Registered Nurse Fee for Service

Job Description

Job Description

$ 70 per visit for regular visit and $ 125 per visit for start of care

Registered Nurse (RN) – CAPABLE Program / Adult Day Health Care (ADHC)

Location: Manhattan and Bronx, NY (Field-Based)

Department: CHHA

Reports To: Project Coordinator

Areas of Assignment: Manhattan and Bronxt 

Position Summary

We are seeking a dedicated and compassionate Registered Nurse (RN) to join our innovative CAPABLE (Community Aging in Place, Advancing Better Living for Elders) Program . This community-based initiative is designed to reduce hospitalizations, prevent re-hospitalizations, and delay long-term care placement by helping older adults safely maintain their independence at home.

The FFS RN will work closely with an Occupational Therapist Registered (OTR) and an interdisciplinary team to assess participants' health status, functional abilities, home environments, and overall well-being. Through comprehensive evaluations, education, care coordination, and participant-centered interventions, the RN will support individuals in achieving their health goals and improving their quality of life.

The successful candidate will complete a 10-hour virtual CAPABLE training program focused on assessment, care planning, implementation, and evaluation of CAPABLE services.

Key Responsibilities Clinical Assessment and Care Planning

• Conduct comprehensive in-home nursing assessments to identify factors affecting functional status, independence, safety, and quality of life.
• Evaluate participants' physical, cognitive, emotional, and sensory capabilities.
• Assess participants' ability to perform Activities of Daily Living (ADLs) and recommend appropriate interventions.
• Review acute and chronic medical conditions, medication regimens, and health-related challenges that may impact a participant's ability to remain safely at home.
• Collaborate with participants to develop individualized strategies that promote self-management, independence, and overall wellness.

Home Safety and Environmental Evaluation

• Assess participants' home environments and identify risks that may compromise safety and accessibility.
• Recommend modifications and interventions to improve home safety and support aging in place.
• Collaborate with the OTR to implement participant-centered solutions that enhance independence.

Education and Care Coordination

• Provide education to participants and caregivers regarding disease management, medication adherence, fall prevention, and safety practices.
• Coordinate care with the CAPABLE team, community resources, and healthcare providers to ensure comprehensive participant support.
• Participate in quality improvement initiatives and interdisciplinary care planning activities.

Documentation and Program Compliance

• Complete all required assessments, screenings, evaluations, progress notes, attendance records, and other documentation in accordance with CAPABLE program requirements.
• Maintain accurate, timely, and compliant medical records in accordance with New York State Department of Health (NYSDOH) regulations and agency policies.
• Prepare and maintain required statistical and program reports.
• Ensure adherence to all federal, state, and local regulations, including HIPAA privacy standards and infection control protocols.

Administrative and Program Support

• Coordinate and maintain scheduling for nursing assessments and participant visits.
• Provide nursing support to the Adult Day Health Care (ADHC) program as assigned.
• Maintain professional competency through continuing education, training programs, and professional development opportunities.
• Communicate regularly with the Project Coordinator regarding participant progress, program activities, and operational needs.

Required Qualifications Education & Licensure

• Current, active, and unrestricted Registered Nurse (RN) license in New York State.
• Graduate of an accredited nursing program.

Experience

• Minimum of two (2) years of nursing experience in:
  • Home Health Care
  • Certified Home Health Agency (CHHA)
  • Community Health
  • Geriatric or population health settings

Skills & Competencies

• Strong clinical assessment and critical-thinking abilities.
• Excellent communication, interpersonal, and patient education skills.
• Ability to work independently while managing multiple priorities.
• Experience using Electronic Medical Record (EMR) systems.
• Commitment to person-centered, culturally sensitive care.
• Willingness and ability to travel throughout the assigned service area.

Preferred Qualifications

• Five (5) or more years of experience working with older adults or geriatric populations.
• Experience conducting home-based assessments.
• Bilingual language skills.
• Experience working within interdisciplinary care teams.
• Knowledge of community-based services and resources available to aging populations.

Physical Requirements

• Ability to stand, walk, bend, reach, and assist participants as needed to provide safe and effective care.
• Ability to navigate a variety of home environments, including locations that may have limited accessibility.
• Ability to travel throughout Manhattan and the Bronx for participant visits.