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Director of Nursing (DON)

Sylva, NC | Full Time

Job Description

Purpose of Your Job Position



The primary purpose of your job position is to plan, organize, develop and direct the overall operation of our Nursing Service Department in accordance with current federal, state, and local standards, guidelines, and regulations that govern our facility, and as may be directed by the Administrator and the Medical Director, to ensure that the highest degree of quality care is maintained at all times.



Delegation of Authority



As Director of Nursing Services, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties.  In the absence of the Medical Director, 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

Plan, develop, organize, implement, evaluate, and direct the nursing service department, as well as its programs and activities, in accordance with current rules, regulations, and guidelines that govern the nursing care facilities.

Develop, maintain, and implement written policies, processes and procedures that govern the day-to-day functions of the nursing service department.

Maintain a reference library of written nursing material (i.e., PDR’S, Regulations, Standards of Practice, etc.) that will assist the nursing service department in meeting the day-to-day needs of the resident.

Review, make recommendations and annually adopt the Nursing Service Procedures Manual.

Develop and implement a nursing service organization structure.

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

Develop, maintain, and periodically update written job descriptions for each level of nursing personnel in accordance with pertinent laws and regulations.

Develop methods for coordination of nursing services with other resident services to ensure the continuity of the residents’ total regimen of care.

Assist in the development of, implement, and maintain an ongoing quality assurance program for the nursing service department.

Participate in facility surveys (inspections) made by authorized government agencies as necessary or as may be directed.

Assist the Quality Assessment & Assurance Committee in developing and implementing appropriate plans of action to correct identified deficiencies.

Assist the Discharge Planning Coordinator in developing, implementing and periodically updating the written procedures for the Discharge Planning Program.

Assist the resident and Discharge Planning Coordinator in planning the nursing services portion of the resident’s discharge plan.

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

Monitor the facility’s QI, QM, and survey reports. Assist in developing plans of action to correct potential or identified problem areas.

Assist in calculating the number of direct nursing care personnel on duty each shift. Report such information to the Administrator or his/her designee to ensure that accurate staffing information is posted.

Agree not to disclose assigned user ID code and password for accessing resident/facility information and promptly report suspected or known violations of such disclosure to the Administrator.

Agree not to disclose resident’s protected health information and promptly report suspected or known violations of such disclosure to the Administrator.

Report any known or suspected unauthorized attempt to access facility’s information system.

Other duties as assigned.


Committee Functions

Serve on, participate in, and attend various committees of the facility as appointed by the Administrator.

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

Assist the Pharmaceutical Services Committee in developing, maintaining, implementing, and periodically updating written policies and procedures for the administration, storage, and control of medications and supplies.

Schedule, attend, and participate in developing the agenda for Care Plan Committee meetings as necessary.

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

Other duties as assigned.





Personnel Functions

Determine the staffing needs of the nursing service department necessary to meet the total nursing needs of the residents.

Recommend the number and level of nursing personnel to be employed.

Recruit, interview, screen and secure the appropriate number of trained, skilled nursing service personnel.

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

Assign a sufficient number of licensed practical and/or registered nurses for each tour of duty to ensure that quality care is maintained.

Assign a sufficient number of certified nursing assistants for each tour of duty to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident

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

Develop work assignments and schedule duty hours, and/or assist nursing supervisory staff in completing and performing such tasks.

Delegate to nursing service supervisory personnel the administrative authority, responsibility, and accountability necessary to perform their assigned duties.

Conduct probationary and annual performance evaluation schedules, criteria, and annual reviews for the nursing service department (e.g., RNs, LPNs, CNAs, medication aides, etc.)

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

Monitor missed punches, unauthorized OT, absenteeism and lateness to ensure that an adequate number of nursing care personnel are on duty at all times and staff practices are in accordance with facility policy.

Assist in the development of, maintain, and implements written procedure for ensuring that professional nursing personnel, including private duty nurses, have valid and current licenses as required by this State.

Promptly review complaints and grievances made or filed by department personnel. 

Promptly provide complaint/grievance reports to the Administrator 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.

Appoint an Infection Control Coordinator; ensuring adequate training and the establishment of an adequate infection control program.

Report occupational exposures to blood, body fluids, infectious materials, and hazardous chemicals in accordance with the facility’s policies and procedures governing accidents and incidents.

Conduct annual inservice training and clinical competencies with nursing staff.

Ensure that all CNA’s credentials are verified through the State Nurse Aide Registry.

Ensure that appropriate adverse personnel actions relative to CNA’s employment criteria are reported to the State Nurse Aide Registry.

Terminate employment of personnel when necessary, documenting and coordinating such actions with the Administrator/Home office

Report known or suspected incidents of fraud to the Administrator.

Ensure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen-saver activates within established facility policy guidelines.

Other duties as assigned.


Nursing Care Functions

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

Provide the Administrator with information relative to the nursing needs of the resident and the nursing service 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. Escort to room as necessary.

Make rounds with physicians as necessary. Schedule physician visits as necessary.

Monitor and ensure that attending physicians record and sign progress notes, physicians’ orders, etc., on a timely basis and in accordance with current regulations.

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

Review nurses’ notes to ensure that they are informative and descriptive of the 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 in accordance with the resident’s request.

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

Provide direct nursing care as necessary.

Evaluate and monitor 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.

Conduct routine clinical review meetings such as daily clinical stand up/down, weekly at-risk meetings.  Maintain minutes and ensure prompt follow up.

Review the 24-hour report daily; ensuring prompt, accurate follow up.

Ensure timely, accurate responses to pharmacy concerns or needs (e.g. PA’s, etc.)

Other duties as assigned.





Staff Development

Develop and participate in the planning, conducting, and scheduling of timely in-service training classes that provide instructions on “how to do the job,” and ensure a well-educated nursing service department.

Develop, implement, and maintain an effective clinical orientation program that orients the new employee to the facility, its policies and procedures, and to his/her job position and duties.

Provide leadership training that includes the administrative and supervisory principles essential for Nurse Supervisors/Charge Nurses.

Encourage the nursing supervisory staff to attend and participate in outside training programs. Schedule times as appropriate.

Coordinate and assist with the facility’s annual in-service training programs (e.g., OSHA, TB, HIPAA, Abuse Prevention, Resident Rights, Advance Directives, Safety, Infection Control, etc.).  Make recommendations for change as appropriate.

Assist support services in developing, implementing, and conducting in-service training programs that relate to the nursing service department

Assist with the development of in-service training programs for the nursing staff. Ensure that these programs meet the continuing education requirements that allow licensed personnel (e.g., RNs, LPNs, CNAs, etc.) to keep their licenses on an active status.

Attend and participate in continuing educational programs designed to keep you abreast of changes in your profession, as well as to maintain your license on a current status.

Other duties as assigned.


Safety and Sanitation

Assist the Safety Officer in developing safety standards for the nursing service department.

Ensure that the department’s policy and procedure manuals identify safety precautions and equipment to use when performing tasks that could result in bodily injury.

Assist the Infection Preventionist in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which 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 adequate supplies of personal protective equipment are on hand and are 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 preparation rooms, etc.) are maintained in a clean and sanitary manner.

Ensure that all resident care 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.

Develop, implement and maintain a program for monitoring communicable and/or infectious diseases, including TB, among the residents and personnel.

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

Develop, implement, and maintain a procedure for reporting hazardous conditions or equipment.

Ensure that personnel wear and/or use safety equipment and supplies (e.g., back brace, mechanical lifts, etc.) when lifting or moving residents.

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

Other duties as assigned.


Equipment and Supply Functions

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

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

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

Develop and implement 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.

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

Ensure that personal protective equipment used in the handling of infectious materials are available and easily accessible to nursing service personnel.

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

Other duties as assigned.







MDS & Care Plan and Assessment Functions



Assign, assist and monitor the development of baseline and comprehensive assessments of the nursing needs of each resident.

With the resident/representative, develop a person centered written plan of care (baseline and comprehensive) for each resident that identifies the problems/needs of the resident, indicates the care to be given, goals to be accomplished, and which professional service is responsible for each element of care.

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

Assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the completion of CAA’s.

Work with the Resident Assessment/Care Plan Coordinator to ensure the development of an MDS schedule, timely and accurate completion of MDS’s, accurate coordination of services and scheduling of resident care conferences in accordance with regulations. 

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.

Conduct rounds and review nurses’ notes to determine if the care plan is being followed.

Ensure that resident assessment information is transmitted on a timely basis.

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 a comprehensive plan of care.

Ensure that medical and nursing care is administered in accordance with the resident’s wishes, including the implementation of advance directives.

Other duties as assigned.



Budget and Planning Functions

Evaluate and make recommendations to the nursing service department’s budget and submit to the Administrator for his/her review, recommendations, and/or approval.

Keep abreast of economic conditions/situations, and recommend to the Administrator adjustments in nursing services that ensure the continued ability to provide quality care.

Recommend to the Administrator the equipment and supply needs of the nursing service department.

Report suspected or known incidence of fraud relative to false billings, cost reports, kickbacks, etc.

Coordinate and monitor the provision of clinical services in accordance with the budget and compliance.

Other duties as assigned.




Resident Rights

Maintain the confidentiality of all resident care information including protected health information. Report known or suspected incidents of unauthorized disclosure of such 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 report to the Administrator 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 grievances that indicates the action taken to resolve the complaint and the current status of the complaint.

Ensure that appropriate notices are given to residents before their room or roommate is changed.

Report and investigate all allegations of resident abuse and/or misappropriation of resident property.

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

Ensure that the facility’s policies and procedures governing advance directives are reviewed with the resident and/or representative.

Other duties as assigned.













Working Conditions


Works in office area(s) as well as throughout the nursing service area (i.e., drug rooms, nurses’ stations, resident rooms, etc.).

Moves intermittently during working hours.

Is subject to frequent interruptions.

Is involved with residents, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances.

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

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

Works beyond normal working hours and on weekends and holidays when necessary. 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.).

Is involved in community/civic health matters/projects as appropriate.

Attends and participates in continuing educational programs.

Is subject to injury from falls, burns from equipment, odors, etc., throughout the workday, as well as to reactions from dust, disinfectants, tobacco smoke, and other air contaminants.

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.

Maintains a liaison with the residents, their families, support departments, etc., to adequately plan for the residents’ needs.




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




Must have, as a minimum, three (3) years of experience as a supervisor in a hospital, nursing care facility, or other related health care facility.

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


Specific Requirements


Must possess a current, unencumbered, active license to practice as a Registered Nurse in this state.

Must demonstrate the knowledge and skills necessary to provide care appropriate to the age-related needs of the residents served.

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

Must be a supportive team member, contribute to and be an example of team work and team concept.

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 pertain to nursing care facilities.

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 be able to relate information concerning a resident’s condition.

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 workday.

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 be able to see and hear or use prosthetics that will enable these senses to function adequately to ensure that the requirements of this position can be fully met.

Must function independently, and 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 the 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 25 pounds to a minimum height of 5 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 50 feet.

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


Skills for Director of Nursing (DON)

The job skills required for Director of Nursing (DON) include Leadership, Nursing Care, Health care, Planning, Responsibility,and Infection control etc. Having related job skills and expertise will give you an advantage when applying to be a Director of Nursing (DON). That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Director of Nursing (DON). Select any job title you are interested in and start to search job requirements.

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Career Path for Director of Nursing (DON)

The following is the career advancement route for Director of Nursing (DON) positions, which can be used as a reference in future career path planning. As a Director of Nursing (DON), it can be promoted into senior positions as a Head of Nursing that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Director of Nursing (DON). You can explore the career advancement for a Director of Nursing (DON) below and select your interested title to get hiring information.