Registered Nurse (RN - Hospital) - Home Health & Hospice

Jamestown Regional Medical Center Jamestown, ND, US

Apply Now

$30.37 - $45.54 / hour

Apply Now

Description

STATEMENT OF PURPOSE

Coordinates total nursing care for patients, participates in patient and family teaching and provides leadership by working cooperatively with ancillary nursing and other patient team personnel in maintaining standards for professional nursing practice in the clinical setting.

Full-time benefitted position working 72 hours per two weeks. Days are Monday - Friday with every 4th weekend and every 5th holiday. Night call is one night every 2 weeks and one weekend every 9th weekend.

JOB FUNCTIONS

Maintains the standards of nursing care and implements the policies and procedures of the hospital and clinical services.
Maintains the standards of nursing care and implements the policies and procedures of the hospital and Nursing Department.
Evaluates patient eligibility, status and current coverage of service requirements. Collaborates with Home Health Manager or designee prior to admission.
Assesses the patient's condition and nursing needs; sets goals; prescribes appropriate nursing action to meet those goals and the physical, psychological, social and rehabilitative needs of the patient, including discharge planning.
Reports pertinent observations and reactions regarding patients to the appropriate person (i.e., physicians) and records those observations accurately and concisely.
Initiates and develops individualized nursing care plans for assigned patients.
Administers medications and performs treatments to assigned patients.
Provides for instruction of patient and family in use of specialized equipment.
Participates in Hospice/HH call rotation consisting of nights, weekends and holidays.
Participates in economical utilization of supplies and ensures that equipment is maintained in a clean and safe manner.
Participates in orientation of new personnel and peer performance evaluations of nursing staff.
Coordinates nursing care of patients when scheduled for therapy or procedures by other departments.
Establishes and maintains communications and utilizes teaching opportunities with patients and other significant individuals.
Assists with or institutes emergency measures for sudden adverse developments in patients such as cardiac arrest.
Participates in the maintenance of a clean and safe environment.
Participates in staff development programs.
Delegates and supervises Home Health Aide per CMS Conditions of Participation and Nursing Standard of Practice.
The above statement reflects the general duties considered necessary to describe the principal functions of the job as identified, and shall not be considered as a detailed description of all the work requirements that may be inherent in the position.

Requirements

Qualifications/Requirements for This Position

Preparation and Training - Work requires a professional level of knowledge acquired by completing an accredited RN nursing education program. Must hold RN licensure from the ND State Board of Nursing for the current year. Position requires completion of BLS CPR. Position is required to attend Crisis Prevention Intervention (CPI) training in the appropriate timeframe according to department orientation checklist.
Work Experience - Requires 1 year general Medical/Surgical nursing experience. Preferable 1 year Home Health or Community Health experience.
Attendance - Punctual and regular attendance is an essential responsibility of each employee at JRMC. Employees are expected to report to work as scheduled, on time and prepared to start working. Employees are also expected to remain at work for their entire work schedule.
Analytical Ability -
Independent Judgement -
Contact and Interpersonal Skills - Aware of high degree of visibility in community representing JRMC Home Health Agency. Considerable contact with physicians and personnel from other departments and residents of area served.
Supervising the Work of Others - May be required to plan, assign work to and check the work of 1 to 5 nursing personnel doing related work on the shift. Supervision is provided to LPNs, Nurse Techs, Nursing Aides and Ward Clerks.
Responsibility for Welfare of Others - High frequency with which work performed by the staff RN may result in very serious physical or emotional harm to others. It is the responsibility of the professional RN to continuously uphold the highest degree of performance within currently defined and acceptable nursing practice standards.
Responsibility for Making Decisions and Recommendations - Independent nursing judgment is often required by the professional RN based on established policies and procedures. Substandard performance in nursing skills or judgment may adversely affect patient care, patient welfare and hospital goodwill.
Mental / Visual Effort - Must be able to work with terminally ill patients and their families to effectively cope with death and dying. Visual acuity necessary for reading charts and working with medical devices; color perception necessary for interpreting testing procedures involving color comparisons.
Working Conditions - Exposure to patients with infectious diseases, unsanitary conditions within patient's residence. Exposure to elements at higher risk than usual due to extensive travel by car and working in adverse conditions in residences.
Promotion - No formal line of promotion.
Background Check - A comprehensive background check and drug screening will be conducted as a condition of employment for this role.
Drug Screen - A urine drug screening is required for all positions and must be completed within 30 days of the date of hire.
Physical Requirement - These are physical requirements of the position that may be performed as part of daily duties. Inability to meet one or more of these physical requirements will not automatically disqualify a candidate or employee from the position. Upon request for reasonable accommodation, JRMC may be able to adjust or excuse one or more of these requirements, depending on the requirement, the essential functions to which it relates and the proposed accommodation.

EMPLOYEE REQUIREMENTS -

Visual Observation - Continuously

Standing - Rarely

Walking - Rarely

Sitting - Continuously

Hands and Finger Dexterity - Frequently

Reaching with Hands and Arms - Rarely

Climbing - Rarely

Stooping/Kneeling/Crouching/Crawling - Rarely

Hearing/Listening - Continuously

Tasting or Smelling - Rarely

Working Inside - Continuously

Working Outside - Rarely

Working in Extreme Heat - Rarely

Working in Extreme Cold - Rarely

Working with Hazardous Materials - Rarely

Noise - Continuously

Working in Dirt/Dust - Never

Driving - Never

Lifting / Carrying / Pushing / Pulling:

Up to 10 pounds - Occasionally

Up to 25 pounds - Rarely

Up to 50 pounds - Never

Up to 75 pounds - Never

Up to 100 pounds - Never

Over 100 pounds - Never

Share this job

Related Jobs

Visiting Nurses Association - Registered Nurse - Hospice - Full TIme

VNA Home Health and Hospice Services Manchester, NH

Come work at the best place to give and receive care! Job Description: $10,000 Sign-On Bonus! Who We Are: The VNA HOSPICE team is an interdisciplinary group that works collaboratively to ensure our patients have dignity joy and comfort as they move toward the end of their lives. We support and educate patients, families, and caregivers throughout this journey. After death we provide ongoing support to those left behind, through our community bereavement program. About the Job: Delivers care to patients and families with needs ranging from basic to complex utilizing the nursing process. Creates a therapeutic and caring environment for patient and families. Practices in a manner consistent with the Elliot Hospital Interprofessional Practice model; the ANA’s Social Policy Statement, Scope and Standards of Practice, and the Nursing Code of Ethics; and relevant specialty standards of practice. What You’ll Do: Innovation & Inspiration Embraces and promotes change to support optimal patient outcomes and an effective professional practice environment. Collaboration & Continuity in Caring Involves patient/family in goal setting and planning and communicates that plan of care to patient and family for input; and to colleagues to ensure seamless care across shifts and settings. Accountability Demonstrates accountability for continued professional growth and development. Demonstrates accountability for own role in smooth operations of unit. Demonstrates the ability to recognize and manage rapidly changing situations. Respect & Role Modeling Utilizes current evidence and relevant national/specialty standards to guide practice and/or performance and identifies areas for improvement. Demonstrates competent clinical practice utilizing clinical decision-making and critical thinking skills. Who You Are: Education: Graduate of an accredited school of nursing. Bachelor of Science in Nursing preferred. Licensure: New Hampshire Registered Nurse or Compact State Registered Nurse License. Technical Certification: Ability to obtain BLS qualification during orientation period and maintain during employment. Professional Certification: Nurses are expected to pursue professional certification upon eligibility or within three years of entering the specialty practice. Schedule: Work schedule may include 8-12 hours per day with weekend/holiday coverage based on individual unit needs. Personnel are expected to cover for absences by rotating, working extra shifts, or use of on-call as needed. Nursing personnel are assigned to one area upon employment but may be required to assume assignments in other areas to meet patient needs. Other: Valid Driver's License required to travel throughout southern New Hampshire to provide home health care service and other job-related activities. Proof of automobile insurance required. Motor vehicle background report will be conducted. Why You’ll Love Us: Health, dental, prescription, and vision coverage for full-time & part-time employees Short-term disability, long-term disability, and life insurance coverage Competitive pay Tuition Reimbursement 403(b) Retirement Savings Plan And more ! #ACR Work Shift: Days | 8:00am-4:30pm | Rotating weekend and on call SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.

MANAGER PALLIATIVE HOME CARE & HOSPICE

Independence Health System Greensburg, PA

Actively promotes a Lean work culture by performing team member duties to encourage consistent use of LEAN principles and processes, including continually seeking work process improvements. Recognizes the necessity of taking ownership of one’s own motivation, morale, performance and professional development. Strives for behavior consistent with being committed to Excela’s missions, vision and values. Essential Job Responsibilities The position is responsible for leading the department and accountable for hospice/palliative care. This position has direct supervisory responsibilities such as hiring, coaching/mentoring, skills development, recognition and rewards, staff productivity, performance management and succession planning. Equitably and consistently apply and practice policies and procedures for all staff. Develop and manage department budget at or below budget expectations and consistent with adjusted volume variations. Identify and implement revenue enhancement opportunities. Articulate compelling program direction and translate direction into goals. Model and exemplify the Leadership Pledge in a consistent and proactive manner. Lead change in a complex healthcare environment. Align department with strategy map and continually work to implement drivers in support of Excela Health’s mission and vision. Act promptly to resolve problems and initiate better ways of doing things by acting as a catalyst for change. Implement at least one process improvement initiative for department on an annual basis. Investigate root case analysis of recurring problems and take appropriate action. Tie contributions to bigger goals while influencing and persuading others by building commitment among diverse groups. Demonstrate ability to eliminate silos by modeling actions and setting example and influence others to think and act as a unified health system. Challenge oneself to a higher level of performance by taking responsibility for professional growth and development. Promote Excela Health through participation in one community outreach or educational event per year. Hold self and others accountable and take responsibility for outcomes. Establish and maintain a safe working environment and assure staff complies with safety, environmental, and infection control guidelines. Equitably apply policies and procedures by issuing corrective action in a fair and consistent manner. Demonstrate expectation of confidentiality by continually encouraging staff to keep private information confidential and share information on a need to know basis. Assess customer’s needs, exceed customer expectations, and consider customers in decision making to improve customer satisfaction. Perform in accordance with Excela Health’s behavioral standards in support of the mission, vision, and values. Actively and positively promote the Respect and Recognition initiatives by supporting staff participation in committee membership, activities, and projects. Analyze issues before acting, generate creative ideas, detect patterns and connections, and break down complex problems. Practice participatory leadership by involving staff in decision-making and problem solving. Act on most urgent tasks, leverage available resources, review own workload, implement workable systems, and provide clear direction. Provide constructive feedback to help others improve performance and articulate areas of deficiency. Provide opportunities for staff to actively provide input into decision-making process. Update stakeholders on project progress. Facilitate open communication, diffuse sources of conflict, demonstrate respect for others, and diplomatically negotiate solutions. Facilitate teamwork through coaching and mentoring staff. Cognitive ability to function and concentrate on the essential and specialty functions of the job at a high level. Achieves thoroughness and accuracy when accomplishing an essential or specialty function of the job. Ability to think and concentrate for an entire shift. Accept appropriate patient referrals to the Home Health/Hospice team. Assign qualified professional personnel to meet the needs of the adult, geriatric, and pediatric patients. With clinical staff, prepares on-call schedules, plan and organize daily assignments including the review and assignment of new patient referrals. Supervise all assigned hospice nursing personnel and home health aides in the delivery of nursing and home health aide services to clients and families. Assign work to staff, provide direction and review work. Participate in and provide coordination and management of all professional services rendered to clients and families by Home Health/Hospice staff. Review all hospice DME and Pharmacy bills to identify ways to improve costs while providing quality products to patients. Responsible for monitoring the ordering of all narcotics including comfort kits for all hospice patients under the direction of medical director/complete documentation on all patients. Responsible for monitoring all documentation on all hospice patients’ narcotic refills is complete. Supervise maintenance of a balanced caseload and organize the follow of work, utilizing clinical staff and make field assessments as needed. Perform periodic home visits with staff for the purpose of role modeling, problem solving, supervising and evaluating of performance/quality of care. Assume an active role in the professional development of assigned staff including participation in orientation, ongoing skill development and other mentoring activities. Include participation in orientation, ongoing skill development and other mentoring activities. Responsible for maintaining an office environment that fosters the professional growth and development of assigned staff. Participate in staff recruitment and selection. Discipline and termination of employment not performing according to policies procedures and Hospice/Home Health standards. Conduct clinical record review to assess the appropriateness of care plan, the utilization of services and ensure complete documentation of needed services. Participate in program planning and evaluation activities related to the clinical services of the Home Health/Hospice department. Demonstrate timely and accurate computer entry of patient/job information to facilitate the devolvement of the OASIS data set, HIS Tool Oversight, orders for services, creation of time sheets and other required patient/employment documents and reports. Participate in Administrative call on a rotating basis with other members of the management team. Participate in program planning and evaluation activities related to the clinical services of the Home Health/Hospice department. Communicate effectively and tactfully with clients, recognizing their age, cultural diversity needs and abilities. Report to work on time, use time off appropriately and complete annual education and medical requirements. Active participants in IDG meetings. Active Managing role in Palliative home health and community programs. Responsible for making data driven decisions regarding capacity and productivity based on electronic reporting. Responsible for creating and executing annual agency goals supported by actionable 90 day plans. Other duties as assigned. Competency and Experience [Knowledge, Skills and Abilities] Required Qualifications/Experience Bachelor’s Degree or higher in Nursing or related field and five (5) years of Home Health/Hospice experience. Two (2) to Four (4) years supervisory/management experience in functional area. Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects and liability of functional area. Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience. Preferred Qualifications/Experience Master’s Degree in Nursing or related field preferred. Certified Hospice and Palliative Nurse (CHPN) preferred. Experience in Healthcare setting. License, Certification & Clearances Current licensure to practice as a Registered Nurse in the State of Pennsylvania. Current Basic Life Support (BLS) approved curriculum of the American Heart Association (CPR and AED) program. Act 33 with renewal Act 34 with renewal Act 73 FBI Clearance Valid Driver’s License (if out of state hire, the record report from applicable state driver’s license department is required) Position Type/Expected Hours of Work Incumbent will be scheduled based on operational need (rotate shifts, standby, on-call, etc.). Travel may be expected locally between System locations. Equal Employment Opportunity Independence Health and its affiliated companies are Equal Opportunity Employers. It is their policy to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, veteran status, or genetic information, or any other classification protected by law. Independence Health and its affiliated companies will comply with all applicable laws and regulations. Disclaimer This job description is not designed to contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee. Moreover, duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice. Work Environment Effective March 2020 or during pandemic: goggles, face shield and mask are required according to CDC guidelines When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required. Essential – Absolute Necessity. Marginal – Minimal Necessity. Constantly – 5.5 to 8 hours or more or 200 reps/shift. Frequently – 2.5 to 5.5 hours or more or 32-200 reps/shift. Occasionally – 0.25 to 2.5 hours or 2-32 reps/shift. Rarely – Less than 0.25 hours or less than 2 reps/shift. Physical Condition Essential Marginal Constantly Frequently Occasionally Rarely Never Extreme Heat X Extreme Cold X Heights X Confined Spaces X Extreme Noise(>85dB) X Mechanical Hazards X Use of Vibrating Tools X Operates Vehicle (company) x Operates Heavy Equipment X Use of Lifting/Transfer Devices X Rotates All Shifts X 8 Hours Shifts X X 10-12 Hours Shifts X X On-Call X Overtime(+8/hrs/shift; 40/hr/wk) X Travel Between Sites X X Direct Patient Care X Respirator Protective Equipment X Eye Protection X Head Protection (hard hat) X Hearing Protection X Hand Protection X Feet, Toe Protection X Body Protection X Latex Exposure X X Solvent Exposure X Paint (direct use) Exposure X Dust (sanding) Exposure X Ethylene Oxide Exposure X Cytotoxic (Chemo) Exposure X Blood/Body Fluid Exposure X Chemicals (direct use) Exposure X Mist Exposure X Wax Stripper (direct use) X Non-Ionizing Radiation Exposure X Ionizing Radiation Exposure X Laser Exposure X Physical Demands When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required. Essential – Absolute Necessity. Marginal – Minimal Necessity. Constantly – 5.5 to 8 hours or more or 200 reps/shift. Frequently – 2.5 to 5.5 hours or more or 32-200 reps/shift. Occasionally – 0.25 to 2.5 hours or 2-32 reps/shift. Rarely – Less than 0.25 hours or less than 2 reps/shift. Physical Condition Essential Marginal Constantly Frequently Occasionally Rarely Never Bending (Stooping) X X Sitting X X Walking X X Climbing Stairs X X Climbing Ladders X Standing X X Kneeling X Squatting (Crouching) X X Twisting/Turning X Keyboard/Computer Operation X X Gross Grasp X X Fine Finger Manipulation X X Hand/Arm Coordination X X Pushing/Pulling(lbs. of force) X

RN-Home Health and Hospice (H)

SSM Health Fond du Lac, WI

It's more than a career, it's a calling. WI-St. Agnes Hospital Home Care & Hospice Worker Type: Regular Job Summary: 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. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Assesses and coordinates patient's discharge planning needs with members of the healthcare team. May perform point of care testing according to policies and procedures. Collaborates, consults and communicates with physician regarding the plan of care and changes to patient status. Provides physician with regular updates on progress and recommends revision of plan care, documents status and communication in adherence with regulations. Coordinates and communicates with multi-disciplinary team members and outside agencies as appropriate to achieve expected outcomes for patient care and education through end of life or discharge, ensuring accurate and complete documentation and coordination of unique care plan. Completes admission paperwork and verifies insurance information. Completes a comprehensive medical assessment by entering data into the clinical computer program. Ensures that patient assessment is completed in a timely manner. Provides skilled nursing care within the established plan of care, including performance of tasks such as taking vitals, performing wound care, IV care, ostomy care, blood draws, injections, and the physical assessment of the overall patient’s medical condition. Documents visit notes, treatments, and care. Follows visit pattern according to physicians orders and ensures required visits are completed in a timely manner. Ensures all documentation is timely, accurate and complete in adherence to regulations. Collaborates with the patient, patient’s family and healthcare team to develop a comprehensive plan of care based on the unique needs of the patient. Responds to calls from patients, family members and others, completes follow-up to address needs, issues, or concerns. Works in a constant state of alertness and safe manner. Performs other duties as assigned. EDUCATION Graduate of accredited school of nursing or education equivalency for licensing EXPERIENCE No experience required ADDITIONAL REQUIREMENTS Proof of motor vehicle liability insurance that meets minimum state requirements upon hire and upon request. PHYSICAL REQUIREMENTS Constant use of speech to share information through oral communication. Constant standing and walking. Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. Frequent use of smell to detect/recognize odors. Frequent use of hearing to receive oral communication, distinguish body sounds and/or hear alarms, malfunctioning machinery, etc. Frequent driving. Frequent keyboard use/data entry. Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. Occasional lifting/moving of patients. Occasional bending, stooping, kneeling, squatting, twisting, gripping and repetitive foot/leg and hand/arm movements. Rare crawling and running. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) And Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) And Driving Record - Motor Vehicle Report (MVR) And Driver License – State Issued State of Work Location: Missouri Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) And Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Missouri Division of Professional Registration And Driving Record - Motor Vehicle Report (MVR) And Driver License – State Issued State of Work Location: Oklahoma Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) And Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Oklahoma Board of Nursing (OBN) And Driving Record - Motor Vehicle Report (MVR) And Driver License – State Issued State of Work Location: Wisconsin Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) And Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services And Driving Record - Motor Vehicle Report (MVR) And Driver License – State Issued Work Shift: Day Shift (United States of America) Job Type: Employee Department: 2900000116 HOME CARE FDL Scheduled Weekly Hours: 40 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave : we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage : we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status , or any other characteristic protected by applicable law. Click here to learn more.

RN (Registered Nurse) Case Manager, Home Health

Phoenix Home Care and Hospice Branson, MO

$65,000 - $90,000 / year

Full Time & PRN Availability Branson, MO and surrounding areas Pay Range: $65,000 - $90,000 As a Home Health Case Manager, you will play a vital role in delivering hands-on patient care right in the comfort of their own homes. Your expertise will be needed to coordinate the services of other healthcare providers, communicate with health insurance companies, and oversee the work of visiting nurses. A strong background in physical assessment, diagnostic interpretation, and effective communication will be essential in developing a personalized care plan that aligns with physician orders and incorporates thorough initial assessments. You will be collaborating closely with fellow nurses, as well as professionals in Physical Therapy, Speech Therapy, and Occupational Therapy. Unlike other agencies, we believe in leaving work at work. Here, our nurses complete their charting during visits with the help of Roger’s AI-powered support, allowing you to work smarter and enjoy a better work-life balance. Join us at Phoenix! Benefits Multiple Major Medical Plans to Choose From (Medical, Dental & Vision) Spousal Insurance 401k Options Annual Stay Bonus for both Full-Time and Part-Time nurses PTO Paid Training on the job or in office Internal Awards and Recognition Program Responsibilities Management of caseload including supervision of LPN visits Varied weekly caseload includes routine visits, evaluations, and starts of care, allowing for day-to-day patient interaction. Knowledge to provide education on health conditions including CHF, COPD, Diabetes, Wound Care, and Medication Management Communication with physicians to obtain orders and write diagnosis driven plans of care. Work alongside strong therapy team including PT/OT/Speech. Requirements Missouri or Compact Registered Nursing and Driver's License. Home Health or Critical Care Preferred. Driver's License and Vehicle with Current Auto Insurance We’re taking the journey with you, creating a New Beginning! Choose Phoenix, Apply today! Our mission is to offer New Beginnings and meaningful opportunities to our caregivers and clinicians while providing home care services to our clients built on innovation, skill, and Christ-like values of compassion, honesty, and patience. Service areas include the following counties:

RN (Registered Nurse) Case Manager, Home Health

Phoenix Home Care and Hospice Branson, MO

$65,000 - $90,000 / year