Bedford VA is a Level 3 interdisciplinary teaching facility with service-lines serving rehabilitation, long term care and mental health inpatients and outpatients, with multiple community-based outpatient clinics (CBOC). There is a large outpatient psychiatric population, with admissions for medical co-morbidities. Home-Based Primary Care is provided in the veteran's home. PACT RN Care Coordinator: The responsibilities include, but are not limited to the following description: Participates in daily huddles, weekly pre-planning and monthly team meetings with core members of the PACT team. Relays relevant information to PACT/interdisciplinary team. Coordinates care by working across care settings to assist patients and ensure they receive the necessary care. Assists with care coordination a
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