Provide nursing care to frail elders in their home environment as part of an interdisciplinary team. Must be proficient in geriatric assessment of elders with chronic illness, dementia's, and mental illness. Perform assessments and triage in the home setting which supports or directs the participants plan of care. Responsible for developing home health aide/certified nursing assistants assignments and providing ongoing supervision of participants care. Expected to perform with a high degree of independence and personal accountability. Qualifications/Experience * Highly developed geriatric assessment and clinical skills required. * At least one year of clinical experience in geriatrics required. * At least three years of home care experience required. * B.S. in nursing required for newly hired RNs. * Phlebotomy skills required. * Reliable transportation to make daily home visits in ESP service area required. * Cross-cover in primary care clinic, as required. * Knowledge of PACE (Program of All-inclusive Care for the Elderly) and its national model preferred.