Director of Nursing

Primary Purpose of this Position

The primary purpose of this position is to plan organize develop and direct the overall operation of the nursing services department in accordance with current federal state and local standards guidelines and regulations that govern the facility and as directed by the Administrator and the Medical Director to ensure that the highest degree of quality care is maintained at all times.

Duties and Responsibilities

Administrative Functions

• Collaborate with other health care professionals including consultants government agencies and advocacy groups in the development and support of resident care administrative functions and facility mission.
• Develop and maintain nursing policies and procedures that conform to current standards of nursing practice facility mission and state and federal regulations.
• Maintain knowledge of all current state and federal regulations and facility policies.
• Review all referrals based on facility ability to meet the needs of potential resident.
• Review re-hospitalization trends and implement a plan to reduce unnecessary re-hospitalizations in accordance with facility policies and regulations.
• Participate in the annual facility assessment.
• Work with the Infection Preventionist to establish and maintain an infection prevention and control program designed to help prevent the development and transmission of communicable diseases and infections.
• Provide fiscal oversight and management of the nursing department budget.
• Oversee the staff development program to ensure nursing team members have the tools training and resources to properly care for residents in accordance with facility policies and the resident assessment.
• Assist in developing implementing and periodically updating the written procedures for the discharge planning program.
• Develop and implement a nursing services organizational structure.
• Develop methods for coordinating nursing services with other resident services to ensure the continuity of resident care.
• Develop implement and maintain an ongoing quality assurance and performance improvement (QAPI) program for the nursing services department.

Duties and Responsibilities

• Develop maintain and periodically update written job descriptions for each level of nursing personnel in accordance with pertinent laws and regulations.
• Develop maintain and periodically update written facility policies and procedures that govern the day-to-day functions of the nursing services department; review facility policies at least annually.
• Maintain a reference library of written nursing material (i.e. Physicians Desk Reference (PDR) regulations standards of practice etc.) that will assist the nursing services department in meeting the day-to-day needs of the resident.
• Monitor the facilitys quality measure reports; develop and implement performance improvement plans.
• Participate in facility surveys (inspections) made by authorized government agencies as necessary or as directed.
• Perform administrative duties such as auditing the electronic health record(EHR) completing forms compiling reports producing and approving evaluations studies charting etc. as necessary.
• Oversee and monitor the facility abuse prevention program.
• Ensure that competent and qualified individuals provide nursing care.
• 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 nursing care facilities.
• Participate in all team meetings as required including triple check admission discharge planning standards of care utilization review QAPI safety and risk meetings etc.

Committee Functions

• Participate in regularly scheduled reviews of the discharge plans; revise as necessary to ensure a safe discharge; conduct post-discharge follow-up calls or referrals to state agencies as appropriate.
• Schedule attend and participate in Care Plan Committee meetings as necessary.
• Actively participate in the QAPI Committee providing leadership identifying areas of non-compliance and developing a performance improvement plan.
• Participate in risk management and safety committees to mitigate risk factors for residents and staff.
• Serve on participate in and attend various committees of the facility as appointed by the Administrator.

Nursing Care Functions

• Ensure that residents receive individualized care that is culturally competent and based on resident preferences.
• Monitor residents for preventable decline including weight loss pressure ulcers loss of activities of daily living (ADLs) incontinence dehydration pain etc.
• Implement and monitor the restorative nursing program; review documentation for accuracy.

Duties and Responsibilities

• Monitor the nursing 24-hour and change of shift reports to ensure timely and effective responses to significant change in residents condition transfers discharges new restraints unexplained injuries falls incidents accidents behavioral management episodes and/or medication errors.
• Greet newly admitted residents upon admission; provide resident orientation as needed.
• Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.
• Participate in interviewing and selecting residents for admission to the facility including Preadmission Screening and Resident Review(PASARR)screenings; accept nursing report from transferring hospital as necessary.
• Provide direct nursing care as necessary including clinical care and resident assessments.

Care Plan and Assessment Functions

• Assist with developing resident care plans.
• Encourage the resident and his/her family to participate in the development and review of the residents plan of care.
• Ensure that medical and nursing care are administered in accordance with the residents wishes including the implementation of advance directives.

Personnel Functions

• Assign a sufficient number of Certified Nursing Assistants (CNAs) for each shift to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident.
• Assist the Administrator and/or the Director of Human Resources in the recruitment and selection of nursing services personnel; ensure proper background checks are conducted.
• Assist the Director of Human Resources in developing performance evaluation schedules criteria and annual reviews for the nursing services department (e.g. Registered Nurses (RNs) Licensed Practical Nurses (LPNs) CNAs medication aides etc.).
• Delegate to nursing services supervisory personnel the administrative authority responsibility and accountability necessary to perform their assigned duties.
• Determine the staffing needs of the nursing services department necessary to meet the total nursing needs of the resident population including special skills identified in the facility assessment.
• Develop work assignments and schedule staff hours; ensure required staff ratio postings are completed.
• Ensure that all CNA credentials are verified through the state Nurse Aide Registry.
• Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse as permitted by state and federal regulations.

Duties and Responsibilities

• Ensure that disciplinary actions involving CNAs are reported to the state Nurse Aide Registry as indicated for incidents determined to substantiate abuse allegation.
• Ensure the facility has sufficient nursing staff with the appropriate competencies and skillsets to provide nursing and related services.
• Make daily rounds of the nursing services department to ensure that all nursing services personnel are performing their work assignments in accordance with acceptable nursing standards.
• Report occupational exposures to blood body fluids infectious materials and hazardous chemicals in accordance with the facilitys policies and procedures governing accidents and incidents.
• Review complaints and grievances made or filed by department personnel; develop action plans as necessary.

Staff Development Functions

• Assist the Administrator in developing and revising the Certified Nursing Assistant(CNA)training curriculum used by the facility; submit to the state agency for approval as required.
• Assist the Staff Development Coordinator in developing annual facility in-service training programs (e.g. Occupational Safety and Health Administration (OSHA) tuberculosis (TB) Health Insurance Portability and Accountability Act (HIPAA) abuse prevention safety infection prevention and control etc.).
• Attend continuing education programs to remain knowledgeable with current regulations and nursing best practices.
• Develop implement and maintain an effective orientation program that orients the new employee to the facility its policies and procedures and to his/her job position and duties.
• Educate the nursing team on facility policies and procedures monitor staff practices and implementation of facility policies; ensure team members are trained in advance of implementation of new facility policies.
• Provide leadership training that includes the administrative and supervisory principles essential for the Charge Nurse/Nurse Supervisor; develop performance improvement plans as appropriate.

Safety and Sanitation Functions

• Ensure that the resident environment remains as free of accident hazards as much as possible and that residents receives adequate supervision and assistive devices to prevent accidents.
• Develop implement and maintain a program for monitoring communicable and/or infectious diseases among the residents and personnel.
• Ensure that all resident care rooms treatment areas etc. are maintained in a clean safe and sanitary manner and follow infection prevention and current Centers for Disease Control and Prevention (CDC)standards.
• Ensure that nursing services personnel follow established infection prevention and control procedures.

Duties and Responsibilities

• Ensure that personnel wear and/or use safety equipment and supplies (e.g. back brace mechanical lifts etc.) when lifting or moving residents; follow OSHA standards regarding personal protective equipment (PPE)and PPE fittings.
• Report missing/illegible labels and safety data sheets (SDSs)to the Safety Compliance Officer or other designated person.

Equipment and Supply Functions

• Develop and implement procedures for the safe operation of all nursing services equipment including manufacturers recommendations on use and proper cleaning in accordance with infection prevention efforts.
• Develop and implement procedures that ensure nursing services supplies are used in an efficient manner to avoid waste.
• Ensure that medications medical supplies equipment etc. are maintained on premises at all times to adequately meet the needs of the residents.
• Ensure that only trained and authorized personnel operate facility equipment; retain training records.
• Recommend to the Administrator the equipment and supply needs of the department to meet the needs of the resident population as identified in the annual facility assessment.

Budget and Planning Functions

• Prepare and plan the nursing services departments budget and submit to the Administrator for review recommendations and/or approval.
• Recommend to the Administrator the equipment and supply needs of the nursing services department.

Working Conditions

• Works in office areas as well as throughout the nursing services 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.
• 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 education 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.

Education

Must possess as a minimum a nursing degree from an accredited college or university.

Experience

• Must have as a minimum three (3) year(s)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 (RN) in the 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 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 residents 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.

Job Position Analysis Information

(1) Risk Exposure to Blood/Body Fluids Column:

A check mark entered into this column indicates the risk potential of your exposure to blood or body fluids. Established procedures identify the appropriate personal protective equipment (PPE) that you should use when performing this task.

(2) Essential Functions Column:

A check mark entered into this column indicates that you may be required to perform this task.(3) Safety Factors Column:

RM Repetitive Motion:

A RM in this column indicates that it will be necessary for you to perform some functions of this task repeatedly. When such tasks are not performed properly injury can result. Established procedures identify the precautions and/or equipment that should be used.

WL Minimum Weight Lifting Requirement:

A WL in this column indicates that it will be necessary for you to perform functions of this task that require some lifting moving pushing or pulling. When such tasks are not performed properly injury can result. Established procedures identify the precautions and/or equipment that should be used when performing this task. Minimumweight lifting requirements that you must perform are located in the Physical and Sensory Requirements section of this job description.

SB Prolonged Sitting Standing and Bending:

A SB in this column indicates that some functions of this task require you to sit stand or bend for an extended period of time. When such tasks are not performed properly injury can result. Established procedures identify the precautions and/or equipment that should be used when performing this task.

Required Experience:

Director