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PACE - Home Health Registered Nurse

Company: San Ysidro Health Center
Location: San Ysidro
Posted on: May 3, 2021

Job Description:

Position Summary:

Has the responsibility for providing direct and indirect nursing care under the direct and indirect supervision of the PACE Center Manager or designee but is independent in the application of advanced nursing knowledge and skills. Manages complex clinical situation for which he/she is responsible.

Essential Functions of the Job: Assessment:

Collects patient data and completes required forms with appropriate responses according to unit standards; identifies patient's overt problems/needs and sets priorities; identifies problems requiring further referral and/or follow-up; interprets and records latest diagnostic results; performs advanced nursing assessment using critical thinking skills.

Planning Care:

  • Develops a plan of care based on nursing process and which incorporates the plans of other disciplines and continuing care needs; includes the patient/family in developing or revising the plan of care;
  • Makes referrals to multidisciplinary support services. Initial and periodic assessments (minimally every 6 months) to be completed prior to the scheduled team meeting.
  • Communicates participant changes to team members.

Implementing/Managing Care:

  • Care provided conforms to accepted practice standards; provides correct treatments/procedures and other care as prescribed and according to patient care standards;
  • Demonstrates understanding of age-related characteristics and needs of patients served;
  • Explains nursing procedures in appropriate forms; provides participant and family education in coordination of 24 hour care delivery;
  • Identifies emergency situations and independently initiates advanced therapy;
  • Acts as coordinator of patient care with other health care personnel and evaluates patient care measures instituted; understands and demonstrates respect for patient rights and utilizes established mechanisms for management of ethical issues in patient care.
  • May conduct home visits, SNF, hospital visits as needed. Will participate in family care team meetings.


Records patient care delivered as planned and any variation, with appropriate rationale; makes and records observations related to impending or associated problems; implements nursing measures related to impending or associated problems.


  • Using nursing process, delegates nursing care to appropriate personnel; integrates cost effective measures into nursing practice; recognizes unit problems and takes responsibility for documenting same;
  • Demonstrates active participation in QI processes; complies with hospital expectations to meet staffing demands based on patient care needs; complies with policies addressing safe working conditions; monitors unsafe working conditions; recognizes inappropriate and/or ineffective patient care management, resolves issue/problem and completes written reports;
  • Fulfills call for unit as assigned and adjusts staffing for census (volume) and acuity.
  • Participates as a member of the Interdisciplinary Team. Attends staff meetings and takes part in participant care planning.

Additional Duties and Responsibilities

  • Keeps abreast of all regulations and standards to ensure compliance with orders or directives issued by duly constituted government / regulatory agencies.
  • Enhances professional growth and development through participation in educational programs, current literature, in-service meetings and workshops.
  • Attends meetings as required and participates on committees and directed.
  • Perform other related duties as assigned or requested.

Job Requirements

Education Required (Minimum level of education): Graduate of an accredited school of nursing.

Licensure, Registry or Certification Required: Currently licensed in CA as a Registered Nurse license; must present credentials which demonstrate ability to meet performance criteria for RN.

Preferred Experience:

  • Knowledge and/or 6 months experience working in health care setting, senior or elder care setting - PACE, Nursing Home, Hospice, ADHC. Nursing competency and familiarity with care paths, interact tools commonly used in skilled nursing home settings.
  • Must be able to triage clinical symptoms, apply care paths and clinical interactive tools in patient evaluation and care prior to communications with physicians.
  • Must be comfortable starting IV lines, IV medication administration and monitoring. Must be comfortable with acute care of frail adults, complex wound care and cognitively impaired adults

Verbal and Written Skills Required to Perform the Job: Excellent

Oral, written, and interpersonal communication skills.

Technical Knowledge and Skills Required to Perform the Job:

Must possess the skills to provide care for geriatric patients, must thrive in team environment, must possess good organizational and supervisory skills, ability to effectively handle difficult and unusual interpersonal situations. Meet a standardized set of competencies for the specific position description established by San Diego PACE and approved by CMS.

Equipment Used: Minor medical equipment such as vital signs Monitors, emergency cart, automated external defibrillator (AED), And patient personal assist devices. Networked computer with Various applications, facsimile machine, document center, and Telephone.

Working Conditions and Physical Requirements: Physical clearance

for reaching, bending, stooping, crouching, kneeling and grasping; have full range of motion; ability to lift 50 lbs; need to lift and transfer participants; TB clearance; must maintain current First Aid, CPR and BLS Certification.

Immunizations: Be medically cleared for communicable diseases and have all immunizations up-to-date before engaging in participant care.

About Us

San Ysidro Health is a Federally Qualified Health Care organization committed to providing high quality, compassionate, accessible and affordable healthcare services for the entire family.

The organization was founded by seven women in search of medical services for their families and community. Almost 50 years later, San Ysidro Health now provides innovative care to over 92,000 patients through a vast and integrated network of 34 program sites across the county. San Ysidro Health could not serve our patients without the dedication of our passionate and hardworking employees.

Apply today and become a part of our mission-driven team!

San Ysidro Health has a long-standing commitment to equal employment opportunity for all applicants for employment. Employment decisions including, but not limited to, those such as employee selection, performance evaluation, administration of benefits, working conditions, employee programs, transfers, position changes, training, disciplinary action, compensation, and separations are made without regard to reace, color, religion (including religious dress and grooming), creed, national origin, nationality, citizenship status, domestic partnership status, ancestry, gender, affectional or sexual orientation, gender identity or expression, marital status, civil union status, family status, age, mental or physical disability (including AIDS or HIV-related status), atypical heredity cellular or blood trait of an individual, genetic information or refusal to submit to a genetic test or make available the results of a genetic test, military status, veteran status, or any other characteristic protected by applicable federal, state, or local laws.

Other details

  • Pay Type Hourly

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  • 3364 Beyer Blvd, San Ysidro, CA 92173, USA

Keywords: San Ysidro Health Center, Rio Rancho , PACE - Home Health Registered Nurse, Other , San Ysidro, New Mexico

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