Purpose of Your Job Position

The primary purpose of your job is to coordinate and supervise the nursing care of all residents to ensure that the therapeutic regimen is implemented & documented according to federal, state & local regulations to improve the quality of care and life of the residents.

Delegation of Authority

As the Assistant Director of Nursing, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties. In the absence of the Director of Nursing Service, you are charged with carrying out the resident care policies established by this facility.

Job Functions

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is an essential function of the position.

Duties and Responsibilities

Administrative Functions

Assist the Director of Nursing implementing, developing, organizing, implementing, evaluating, and directing the day-to-day functions of the nursing service department, in accordance with current laws, rules, regulation, and guidelines that govern the long-term care facility.

Participate in developing, maintaining, and updating written policies and procedures that govern the day-to-day functions of the nursing department.

Ensure that reference material (i.e., PDR's, Federal and State Regulations, etc.) maintained at the nurses' station is current.

Recommend to the Director written material that will assist the nursing department in meeting the day-to-day needs of residents.

Ensure that the Nursing Service Procedures Manual is current at all times and reflects the day-to-day nursing care procedures used by the facility.

Develop and periodically update nursing objectives and statements of philosophy.

Assist in developing and implementing a nursing service organization structure.

Make written and oral reports/recommendations to the Director as necessary/required, concerning the operation of the nursing department.

Periodically review the department's policies, procedure manuals, job descriptions, etc. Make recommendations for revisions of policies, procedures, etc. to the Director of Nursing.

Ensure that the Policy and Procedure manuals are reviewed by the QA Committee annually and that the acknowledgement of acceptance is maintained in the Manuals. Ensure that the signature page is printed out December 15th and ensure that it is singed by the Medical Director, Administrator, DON, and Risk Manager Replace these sheets in all Policy and Procedure binders throughout the facility. Maintain a folder with all previous acknowledgements.

Ensure that all policy and procedure manuals throughout the facility are updated each time a new policy and procedure is developed and implemented. Review manuals at least quarterly for completeness. Ensure binders are maintained in the DON’s, Administrator’s and your offices as well as on each unit.

Assist in developing methods for coordinating nursing services with other resident services to ensure the continuity of the resident's total regimen of care.

Ensure that all nursing personnel are following their respective job descriptions. Participate in developing, maintaining, and periodically updating the written job descriptions for each level of nursing personnel in accordance with the Americans with Disabilities Act, OSHA, and other pertinent laws and regulations.

Participate in the development, maintenance, and implementation of the facility's quality assurance program for the nursing department.

Participate in facility surveys (inspections) made by authorized government agencies. Maintain and update QIS Survey Staff Interview Log and distribute to unit managers weekly when the facility is in their survey window

(9 to 15 months since last Recertification Survey)

Participate in developing, implementing, and periodically updating the resident's written discharge plan.

Assist the resident in planning the nursing portion of the resident's discharge plan.

Enter and/or Verify New Employees have been entered into the EMR system. Ensure that “title” is completed on employees (i.e. RN, LPN, CNA) and assign and/or verify Units are assigned to CNAs

Remove employees that are no longer employed out of the EMR system.

Reset passwords for Employees/Service Providers/Medical Staff who lock themselves out of the EMR system

Provide in-service to all new nurses on how to use the EMR System.

Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, etc. as necessary.

Maintain weekly inventory checks of the EDK. Investigate discrepancies and document findings. Run weekly activity reports and completed other associated tasks as directed.

Committee Functions

Serve on, participate in, and attend various committees of the facility (i.e., Infection Control, Safety Quality Assurance & Assessment, etc.) as directed

Serve on the Quality Assurance and Assessment Committee and the Quality Assurance and Performance Improvement committee as directed.

Serve on the Compliance and Ethics Committee

Assist the Director in preparing written and/or oral reports of the nursing programs and activities to submit to such committee(s).

Participate in the development, maintenance, implementation, and updating of the written policies and procedures for the administration, storage, and control of medications and supplies.

Participate in regularly scheduled reviews of the discharge plans and make such plans available to the Care Plan team as required or as may be necessary.

Evaluate and implement recommendations from established committees as they may pertain to nursing services.

Personnel Functions

Assist the Director in determining the staffing needs of the nursing department. Recommend to the Director the number and level of nursing personnel to be employed. Assist the Director in the recruitment and selection of nursing service personnel.

Maintain and update the Nurse Manager On-Call schedule

Ensure that a sufficient number of licensed practical and/or registered nurses are available for each shift to ensure that quality care is maintained and staffing regulations are met.

Ensure that a sufficient number of certified nursing assistants are available for each shift to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident and staffing regulations are met.

Ensure that all nursing assistants are enrolled in or have graduated from an approved nursing assistant training program.

Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse, if applicable.

Delegate to the Charge Nurses and Nurse Supervisors the administrative authority, responsibility, and accountability necessary to perform their assigned duties.

Assist the Director in preparing and conducting performance and competency evaluations, as directed.

Participate in the development and implementation of performance evaluations for the nursing department.

Make daily rounds of the nursing department to ensure that all nursing personnel are performing their work assignments in accordance with acceptable nursing standards and report findings to Director.

Monitor absenteeism to ensure that an adequate number of nursing care personnel are on duty at all times and report problem areas to the Director.

Monitor the professional nurses' licensing status to ensure that they remain current and inform nurses at least 30 days in advance of their license expiration date.

Review complaints and grievances made or filed by department personnel. Make appropriate reports to the Director as required or as may be necessary.

Ensure that departmental disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.

Interpret the department's policies and procedures to personnel, residents, visitors, and government agencies as necessary.

Ensure that all nursing personnel participate in the facility's TB testing program.

Report occupational exposures to blood, body fluid, infectious materials, and hazardous chemicals in accordance with the facility's policies and procedures governing accident and incidents.

Conduct new employee, random, directed and Work Place Incident Drug Screen Testing. Order supplies from the Lab; call in specimen collections for pickup. Review all test results (if any positive finding – advise HR immediately).Maintain files with Drug Screen Results.

Implement the Employee Flu Vaccine Administration program; Obtain and Maintain signature forms to receive or decline the vaccine; Post administration date(s) for which the Employee vaccine will be available and the cost of the vaccine.

Complete new and annual employee PPD administration; Ensure availability of solution; Order solution as necessary; Maintain files with PPD documentation and any other health issues of the employee.

Nursing Care Functions

Participate in the interviewing and selection of residents for admission to the facility, including the PASRR screenings.

Provide the Director with the information relative to the nursing needs of the resident and to the nursing department’s ability to meet those needs.

Inform nursing service personnel of new admissions, their expected time of arrival, room assignment, etc.

Ensure that rooms are ready for new admissions.

Greet newly admitted residents upon admission and escort them to their rooms as necessary.

Make rounds with physicians as necessary.

Inform the Director when physician visits are not made in a timely manner. Encourage attending physicians to record and sign progress notes, physicians' orders, etc., in the EMR system on a timely basis and in accordance with current regulations.

Ensure that direct nursing care be provided by a licensed nurse, a certified nursing assistant, and/or a nurse aide trainee qualified to perform the procedure.

Review nurses' notes to ensure that they are informative and descriptive of nursing care being provided, that they reflect the resident's response to the care, and that such care is provided in accordance with the resident's wishes.

Schedule daily rounds to observe residents and to determine if nursing needs are being met.

Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.

Report medication errors to the Director.

Provide direct nursing care as necessary.

Report problem areas to the Director and assist in developing and implementing corrective action.

Authorize the use of restraints when necessary and in accordance with our established policies and procedures.

Ensure that residents who are unable to call for help are checked frequently.

Assist the Pharmacy Consultant.

Assist the Pharmacy Consultant by printing active Inventory Reports with Expiration Dates for the EDK Machine for signature during monthly visit; providing a copy of the months falls for review; providing a list of Nurses for which DON or ADON want a Medication pass review completed; and as necessary.

Safety and Sanitation/Infection Control Functions

Assist the Safety Officer in developing safety standards for the nursing department assist the Director in identifying, evaluating, and classifying routine and job related functions to ensure that tasks in which there are potential exposure to blood/body fluids are properly identified and recorded.

Ensure that all personnel performing tasks that involve potential exposure to blood/body fluids participate in appropriate in-service training programs prior to performing such tasks.

Ensure that an adequate supply of personal protective equipment is on hand and readily available to personnel who perform procedures that involve exposure to blood or body fluids.

Monitor nursing service personnel to ensure that they are following established safety regulations in the use of equipment and supplies.

Ensure that nursing service work areas (i.e., nurses' stations, medicine preparations rooms, etc.) are maintained in a clean and sanitary manner.

Ensure that all resident rooms, treatment areas, etc., are maintained in a clean, safe, and sanitary manner.

Ensure that all nursing service personnel follow established departmental policies and procedures, including appropriate dress codes.

Ensure that nursing service personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.

Assist the Infection Control Committee in the development, implementation, and revising of written aseptic and isolation techniques.

Participate in the development, implementation, and maintenance of the infection control program for monitoring communicable and/or infectious diseases among the residents and personnel.

Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary.

Participate in the development, implementation and maintenance of the procedures for reporting hazardous conditions or equipment.

Ensure that all personnel wear and/or; use safety equipment and supplies (e.g., gait belts, mechanical lifts, etc.) when moving or lifting a resident.

Report missing/illegible labels and MSDSs to the safety officer or other designated person.

Equipment and Supply Functions

Recommend to the Director the equipment and supply needs of the department.

Ensure that an adequate stock level of medications, medical supplies, equipment, etc. is maintained on premises at all times to adequately meet the need of the resident.

Assist the Maintenance Director in developing a preventive maintenance program for maintaining the nursing department's equipment and supplies in a safe and operable manner.

Participate in the development and implementation of the procedures for the safe operation of all nursing service equipment.

Ensure that only trained and authorized personnel operate the department's equipment. Ensure that all personnel operate nursing service equipment in a safe manner.

Monitor nursing procedures to ensure that nursing service supplies are used in an efficient manner to avoid waste.

Ensure that appropriate MSDSs are on file for hazardous chemicals used in the nursing department.

Care Plan Functions

Encourage the resident and his/her family to participate in the development and review of the resident's plan of care.

Ensure that all personnel involved in providing care to the resident are aware of the resident's care plan.

Ensure that nursing personnel refer to the resident's care plan prior to administering daily care to the resident.

Review nurses' notes to determine if the care plan is being followed.

Review and revise care plans and assessments as necessary, but at least quarterly. Develop and maintain a good rapport with all services involved with the care plan to ensure that a team effort is achieved in developing the resident's comprehensive care plan.

Be sure that staff members are providing care that reflects the wishes of the resident

Budget and Planning Functions

Participate in the preparation of and planning of the nursing department's budget and submit to the Director for his/her review, recommendation, and/or approval.

Keep abreast of economic conditions/situation, and recommend to the Director adjustments in nursing services that ensure the continued ability to provide quality care. Recommend to the Director the equipment needs of the nursing department.

Resident Rights

Maintain the confidentiality of all resident information.

Monitor nursing care to ensure that all residents are treated fairly, and with kindness, dignity, and respect.

Ensure that all nursing care is provided in privacy and that nursing service personnel knock before entering the resident's room.

Ensure that all nursing service personnel are knowledgeable of the residents' responsibilities and rights including the right to refuse treatment.

Review complaints and grievances made by the resident and make a written/oral reports to the Director indicating what action(s) were taken to resolve the complaint or grievance. Follow facility's established procedures.

Maintain a written record of the resident's complaints and/or grievance that indicates the action taken to resolve the complaint and the current status of the complaint. Follow the facility’s established procedures

Ensure that appropriate notices are received by the resident before his/her room or roommate is changed.

Report and investigate all allegations of resident abuse and/or misappropriation of resident property. Follow facility’s established procedures.

Ensure that nursing staff personnel honor the resident's refusal of treatment request. Ensure that refusal of treatment requests are in accordance with the facility's policies governing advance directives.

Review the facility's advance directive policies and procedures with resident and/or family members as necessary.

Working Conditions

Works in office areas as well as throughout the facility.

Moves intermittently during work hours.

Is subject to frequent interruptions.

Works beyond normal working hours, weekends and holidays and on other shift/positions as necessary.

This position is subject to being on call 24 hours per day, 7 days per week.

Is subject to call-back during emergency conditions (e.g. severe weather, evacuation, post-disaster, etc.).

Attends and participates in continual educational programs.

Is subject to injury from falls, bums from equipment, odors, assaults from hostile residents, etc. throughout the work day, as well as reactions from dust, disinfectants, tobacco smoke, and other air contaminants.

Communicates with the medical staff, nursing personnel, and other department supervisors.

Is subject to hostile and emotionally upset residents, family members, personnel, and visitors.

Is involved in community, civic health matters, and projects as appropriate.

Is subject to exposure to infectious waste, diseases, conditions, etc., including TB and the AIDS and Hepatitis B viruses.

May be subject to the handling of and exposure to hazardous chemicals.

Education Requirements

Must possess, as a minimum, a Nursing Degree from an accredited nursing school, college or university.

Must possess a current State of Florida nursing license. Must possess current CPR certification.

Experience

Must have, as a minimum, one (1) year of experience as a supervisor in a hospital, long term care facility, or other related health care facility.

Must have, as a minimum, six (6) months training experience in rehabilitative and restorative nursing practices.

Specific Requirements

Must posses a current, unencumbered, active license to practice as a Registered Nurse in this state. An unencumbered, current, active Licensed Practical Nurse License from this state may be considered in buildings with 120 or less beds.

Must possess and maintain an “Eligible” ACHA Background Screening status.

Knowledge of laws, rules, regulations, and guidelines pertaining to Long Term Care Facilities.

Knowledge of ADA and OSHA laws and regulations.

Knowledge of HIPAA and HITECH Laws and regulations.

Knowledge of the Nurse Practice Act and other laws, rules and regulations governing nursing practice.

Must be able to read, write, speak, and understand the English language.

Must possess the ability to make independent decisions when circumstances warrant such action.

Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel, and the general public.

Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pe1iain to long-term care.

Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise other personnel.

Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc. that are necessary for providing quality care.

Must have patience, tact, a cheerful disposition and enthusiasm, as well as the willingness to handle difficult residents.

Must be willing to seek out new methods and principles and be willing to incorporate them into existing nursing practices.

Must not pose a direct threat to the health or safety of other individuals in the workplace.

Physical and Sensory Requirements

(With or Without the Aid of Mechanical Devices)

Must be able to move intermittently throughout the work day.

Must be able to speak and write the English language in an understandable manner.

Must be able to cope with the mental and emotional stress of the position.

Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of the position can be fully met.

Must function independently, have flexibility, personal integrity, and the ability to work effectively with residents, personnel, and support agencies.

Must meet the general health requirements set forth by the policies of this facility which include a medical and physical examination.

Must be able to relate to and work with ill, disabled, elderly, emotionally upset, and at

times hostile people within the facility.

Must be able to push, pull, move, and/or lift a minimum of 35 pounds to a minimum height of 5 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 450 feet.

May be required to lift, or assist with lifting of, residents.

May be necessary to assist in the evacuation of residents during emergency situations.