Job Description

San Diego’s St. Paul's PACE program (Program of All-Inclusive Care for the Elderly). This innovative program is for individuals 55 years or older, who are living with chronic illness, or disabilities and need coordinated medical care to continue living as independently as possible in their home and community. The healthcare teams at St. Paul’s PACE provide a hands-on approach coordinating medical, social, and home care services so individuals no longer need to manage their medical care alone.

Under the direction and supervision of the In Home Services Manager, provides skilled nursing care to participants in their homes, ensuring safe transitions of care, effective medication management, and timely clinical interventions following hospitalization or changes in condition. This role supports participants receiving home health, hospice, or in-home services by delivering provider-ordered skilled nursing care, completing medication reconciliations, developing care plans, and coordinating closely with the interdisciplinary care team. The In-Home Services Nurse plays an important role with in-home skilled nurses services, post-acute follow-up, participant education, and documentation to promote continuity of care, reduce hospital readmissions, and ensure compliance with regulatory and organizational standards.

Duties and Responsibilities:
• Review daily morning meeting updates to identify participant hospitalizations, discharges, or changes in condition requiring follow-up.
• Complete wellness checks as assigned by the Case Manager for participants recently discharged from the hospital or skilled nursing facility.
• Communicate changes in participant status and concerns to the Case Manager and appropriate interdisciplinary team members.
• Provide in-home skilled nursing services as ordered by the provider, including but not limited to injections, wound care, and clinical evaluations.
• Deliver education to participants and families related to disease processes, medications, treatments, and safety.
• Complete weekly or bi-weekly skilled nursing visits for participants receiving hospice services.
• Complete medication reconciliations for participants receiving medication management services.
• Monitor medication adherence and report discrepancies, concerns, or adverse effects to the appropriate provider. Refill medications through EireneRx as needed to ensure uninterrupted therapy.
• Administer narcotic medications for hospice participants in the home or licensed residential care settings, in accordance with policy and regulatory standards.
• Process In-Home Services orders in a timely manner and create required nursing care plans.
• Develop and maintain care plans for participants receiving home health services, ensuring accuracy and compliance with regulatory requirements.
• Deliver medical supplies is necessary to support participants receiving in-home services.
• Enter all scheduled home health visits into Greenway to capture encounters, including checking participants in and out and linking all required documentation. Maintain timely, accurate, and complete clinical documentation in accordance with organizational policies and regulatory standards.
• Shall attend in-service education program, including orientation and skill training and continuing education.
• Shall receive in-service training in first aid and in cardiopulmonary resuscitation within the first six months of employment.
• Follows all St. Paul’s PACE Policies and Procedures and OSHA safety guidelines.
• Maintains the confidentiality of all company procedures, results, and information about participants, clients or families.
• Practices Universal precautions and follows appropriate Infection Control procedures.
• Maintains safe working environment. Follows St. Paul’s PACE Safety Policies and Procedures.
• Participates in and supports Quality Improvement initiatives.
• Performs other duties as required or requested

Qualification and Requirements:
• Education - Graduate of a school of professional nursing required. Current Registered Nurse or Licensed Vocational Nurse. CPR certification required.
• Experience – A minimum of one year’s experience in working with the frail or elderly population required. IV Certification preferred. Experience in home health, hospice, or community-based nursing highly preferred.

St. Paul’s Benefits:
• Health, dental, vision, life
• Same day pay available!
• Flexible Vacation Time - 17 days!
• Paid Sick Time
• Education reimbursement - up to $3,000 a year!
• Qualified Public Student Loan Forgiveness (PSLF) employer
• 403(b) with match
• Child care available
• Employee referral bonuses
• Upward mobility!
You Make Us Who We Are!

At St. Paul’s Senior Services, we believe a diverse workforce has driven our history of enriching the lives of senior communities in San Diego, which is why we are committed to cultivating an environment where you feel empowered, supported and respected. By valuing your unique perspective, voice, strengths, experience and background, we aim to foster a culture where you feel included and comfortable being your true self. You matter!

St. Paul's is the leading provider of caring senior services since 1960. We have locations throughout San Diego County including 5 in San Diego (Bankers Hill), 2 in Chula Vista, and 1 in El Cajon. St. Paul's strives to be the most outstanding and innovative senior home and service provider in California. We are dedicated to serving the physical, spiritual and social needs of the elderly and community, fostering a culture of diversity and inclusion within the highest quality facilities, health care and programs consistent with affordable costs.

YOU MUST BE ABLE TO CLEAR FINGERPRINTS THROUGH DOJ AND FBI IN ADDITION TO A DRUG SCREEN CLEARANCE.

To learn more about St. Paul’s Senior Services, please visit www.stpaulseniors.org.

St. Paul’s Senior Services is an Equal Opportunity Employer