Director of Nursing - Skilled Nursing and Assisted Living

DUTIES AND RESPONSIBILITIES:Develop and maintain the nursing-service objectives, standards of nursing practice, nursing policy and procedure manuals, written job descriptions for each level of nursing personnel; make daily rounds, coordinate nursing services with other resident services; staff the recommended number and levels of nursing personnel to be employed; and staff development. Exercise the ability to delegate responsibility and exercise authority as needed.Participate in planning, budgeting, and the development and implementation of resident-care policies; plan orientation programs for personnel; plan scheduled in-service training for all direct resident-care personnel; participate in medical reviews as dictated by the resident’s levels of care.The person holding this position is delegated the responsibility for carrying out the assigned duties and responsibilities in accordance with current existing federal and state regulations and established company policies and procedures.FUNCTIONS:Clinical Oversight & Care Management

• Ensure that nursing personnel provide treatments, medications, rehabilitative nursing care, and activities of daily living as stated in care plans to make certain optimum comfort and care is provided.
• Attend, as needed, regularly scheduled conferences with resident Activities Manager, Social Service staff, Dietary Service Manager, and other professionals to review and update resident assessment, MDS, and comprehensive care plan and other services needed by residents.
• Assure that visiting physicians are accompanied by licensed personnel and physician’s orders are carried out properly.
• Attend, as needed, conferences with resident and/or family member as necessary and inform them as significant resident changes occur.
• Refer residents and family members to social services and/or proper community agencies if necessary.
• Conduct daily rounds of residents in order to update knowledge of resident’s physical and emotional conditions, and assure that staff is providing proper and adequate care.
• Conduct regular conferences with nursing staff to explain resident behavior and significant changes.
• Oversee and review controlled substances to assure proper count and documentation.
• Oversee chart audits to assure proper charting and documentation of care.
• Assure facility is receiving correct payment for level of care administered and for services and supplies including Medicare oversight.
• Attend Risk & Quality Management Committee meetings and assist in maintaining quality assurance data and preparing reports.
• Supervise nursing activities and promote improvement in nursing care, in collaboration with other departments.
• Coordinate nursing service with other departments.
• Support accurate reporting and recording according to policies and procedures set forth, and evaluate and make recommendations for improvements for the welfare of residents.
• Maintain a comfortable and pleasant environment and promote elimination of hazards.
• Receive reports from charge nurses on shifts and work closely with them to insure maximum total care.
• Where applicable, assure a registered nurse screens resident for goal-directed therapy soon after admission or re-admission according to procedure.

Scheduling Oversight & Staffing Management

• Assure nursing department staff knows lines of authority of the organizational chart.
• Oversee creation and daily review of nursing schedule; approve staffing changes. Monitor and manager PPD, overtime, and agency utilization.
• Oversee, develop, and maintain nursing service goals and objectives, standards of nursing practice, and content of nursing policy and procedure manuals.
• Ensures required staff, in accordance with federal, state, and local laws, to assure uninterrupted service to residents.
• Establish and maintain a procedure to ensure licensed personnel and medication aides have a current and valid license as required by state.
• Periodically evaluate work of each employee in nursing department and discuss each evaluation.  Based upon employees’ merits, award promotions when vacancies or new positions occur, and grant pay increases as merited by employees.
• Manages the nursing staff through appropriate hiring, orientation, in-service training, evaluation, assignment, delegation of duties and dismissal if warranted.
• Assure that personnel are familiar with fire drill regulations, procedures, and the disaster plan.  Responsible for direct handling of emergency situations.
• Assist interpreting the goals and objectives of the facility to nursing service personnel.
• Verify time worked as reported on personnel time cards.
• Promote effective working relationships with the administrator, medical staff, personnel, volunteers and agencies affiliated with the facility.
• Develop and implement resident care plans in coordination with physician, medical director, consultants, staff, and therapist.
• Oversees Nursing-related Committees.
• Evaluate, plan and organize nursing care according to established policies.

Admission Process Leadership

• Coordinate admissions, room assignments, and discharges of residents.
• Review all potential clinical admission for appropriate placement and facility capacity.
• In collaboration with Social Services communicate admission details to all clinical departments.
• Monitor transition of care documentation for new admissions.
• Personally, follow-up on each new admission within 24 hours and review care delivery.

Quality Assurance & Regulatory Compliance

• Be accountable for nursing compliance, excellence, and delivery of resident-care services in adherence with federal, state, and local regulations. Including investigating incidents, completing root cause analyses, and guiding corrective action.
• Maintain survey readiness through proactive rounding, chart review, and staff tools in conjunction with QA Coordinator.
• Insure that adequate and proper equipment and supplies are available to staff.
• Perform related duties as assigned or as the situation dictates.

Inventory & Financial Oversight

• Review, approve, and monitor nursing supply orders; maintain cost-effective par levels.
• Identify and address overuse or mismanagement of high-cost items.
• Audit supply storage for waste, shortage, or product misuse.
• Collaborate with Administrator to ensure financial targets related to labor and supplies.

QUALIFICATIONS:

• License/Registration:  Hold a current, unencumbered license in this state as a registered nurse.  Registered with Professional Board of Nurse Examiners in this state.
• Continuing Education:  Encouraged and required if necessary to meet state regulations.
• Education:  Must be a graduate of an accredited educational institution (school of nursing).
• Experience:  At least two full years of nursing experience, preferably in long-term care with proven leadership and management skills.
• Job knowledge:   Working knowledge of nursing services, rehabilitation, therapy, administration, supervision, resident care, etc.; comprehensive knowledge of general nursing theory and practice with knowledge of principles and methods involved in instruction of nursing and auxiliary personnel; ability to assess resident’s needs, familiarity with nursing facility policies, regulations, and procedures; knowledge of application of principles of personnel administration in assigning, supervising, and evaluating activities of staff; knowledge and application of techniques and methods of resident care; awareness of special diets and their observations; use of medical and nursing equipment; and knowledge of medications and their effects.
• Standards:  Professional standards and code of ethics must be adhered to at all times.
• Professional Memberships:  Very much desired and encouraged.
• Other:  A sincere interest in geriatric nursing, maintain a good working relationship with staff, residents, families, and others; identify problems and make decisions; process leadership skills, compassion, understanding, competence, and be a visionary.

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