Jacksonville, FL 32205
Under the supervision of the PACE Clinical Manager, assist with the flow of clinic or home care services ensuring high quality standards. Performs duties such as delivering participant care, administering treatments, monitoring vital signs, performing tests, handling medical emergencies, recording participant behavior and all additional participant care services performed in the home. May be asked to be present for the daily IDT (Interdisciplinary Team) Meeting and coordinated services with primary care team. Assesses and monitors participants’ health status, provides nursing care, administers prescribed medications, educates and counsels participants and families, in collaboration with primary care physician and other team members.
As needed, conducts initial assessments, start of care assessments, and periodic reassessments, plan of care, coordination of 24-hour care delivery, regularly informing the Interdisciplinary Team (IDT) of the medical, functional, and psychosocial condition of each participant, remaining alert to pertinent input from other team members, participants caregivers, as well as documenting changes in a participant’s medical record consistent with documentation policies established by the Clinical Manager or Medical Director. May provide care at the PACE Clinic, participant’s home, and in a facility during short term care/ respite. Participates in nurse on-call rotation to cover after hours clinical needs of participants.

Duties and Responsibilities:

Perform clinical nursing duties with high integrity and quality
Oversight of a patient care team; providing clinical nurse care management to all aspects of the participant care needs and collaboration with the Inter-Disciplinary Team
Conduct nursing visits which may include, but not limited to wound care, assessments, injections, urine, pill counts, TB tests, etc. (as directed by providers)
Ensure participants are seen on a timely basis
Perform basic in-house lab tests; obtain and process specimens for outside laboratories, when applicable
Take and record vital signs, recognize any variances, outliers, or red flags, and take appropriate action
Conducts an in person comprehensive initial nursing assessment with new PACE Partners enrollees
According to PACE Partners policies and/or as directed by the Medical Director or Clinical Manager, provide medications, and conduct medication reconciliation
As directed, participate in the Intake and Assessment meetings
Completes the nursing assessment form on visitors and on participants at assigned schedule as needed
Provide participant triage and assessment and obtain health information and relevant data
Observes, records, and reports participant’s condition and reaction to drugs and treatments to Clinical Manager and Medical Director
Implements orders written by the Medical Director
Notify the Medical Director of any marked change in the participant’s condition
Provision of emergency care including arrangements for transportation
Instructs and educates participants and family regarding medications and treatment instructions
Maintains and reviews participant records, charts, and other pertinent information
Documents test and examination results
Ensure narrative nursing notes are documented in a timely manner (within 24-hours)
Ensures that appropriate staff maintains a list of medical supplies
Develops and implements an individualized "self-administration of medications" education program for participants
Demonstrates positive interpersonal relations in dealing with fellow employees, managers, and other department employees to maximize positive employee relations and productivity
Maintains a clean, safe, home environment, promotes accident prevention, and reports potential hazards
Demonstrates professional practice in participant care by use of established standards in planning, organizing, implementing, and evaluating
Maintains current, written records in compliance with regulatory standards; prepare a variety of written reports and correspondence
Perform duties in accordance with Code of Professional Nurses
Acts only within the scope of his or her authority to practice
Demonstrates the ability to obtain information and interpret information in terms of participants’ needs
Demonstrates knowledge of growth and development
Exhibits appropriate communication skills necessary for ages served (adult/geriatric)
Proactively involves the healthcare team in the care of the participant
The quality of the assessment allows for anticipated changes in the participant’s condition/status
Makes suggestions that positively impact the delivery of care
Be a leader and role model in the planning and provision of participant education.
Works collaboratively with interdisciplinary teams to meet the needs of the participant and family
Consistently demonstrates superior communication skills and developmental knowledge of the geriatric population
Ensures HIPPA compliance in maintenance and storage of medical records.
Communicate effectively with members of the IDT as appropriate to keep them abreast of any issues or concerns
Communicate with weekend and after hour staff, following up appropriately
Manage and review participants’ records, charts, pertinent information, and staff’s documentation
Document as needed in medical records according to PACE Partners Program standards
Perform general skilled nursing care to participants.
Perform or supervise the administration of prescribed medications and treatments in accordance with nursing standards
Assist in treatment, examination and testing of participants
Educate participants, family and caregivers in care, medications, treatments, and all other aspects of health education as needed
Educate staff in care and treatment of the elderly as needed
Follow all PACE Partners Program Policies and Procedures and OSHA safety guidelines
Protect privacy and maintain confidentiality of all company procedures and information about employees, participants, and families
Handle potentially infectious specimens with established biohazard precautions and practice standard precautions
Participate in and supports Quality Improvement initiatives

Qualifications and Requirements:

Education

Associates Nursing Degree required; Bachelor’s degree in nursing preferred
Registered Nurse license
BLS Certification required
ACHA Background Level II

Experience

Have 1 year of experience working with a frail or elderly population OR, if the individual has less than 1 year of experience but meets all other job requirements, the candidate must receive appropriate training from the PACE organization on working with a frail or elderly population upon hiring.
Meet a standardized set of competencies for the specific position description established by the PACE organization before working independently.
Two-years nursing experience in a hospital, nursing home, or community-based setting, preferred

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Alivia Care

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