LifeSTEPS Community Health Program
Community Health Program is the 2020 HUD Secretary’s Healthy Homes Award Winner
Formerly known as the RN Nursing Program, this innovative program was built through partnership, persistence, and a commitment to redefining senior affordable housing support. LifeSTEPS’ Community Health Program continues to expand because it works. Residents trust the nurse, engage more deeply in their health, and gain confidence to maintain independence. Property owners see improved stability and reduced turnover. Families gain peace of mind knowing their loved ones are supported. Most importantly, seniors receive dignified, community-centered care—right at home.
How It Works
LifeSTEPS’ Community Health Program brings compassionate, commun
ity-based nursing directly to affordable senior housing communities. By placing highly trained Registered Nurses alongside LifeSTEPS’ social workers and property partners, we provide the personalized medical guidance, health education, and care coordination older adults need to remain safe, stable, and thriving at home.
Our approach is simple yet transformational: consistent nurse engagement, coordinated support, and early intervention—all right where residents live.
As Executive Director Beth Southorn explains:
“Our biggest goal is finding ways for our seniors to age in place, where they’re not having to be hospitalized over and over again, and they get the quality care they need when they come back from the hospital. And so for that reason we developed our nursing program.”
While the program is grounded in the work of licensed Registered Nurses, LifeSTEPS also partners with emerging nursing professionals. While we do occasionally receive Registered Nurses who are pursuing their bachelor’s degrees, this typically occurs only once a year. For the rest of the year, we primarily work with nursing students in their final year completing their Community Health course. These students work under the supervision of a licensed RN instructor and collaborate closely with LifeSTEPS social workers and property partners—allowing them to contribute meaningfully while gaining real-world experience in community-based care.
The Community Health Program Measurable Impact
Pilot data from 5,893 total outcomes demonstrates real improvements in health stability, safety, and quality of life:
Chronic Disease Management & Healthy Aging
Care Coordination
Care Plan Creation
Medication Management
Social Determinants Support
Fall Prevention & Home Modifications
Why Community Health Matters
Many residents face barriers—limited income, low health literacy, mobility challenges, and complicated medication regimens—that make navigating healthcare overwhelming. The Community Health Program addresses these issues with: Clear explanations of diagnoses, medications, and treatment plans Assistance understanding Medicare/insurance barriers Support coordinating care after hospital discharge Early detection of changes in health status Links to community resources, food programs, transportation, and more.
thers—found herself facing growing health challenges. Episodes of high blood pressure, swollen legs, and limited mobility made it difficult for her to manage daily tasks, especially with her adult children living out of state. Through LifeSTEPS, and with guidance from RN students, she received hands-on support that helped her regain stability. The team provided a weekly pill organizer and taught her how to manage her medications safely, conducted regular blood pressure checks, and helped her obtain a walker to improve her mobility. These consistent touchpoints not only addressed her immediate health concerns but also gave her the reassurance of having a trusted support system close by.
