Position: Director of Nursing (DON)

Department: Nursing

Reports to: Administrator

FLSA Status: Salaried/Exempt

Committed to promoting wellness, healing, and independence for all lives we touch.

Summary:

To manage the overall operations of the Nursing Department in accordance with Company policies, standards of nursing practices and governmental regulations to maintain excellent care of all residents’ needs.

Environment:

Work will be performed primarily indoors at one of our long-term healthcare facilities, throughout all areas, including in resident rooms, and on carpeted and/or tiled floors. Work will be performed there routinely around other co-workers, healthcare staff, residents, and guests. Due to the nature of facility’s business, worker may be exposed to occasional slippery floors, object on floors, chemicals, sharp objects, hazardous materials and waste (including human), blood­ borne pathogens, and communicable diseases, as well as high-stress medical and/or life-threatening situations.

Essential Duties & Responsibilities:

• Meet physical and sensory requirements stated below and be able to work in the described environment.
• Identify and participate in process improvement initiatives that improve the customer experience, enhance work flow, and/or improve the work environment.
• Management duties including, but not limited to, hiring, training and developing, coaching and counseling, and terminating department staff, as deemed necessary.
• Ensure that all employment practices are administered fairly and without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, marital status, amnesty, or veteran status in accordance with applicable federal, state and local laws.

• Participate in facility surveys (inspections) made by authorized governmental agencies.
• In the absence of the Administrator and Assistant Administrator (if applicable), assume responsibility of the facility.
• Oversee the employee health program in cooperation with the Medical Director and Staff Development Coordinator.
• Monitor the Weekly Level of Care Report, Dietary Consultant Report, Pharmacy Consultant Report and take appropriate actions.

• Plan, develop, organize, implement, evaluate and direct the nursing services department, as well as its programs and activities, in accordance with current rules, regulations, and guidelines that govern the long-term care facility.
• Assume administrative authority, responsibility and accountability for all functions, activities, and training of the nursing department.

• Organize, develop, and direct the administration and resident care of the nursing service department.

• Participate in Department Supervisor Meetings, Resident Care Plan Meetings, Budget Committee Meetings, Safety Committee Meetings, Quality Assessment and Assurance Committee Meetings, In-service Education, Family Council and any other meeting as directed by the Administrator.
• Meet monthly with staff on each shift.

• Meet daily with Director of Admissions/Marketing, Business Office Manager, and Administrator regarding admission and placement of proposed residents. Evaluate prospective residents in terms of the nursing service they need and the capability of the facility to supply the needed service.
• Participate in coordination of resident services through departmental and appropriate staff committee meetings.
• Meet monthly with nursing staff regarding Chart Audit and Physician’s orders. Review audit with Medical Records prior to submitting to Administration.
• Delegate to nursing service supervisory personnel the administrative authority, responsibility, and accountability necessary to perform their assigned duties.
• Make daily rounds of the nursing department to verify that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards.
• Coordinate with the ADON to determine staffing requirements based on current needs and State and Federal guidelines.
• Provide appropriate departmental in-service education programs in compliance with Corporate, State and Federal guidelines. 

• Work closely with Administrator in resolving grievances with nursing staff, family members, and residents.

• Perform nursing services and deliver resident care services in compliance with corporate policies and State and Federal regulations.
• Inform state of any reportable incidents within appropriate time frames. Complete investigative analysis as required.
• Inform nursing service personnel of new admissions, their expected time of arrival, room assignment, etc.
• Greet newly admitted residents upon admission. Escort to room as necessary.
• Make rounds with physicians as necessary. Schedule physician visits as necessary.
• 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 verify that medications are being administered as ordered and that treatments are provided, as scheduled.
• Provide direct nursing care, as necessary.

• Regularly inspect the facility and nursing practices for compliance with federal, state, and local standards and regulations.
• Study Infection Control Reports, Medication Incident Reports and Resident Incident Reports for corrective action.
• Keep Administrator informed daily of nursing department functions, recommending changes in techniques or procedures for a more efficient operation.
• Promote favorable working conditions and relationships with administration, medical staff, consultants, other departments, residents, family members, volunteers, agencies, and any other individual or group affiliated with the facility.
• Review discharge summaries on a timely basis.

• Monitor nursing service personnel to verify that they are following established safety regulations in the use of equipment and supplies.
• Ensure that all nursing service personnel follow established departmental policies and procedures, including appropriate dress codes.

• Be on call for emergencies that supervisory personnel cannot handle.
• Assure proper handling and emergency care of residents, personnel, and visitors while on the job or in the building.
• Assure residents a comfortable, clean, orderly and safe environment.
• Comply with, support and enforce Company policies involving all safety and infection control procedures to include the proper use of mechanical lifts and gait belts.

• Monitor stock level of medications, medical supplies, equipment, etc., to verify they are always maintained on premises to adequately meet the needs of the resident.
• Create and implement procedures for department equipment to be operated only by trained, authorized personnel in a safe manner.
• Develop and implement procedures for nursing supplies to be used in an efficient manner to avoid waste.

• Work closely with Central Supply to confirm that changes are made on a timely basis and that inventory is current and medical-nursing supplies are adequate on the nursing stations.
• Verify that medical and nursing care is administered in accordance with the resident’s wishes, including the implementation of advance directives.
• Assist with development of and approve final version of the Interdisciplinary Plan of Care for each resident in coordination with the physician, Medical Director, nursing staff, and outside consultants (i.e., nursing, dietary, pharmacy, therapists, etc.) and in accordance with corporate, state and federal guidelines.
• Confirm accurate completion of forms/reports for the admission, transfer and/or discharge of each resident including, but not limited to, the nursing portion of the PAE, Initial Nursing Assessment, Minimum Data Set (MDS), Resident Care Plan, and the Annual MDS.
• Review and verify that documentation procedures for nursing are met according to corporate, state and federal guidelines.

• Review nurses notes to confirm 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.
• Review Quality Indicator reports and submit to Vice President of Clinical Services on a monthly basis.
• Assist in preparing and planning the nursing service department’s budget and submit to the Administrator for his/her review, recommendations, and/or approval.
• Recommend to the Administrator the equipment and supply needs of the nursing department.

• Be conscious of cost and attempt to provide quality staff for the nursing department within budgetary constraints.
• Participate in monthly QA.
• Ensure staffing levels are maintained.
• Participate in the facility assessment.
• Along with the Administrator engage the medical director in all department activity.
• Ensure all department employees have annual performance reviews and competencies timely. Maintain attendance records for department staff.

• Other special projects and duties, as assigned.

Job Requirements:

• Registered Nurse in good standing with required current state license.
• Minimum of five (5) years’ experience.
• One (1) to two (2) years management/supervisory experience required.
• Must have a current/active CPR certification.
• Significant technical experience and demonstrated leadership/management skills
• Restorative care philosophy, excellent professional skills (both assessment and hands-on), and good communication and organizational skills.
• Working knowledge of long-term care regulations.
• Effective verbal and written English communication skills.
• Demonstrated intermediate to advanced skills in Microsoft Word, Excel, Power Point and Outlook, Internet and Intranet navigation.
• Highest level of professionalism with the ability to maintain confidentiality.
• Ability to communicate at all levels of organization and work well within a team environment in support of company objectives.
• Customer service oriented with the ability to work well under pressure.
• Strong attention to detail and accuracy, excellent organizational skills with ability to prioritize, coordinate and simultaneously maintain multiple projects with high level of quality and productivity.
• Strong analytical and problem-solving skills.
• Ability to work with minimal supervision, take initiative and make independent decisions.
• Ability to deal with new tasks without the benefit of written procedures.
• Approachable, flexible and adaptable to change.
• Function independently, and have flexibility, personal integrity, and the ability to work effectively with employees and vendors.

Physical and Sensory Requirements:

• Moderate physical activity:
• Push, pull, move, and/or lift a minimum of fifty (50) pounds to a minimum height of three (3) feet and be able to push, pull, move, and/or carry such weight a minimum distance of fifty (50) feet.
• Standing and/or walking for more than four (4) hours per day.
• Bending and/or stooping for more than one (1) hour at a time.
• Sitting for more than two (2) hours at a time.
• Requires writing and/or computer work with repetitive typing and concentrating on computer screen and/or documents for more than two (2) hours at a time.