Universal RN

The Universal RN (Registered Nurse) provides skilled nursing care in accordance with Innov Age policies, clinical standards, and all applicable regulations. This universal role supports participants in both clinic and in-home settings (as assigned), partners with the interdisciplinary team (IDT) to develop and execute individualized Plans of Care, and supports safe, efficient care delivery for frail and elderly participants.

Physical presence at an Innov Age center and/or participant home is essential to performing the duties of this role.

• Perform comprehensive assessments, reassessments, and ongoing monitoring to identify needs, changes in condition, and appropriate level of care; update Plans of Care accordingly.
• Implement provider orders (MD/DO/NP/PA), including administering medications, treatments, wound care, and other skilled nursing interventions.
• Triage participant and staff calls to determine priority and route/escalate appropriately.
• Provide medication administration, reconciliation, and training in self-administration for non-scheduled medications; monitor and promote adherence.
• Educate participants and caregivers/families on conditions, medications, equipment, safety, and disease management.
• Schedule and coordinate outside specialist visits, diagnostics, and hospital admissions as needed; arrange transportation when applicable.
• Observe, record, and promptly report participant condition and response to treatments/medications to providers.
• Participate in IDT meetings, family conferences, and case reviews; contribute to the development and adjustment of Plans of Care.
• Complete timely, accurate documentation in the medical record; meet all agency and regulatory charting, reporting, certification/recertification, and discharge summary requirements.
• Support utilization review, peer review, and quality management activities as assigned.

• Prepare, stock, and maintain exam and triage rooms; ensure availability of required supplies and materials.
• Assist with participant examinations, testing, and treatments performed in the clinic.
• In the absence of the Nursing Services Director/Clinic Nurse Supervisor, supervise clinic staff and support overall clinic workflow.

• Provide skilled nursing care in the participant’s place of residence; deliver preventive, restorative, and rehabilitative nursing procedures.
• Determine type and amount of nursing care needed for each participant and coordinate with Home Care resources.
• Supervise LPNs at least every 30 days and HHAs/CNAs at least every 14 days (or per regulatory requirements); provide teaching and competency reinforcement. Supervises unskilled care every 90 days.
• Conduct supervisory visits, care conferences, and periodic participant/caregiver check-ins; trend data and collaborate with the Home Care Manager and Nursing Services Director to ensure quality care delivery.

• Adhere to Innov Age policies and all applicable federal, state, and local regulations (e.g., HIPAA, OSHA, infection prevention, medication safety, scope of practice).
• Use PPE and follow standard, transmission-based, and universal precautions.
• Participate in on-call, after-hours, and holiday coverage as assigned.
• Support continuous improvement, patient safety initiatives, and cost stewardship.

• Develop EOL (end of life) documentation, forms, standards, and protocols
• Conduct initial EOL assessments of participants to determine their individual needs and coordinate a plan of care.
• Provide decision-makers with care options and resources to aid them in making difficult decisions in the best interest of the participant.
• Educate family members about the end-of-life process and ensure they receive the "Caregiving at Life's End" manual.
• Provide psychosocial support to participants and their families, including coping and bereavement resources in collaboration with the Social Work department.
• Inquire about participants' and families' spiritual needs and call upon appropriate resources.

• Will as required, coordinate…