Registered Nurse

Reports To: Project Coordinator

Areas of Assignment: Manhattan and Bronxt 

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 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.

• 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.

• 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.

• 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.

• 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.

• 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.