse (RN) — PRN / Per Diem / ContractViska Homecare | Silver Spring, MD 20901

Pay: $100–$150 per assessment | $75–$100 per supervisory visit | $45–$65/hr

About Viska Homecare

Viska Homecare is a licensed Residential Service Agency (RSA) and home healthcare agency in Silver Spring, Maryland. We provide skilled in-home nursing oversight, personal care, and aide services to older adults, adults with disabilities, and veterans throughout Montgomery County. Our clinical model is built around individualized care plans, RN-supervised caregivers, and a standard of care that families and referral partners can trust.

Position Overview

We are seeking a Registered Nurse to serve as our clinical supervisor on a PRN, per diem, or contract basis. This is a flexible, self-directed field role with no set minimum hours. You will conduct in-home clinical assessments, develop care plans, and provide ongoing caregiver supervision in compliance with Maryland RSA regulations (COMAR 10.07.05). Your schedule and income grow alongside our client census.

Responsibilities

Client Assessment

• Conduct comprehensive in-home assessments including vital signs, physical examination, health history, ADL/IADL evaluation, fall risk scoring, cognitive screening where indicated, and home safety review
• Complete and document the full assessment report within 24 hours of the in-home visit and provide a copy to the client’s family
• Conduct reassessments following hospitalizations, emergency events, significant condition changes, and on a scheduled quarterly basis

Care Plan Development

• Develop a written, individualized care plan for every client based on the initial assessment, specifying daily task assignments, fall prevention protocols, medication schedule, emergency response protocols, and family communication preferences
• Review the care plan with the assigned caregiver before their first shift and confirm comprehension
• Share the completed care plan with the client’s family and obtain written acknowledgment before services begin
• Revise and update care plans promptly when client needs change or when a supervisory visit identifies discrepancies between the plan and care being delivered

Caregiver Supervision

• Perform scheduled and unannounced supervisory visits to observe caregiver performance, assess client wellbeing, and verify care plan adherence
• Conduct a minimum of one supervisory visit per client within the first 30 days of service and quarterly thereafter
• Document all supervisory visits in a written report including observations, client status, any discrepancies identified, and corrective actions taken
• Provide direct, constructive feedback to caregivers and escalate performance concerns to agency leadership with documentation
• Evaluate new hire caregiver competency during orientation and confirm safe performance of all care plan tasks
• Serve as RN supervisor of record in compliance with COMAR 10.07.05 — all aide supervision must be performed by the RN

Medication Management

• Review and document the complete medication list for every new client at intake including all prescription, OTC, and supplement medications, dosages, schedules, and routes of administration
• Create and maintain a Medication Administration Record (MAR) for each client receiving medication assistance
• Review completed MARs during supervisory visits and report any medication errors, missed doses, or refusals to the family within 24 hours and to agency leadership immediately

Clinical Escalation and Emergency Response

• Provide clinical guidance when caregivers report changes in a client’s condition including altered mental status, vital sign changes, skin breakdown, falls, or medication reactions
• Contact the client’s physician when clinical changes warrant a consult and document that communication in the client’s record
• Direct caregivers to activate 911 in any medical emergency and ensure the caregiver remains on-site until emergency services arrive
• Conduct a post-event care plan review following any fall, emergency visit, hospitalization, or significant change in condition

Family and Referral Communication

• Participate in new client onboarding meetings with families, explain the care plan, and answer clinical questions
• Communicate proactively with families when client status changes, the care plan is updated, or a clinical concern arises
• Send written assessment summaries to referring hospital discharge planners or physicians within 48 hours of service start when requested

Documentation and Compliance

• Ensure all clinical activities comply with COMAR 10.07.05 and the Maryland Nurse Practice Act
• Maintain client records in Viska’s home care software in compliance with HIPAA requirements
• Support Electronic Visit Verification (EVV) compliance by ensuring all supervisory visits are properly logged
• Maintain current RN licensure and CPR/First Aid certification throughout the engagement

Requirements

• Active, unencumbered RN license issued by the Maryland Board of Nursing
• Minimum 2 years nursing experience in homecare, home health, community health, visiting nurse services, geriatric nursing, or rehabilitation nursing
• Demonstrated ability to perform independent clinical assessments including vital signs, physical examinations, health histories, and ADL/IADL evaluation
• Experience developing and managing individualized care plans for patients with chronic or complex conditions including dementia, Alzheimer’s disease, and developmental disabilities
• Competency in clinical procedures in the home setting including medication administration (injections, IV infusions), wound care, catheterization, ventilator care, and ostomy management
• Able to coordinate with physicians, case managers, and specialists for discharge planning, follow-up care, and community referrals
• Familiarity with home healthcare regulations and compliance — full orientation and training provided
• Strong documentation skills with ability to meet regulatory timeframes
• Reliable, self-directed, and clinically responsive — available within 2 hours for caregiver clinical questions
• Valid driver’s license and reliable personal vehicle for home visits across Montgomery County
• Current CPR and First Aid certification required

Preferred Not Required

• Bilingual in Spanish, Amharic, French, Vietnamese, or another language serving the Montgomery County community

How to Apply

Send your resume to:

Homecare@viskahomeccs.com

Subject line: Supervising RN — Viska Homecare

We respond to all qualified applicants within 48 hours.

Viska Homecare is an equal opportunity employer. We are committed to building a team that reflects the diverse communities we serve across Montgomery County, Maryland.

Licensed Residential Service Agency — Maryland Department of Health, Office of Health Care Quality (OHCQ) | COMAR 10.07.05

Pay: $45.00 - $65.00 per hour

Work Location: Hybrid remote in Silver Spring, MD 20901