Registered Nurse: PACE - Weekend Sustainability Team RN

About LIFE COORDINATED Commonwealth PACE (Program of All Inclusive Care for the Elderly):

Come join the"gold standard of healthcare" - PACE!

MEET LIFE COORDINATED - welcome home.

LIFE COORDINATED is an integrated care company and PACE Program (Program of All Inclusive Care for the Elderly) with the goal of empowering and supporting frail elders to live independently at home vs a nursing home. Our job is to see around the corner and help members stay healthy and independent. 

LIFE COORDINATED just launched a weekend sustainability team for the weekends - 2 10's or 3 10s of primarily in home support and ER risk mitigation. This role would be supporting the Interdisciplinary and PCP team. A Registered Nurse is integral to delivering comprehensive and integrated care. Are you ACTION oriented, insightful and willing to help change lives. Yes, heroes do wear capes and we need an RN who wants to be part of improvong outcomes and lives.

Our goal is to help our members live their best life based upon their personal goals.

PACE also allows us to invest in the right things to address root cause and environmental factors, not just symptoms and resulting medical care.

The Role Mission:

The mission of the Registered Nurse is to provide and maintain health of PACE program participants through teaching, counseling, and appropriate preventative, intervention, and rehabilitative services. The RN is responsible for the assessment of health needs and actively contributes to the plan of care, the initial implementation of nursing care plans and provides nursing care, as well as periodic and ongoing reassessment of individual and family nursing needs.

Technical, organizational, and interpersonal skills necessary to coordinate the scheduling, communication, and billing documentation of all aspects of the plan efficiently and effectively for home care are also required.

General

a. Knows and adheres to the philosophy and goals of (PACE Program).

b. Maintains a quiet and safe environment for clients, visitors, and staff.

c. Keeps confidentiality of client records, reports, and discussions.

d. Participates in formulation and maintenance of (PACE Program) policies and procedures.

e. Participates in (PACE Program) Committees as requested by the Clinical Services Director.

f. Actively participates in Interdisciplinary Team Meetings (IDT).

g. Attends and participates in scheduled staff meetings and client care meetings as requested.

h. Advises the Clinical Services Director in ways and means to establish better accountability of (PACE Program) services to clients and referral sources.

i. Maintains flexibility in schedule and responds to unexpected emergencies and changes in workload to fulfill responsibilities.

j. Maintains timely and quality documentation of clinical services provided, reviewing medical record for continuity and completeness, and to meet compliance and regulatory requirements.

k. Utilizes supplies and equipment economically.

l. Informs the Clinical Services Director of “unusual incidents.”

m. Identifies nursing service delivery problems and uses good judgment in their solution.

n. Is professional in appearance and manner in the clinical area; recognizes own limits and seeks help and guidance from the Clinical Services Director as appropriate; responds in a positive manner to constructive criticism; serves as a role model for students and staff members.

o. Optionally holds membership in professional organizations.

p. Maintains applicable licensure and certification and pursues professional growth through continuing education process and presenting and publishing scholarly papers.

q. Performs other duties as required or requested in a positive and helpful manner to ensure a smooth-running work environment.

Participant Care

a. Gives skilled nursing care and prescribed treatments to participants in their homes or at the adult day health center and demonstrates nursing care to clients and families.

b. Conducts comprehensive assessments, using the nursing process, to identify the healthcare needs of an elderly population, and appropriately to facilitate the admission and care plan process.

c. Provides routine nursing care for ongoing or episodic illnesses, according to the plan developed by the Team.

d. Counsels and guides participants and families towards self-help in recognition and solution of physical, emotional, and environmental health problems.

e. Participates in on-call coverage to troubleshoot, advise, teach, and coordinate the scheduling of participant care.

f. Manages the medication system at PACE facilities by administering medications and accurately completing documentation processes.

g. Teaches classes and addresses groups related to nursing and health.

h. Makes referrals to other services when participant conditions or situations require the service of other professional disciplines or the products or services of outside companies and agencies. This includes, but is not limited to volunteer agencies, loan closets, therapy services, support groups, etc.

i. Compiles and uses records, reports, and statistical information for evaluation and planning of the assigned programs.

j. May participate in a joint team/family meeting to discuss current nursing practices, concerns, and suggestions for care plan update and/or revisions.

k. Establishes and maintains cooperative working relationships with other program staff, contact agencies, and outside organizations.

l. Communicates effectively with hospital departments to minimize hospital lengths of stay as appropriate and allow for a smooth transition for the client as he/she moves from the hospital to alternative levels of care.

m. Supports Quality Management Program through participation in quality studies, provision of recommendations for improvement, and active participation in performance improvement actions.

Leadership/Management

a. Assists in design of systems for training, orienting, in-servicing, and supervising in-home caregiver staff according to program needs and regulatory requirements.

b. Supervises in-home caregiver staff and directs the provision of quality paraprofessional care.

c. Performs evaluations and professional development of caregivers; supervises caregivers in the home.

d. Demonstrated ability to deliver services to physicians, participants, and fellow employees with compassion and in a responsive, courteous, and concerned manner.

e. Records, maintains, monitors, and verifies accurate home care records including service documentation, attendance/payroll, in-service, medical records, and billing.

EDUCATION:

Associated Degree in Nursing

Bachelor of Science in Nursing [preferred]

a. Licensed as a Registered Nurse (RN) in the state of Kentucky

b. Current valid driver's license

c. Current CPR Certification

REQUIRED KNOWLEDGE, SKILLS AND/OR ABILITIES: MID LEVEL - SENIOR LEVEL RN

a. At least 7 years knowledge of current community health nursing practice.

b. At least 1 year professional experience working with an elderly or frail population.

c. Strong skills in nursing, geriatrics, healthcare, and home health.

d. The ability to effectively work within an interdisciplinary team

e. The ability to work effectively with culturally, economically, and educationally diverse populations

f. The ability to form positive interpersonal relationships with a wide range of staff and clients.

DESIRED OR PREFERRED KNOWLEDGE, SKILLS AND/OR ABILITIES:

a. Supervisory experience desired.

b. Working knowledge of the administrative organization of community facilities.

c. Skill in the application of current procedures and techniques of patient care.

d. Ability to plan and coordinate care for individuals, families, and groups.

e. Ability to communicate effectively.

f. Ability to establish and maintain cooperative working relationships.

g. Ability to perform duties in accordance with AHA Code for professional Nurses and established policies and procedures.

h. Acceptable physical and mental health to carry out the responsibilities of the position.