A Day in the Life of an RCC

Nurses in today’s healthcare landscape are always looking for unique roles that redefine patient care. Those who find opportunities at Contessa, Amedisys’ high-acuity line of care, are often excited to discover exactly that.  

One of Contessa’s roles that allows nurses to be at the forefront of a highly innovative care model is the Recovery Care Coordinator (RCC) position. RCCs are fully integrated into the clinical teams at partner health systems and work directly with a patient and their clinical teams on the floor of the hospital to coordinate a full 30-day episode of care at home.  

With a combination of in-person care coordination and telephonic interface with the patient’s care team and others, an RCC has the unique opportunity to not only coordinate a patient’s recovery from their acute illness, but to help them with the resources they need to improve their health and quality of life going forward.  

To learn more about a day in the life of an RCC, we had a conversation with one of our Lead RCCs, Delaney Puente, and asked her to tell us about her role. 

Why the RCC role is unique 

Delaney says that when she first heard about the RCC role through a recruiter, “I remember being so excited, and it was all I could talk about for weeks.” Like many nurses working in the hospital, Delaney often experienced frustration with not being able to help her patients in ways she felt were most beneficial. “I was excited to be a part of something new and innovative, where the patient’s wellbeing was truly the center of everyone’s thoughts,” she says. “At the end of the day, nurses are always patient advocates. You want to do something that makes you feel good.” 

In her role as an RCC, Delaney has also discovered that her patients share her excitement. “We always receive very positive patient feedback because patients do heal better at home,” she shared. “That’s an amazing part of the job, to see peoples’ faces light up when you tell them they can go home to finish their hospitalization. It’s very rewarding.” 

The beginning of a shift 

The RCC is imbedded in a Contessa partner hospital as part of a team of dedicated Recovery Care at Home providers. This includes hospitalists, Acute Care Registered Nurses (ACRNs) and other providers who work together to support patients through their recovery from acute illness at home.  

Delaney explains, “The RCCs function as admission coordinators and liaisons for the hospital. We’re the first face that the patient sees when discussing the option to finish their hospital stay at home.” To facilitate this, the RCC meets with the providers each day to help screen and identify patients who are potentially eligible for the program, and then participates in a clinical review of those patients alongside the admitting providers.  

If the patient is a good candidate for the program, Delaney says, “Then we approach the patient on the floor with our provider. We discuss the program with the patient, and if interested, we do a thorough health and home assessment to ensure they would be a safe candidate. Then, we work on facilitating a smooth transfer home. We work with our providers, ACRNs, and vendors to ensure all patient care needs are met.” 

To perform their duties, an RCC: 

 • Coordinates referrals and appropriate resources to assist patient and/or caregiver in continuation of care in the outpatient setting.  
• Maintains all required documentation in all interactions with our health systems’ patients and the care team.  
• Interacts with the patient and the multidisciplinary team to coordinate the services ordered by our partners’ physicians.  
• Communicates discharge information to other clinical departments or members of the Care Team.   
• Works with our partner’s providers to confirm admission health and home assessment data collection is accurate ensuring the home environment is safe.  
• Ensures that patients have access to appropriate services to meet their provider-directed care plan needs.  
• Monitors the care that the patient receives based on a discrete set of parameters created for each patient and brings it to the attention of a provider.  
 

During a typical shift, Delaney says this intensive admissions process allows her to meet with two or three new patients. “We also monitor the progress of all admitted patients, and are proactive on coordinating any discharge needs, whether that is home health or continued oxygen. We ensure patients have a safe discharge plan.” 

Other responsibilities of an RCC 

In addition to coordinating care for patients and working with the dedicated team of Contessa providers, RCCs play a key role in interfacing with the partner hospital system. They must: 

• Build and maintain collaborative professional working relationships with physicians, Medical Directors, clinicians, and the community at large to develop and implement a successful cross-continuum care management process  

• Assist as needed in recruiting, client and community outreach and critical incident and complaint management.  

What are some challenges of the RCC role? 

The close interactions between the RCC and the hospital system also means that the RCC can support the entire care at home model in a unique way. “We are so novel that patients and other healthcare professionals have a hard time differentiating between us and other healthcare models,” Delaney explained. “There is a lot of education that we are not home health— these are the higher acuity services we can offer. It breaks the mold of what people are used to. We work closely with our providers to communicate these differences and build relationships within our partner hospital system.”  

But Delaney also says that the advocacy role an RCC holds is making a big difference: “All the networking and education ultimately means we are providing our service to more patients. It’s exciting to be the boots on the ground helping to change the way people view healthcare.” 

How RCCs make a difference in the lives of their patients 

The RCC’s pivotal role in the Recovery Care at Home program means that ultimately patients can benefit from the improved outcomes Contessa offers. Delaney explains, “While in the program, patients get dedicated one-on-one time with the ACRNs. Not only do the ACRNs provide a lot of education, but they are able to assess the safety of their home environment or notice discrepancies in their home medications. 

“Through individualized time with our nurses, patients are empowered to be more involved in their health plan. I believe this education raises their health literacy, and hopefully prevents readmissions. I love that we can have a lasting impact.” 

Wrapping up the shift

At the end of the day, Delaney feels proud of the impact her care has on her patients. “It’s like a little beacon of hope. That’s why we went into the field, to care for and advocate for patients; you want to feel like you’re doing that to the best of your ability.” 

She added: “We’re patient-first, but we also have a very close team where we value everybody’s feedback. I really enjoy the culture here; I think it’s the best place I’ve ever worked.” 

To see available RCC roles, check out our job postings.