Director of Nursing

JOB SUMMARY: The primary purpose of the Director of Nursing position is to plan, organize, develop and direct the overall operation of the Nursing Department to ensure that the highest degree of quality care is maintained at all times.

J O B D U T I E S & R E S P O N S I B I L I T I E S :
A d m i n i s t r a t i v e F u n c t i o n s:

Plan, develop, organize, implement, evaluate, and direct the nursing department, as well as its programs and activities, in accordance with current rules, regulations, and guidelines that govern the long-term care facility.
Develop, maintain, and periodically update written policies and procedures that govern the day-to-day needs of the resident.Maintain a reference library of written nursing material (i.e., PDR’s Federal and State Regulations, Clinical Protocols, etc.) that will assist the nursing department in meeting the day-to-day needs of the resident.
Maintain and periodically review the Nursing Protocols Manual, nursing services objectives, and philosophies
Develop and implement a nursing organization structure.Make written and oral reports/recommendations to the Administrator, as necessary/required, concerning the operation of the nursing department.
Assist the Nurse Educatorin developing, maintaining and periodically updating written job descriptions for each level of nursing personnel in accordance with the Americans with Disabilities Act, OSHA, and other pertinent laws and regulations.
Develop methods for coordination of nursing services with other resident services to ensure the continuity of the residents’ total care regimen.
Develop, implement, and maintain an ongoing quality assurance performance improvement program for the nursing department.
Participate in facility surveys conducted by authorized government agencies.
Assist the Quality AssurancePerformance ImprovementCommittee in developing and implementing appropriate plans of action to correct identified deficiencies.
Assist in the development, implementation, and accurate completion of forms/reports for the admission, transfer, and/or discharge procedures, including the nursing portion of the Initial Nursing Assessment, Minimum Data Set (MDS), Resident Care Plan, and the Annual MDS
Review and ensure that charting documentation procedure for nursing are met according to Vanguard, state, and federal guidelines.
Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, etc., as necessary.Track all Medicare, SNF Medicaid, and private insurance days.
Maintain Medicare census logs, including admissions, discharges, and and number of Medicare days used.
Coordinate all medical reviews and make sureinformation gathered will insure payment by Medicare.
Make sure Certification/Re-certification forms are complete for the physician’s signature.
Conduct daily/weekly skilled meetings with therapy and nursing departments to optimize reimbursement and make decisions regarding de-certification and discharge.
Fill out de-certification letters.Assist with all intermediary inquiries and denials. Notify the therapy department of inquiries or pending denials.
Complete reconsideration requests and sends to intermediaries.
Complete requests for hearing appeals, making sure all medical record copies are accurate and complete. Notify home office of any hearings.
Appear at hearings and present case summary as necessary.File requests for review of hearing decisions with appeals council.
Maintain doctor’s certification sheets filled out completely and accurately as directed by Medicare regulations. Maintain a Medicare Part A log in conjunction with MDS coordinator.

C o m m i t t e e / M e e t i n g F u n c t i o n s
Chair, serve on, participate in, and/or attend various committee meetings of the facility (i.e. Department Supervisor meeting, Resident Care Plan meeting, Budget Committee meeting, Safety Committee meeting, Quality AssurancePerformance Improvementmeeting, Resident Council meeting, In-Service education meeting, Family Council meeting) as required and/or appointed by the Administrator.
Provide written and/or oral reports of the nursing program as required or directed by the above committees.
Evaluate and implement recommendations from established committees pertaining to nursing services.
Attend therapy meetings.

P e r s o n n e l F u n c t i o n s
Determine the staffing needs of the nursing department necessary to meet the total nursing needs of the residents.
Recommend the number and level of nursing personnel to be employed. Develop staffing model.
Assist the Administrator and/or the Nurse Educator in the recruitment, selection, orientation, training, and evaluation of nursing personnel.
Ensure that all nursing assistants are enrolled in or have completed training from an approved training program.
Monitor that all CNA credentials are verified through the State Nurse Aide Registry.
Monitor those appropriate adverse personnel actions relative to CNA employment criteria are reported to the State Nurse Aide Registry.
Ensure that all nursing personnel meets the qualifications established by the home office.
Assign a sufficient number of licensed practical and/or registered nurses for each tour of duty to ensure that quality care is maintained. Evaluate care needs continuously and adjust staffing as indicated.
Assign a specific number of certified nursing assistants for each shift 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, schedule duty hours, and/or assist nursing supervisory staff in completing and performing such tasks.
Delegate to nursing supervisory personnel the administrative authority, responsibility, and accountability necessary to perform their assigned duties.
Assist the Nurse Educator in developing performance evaluation schedules, criteria and annual reviews for the nursing services department (i.e. RNs, LPNs, CNAs)
Make daily rounds of the facility to ensure that all nursing personnel is performing their work assignments in accordance with acceptable nursing standards.
Monitor absenteeism to ensure that an adequate number of nursing care personnel are on duty at all times.Assist the Nurse Educator in developing, maintaining, and periodically updating the written procedure for ensuring that professional nursing personnel, including private duty nurses, have valid and current licenses as required by state and federal agencies.
Review complaints and grievances made or filed by facility personnel.
Provide complaint/grievance reports to the Administrator as required or necessary.
Ensure that departmental disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, disabling, or marital status.
Assist in establishing a TB management program for all associates.
Assist in performing background checks on nursing personnel as requested.
Report occupational exposures to blood, body fluids, infectious materials, and hazardous chemicals in accordance with the facility’s policies and procedures governing such accidents.

N u r s i n g C a r e F u n c t i o n s
Participate in the interview 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 department’s ability to meet those needs.
Inform nursing personnel of new admissions include all pertinent logistical information.
Ensure that rooms are ready for admission.
Greet and welcome newly admitted residents and family members upon admission.
Schedule physician visits and make rounds with physicians as necessary.
Encourage attending physicians to record and sign progress notes, physicians’ orders, etc. on a timely basis and in accordance with current regulations.
Review nurses’ notes to ensure that they are informative, descriptive of the nursing care, and consistent with therapy 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.
Make daily rounds to observe residents and to determine if nursing needs are being met in accordance with the resident’s requests.
Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.
Provide direct, hands-on nursing care as necessary.Authorize the use of restraints when necessary and in accordance with established policies and procedures.
Ensure that residents who are unable to call for help are checked frequently.
Participate in weekly wound rounds to ensure care provision and healing.
Coordinate quarterly skin sweeps.

S a f e t y a n d S a n i ta t i o n
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 Control Coordinator 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 associates performing tasks that involve potential exposure participate in the proper training prior to performing such tasks.
Ensure that adequate supplies of protective equipment are on hand and readily available to associates who might be exposed to blood or body fluids.
Monitor nursing associates to ensure that they are following established safety regulations in the use of equipment and supplies.
Ensure that nursing service work areas are maintained in a clean and sanitary manner.
Ensure that all nursing associates follow an appropriate dress code for their particular area of service.
Ensure that all resident care rooms, treatment areas, etc. are maintained in a clean, safe, and sanitary manner.
Ensure that nursing associates 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 residents and associates.
Ensure that nursing associates 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 when lifting or moving residents.
Report missing/illegible labels and MSDSs to the safety coordinator or designated person.

E q u i p m e n t a n d Su p p l y F u n c t i o n s
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 residents.
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 equipment.
Develop and implement procedures that ensure nursing supplies are used in an efficient manner to avoid waste.
Ensure that appropriate MSDS are on file for hazardous chemicals used in the nursing department.

C a r e P l a n a n d A s s e s s m e n t F u n c t i o n s
Assist in the development of preliminary and comprehensive assessments of the nursing needs of each resident.
Ensures a written plan of care for each resident is developed 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 as appropriate.
Assist the Resident Assessment/Care Plan Coordinator in the scheduling of care plans and assessments to be presented and discussed at each committee meeting.
Ensure that all personnel involved in providing care to the residents are aware of the resident’s care plan. Ensure that nursing personnel refers 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.
Assist the Resident Assessment/Care Plan Coordinator in planning, scheduling, and revising the MDS, including the implementation of CAA’s and Triggers.
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 advanced directives.

B u d g e t i n g a n d P l a n n i n g F u n c t i o n s
Prepare and plan the nursing department’s budget and submit to the Administrator for review and approval.
Keep abreast of economic conditions and recommend to the Administrator adjustments in nursing that ensure the continued ability to provide quality care.

R e s i d e n t R i gh t s R e s p o n s i b i l i t i e s
Maintain the confidentiality of all resident care 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 associates knock before entering the resident’s room.
Ensure that all nursing associates 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 an action plan to resolve the issue. Maintain a written record of the resolution and status updates.
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 associates honor the resident’s refusal of treatment requests. 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.

W o r k i n g C o n d i t i o n s
Works in office area as well as throughout the facility.
Moves intermittently during working hours.Is subject to frequent interruptions
Is involved with residents, associates, visitors, family members, government agency personnel, etc. under all conditions and circumstances.Is subject to hostile and emotionally upset residents, family members, associates, and visitors.
Communicate with the medical staff, nursing associates, and other department supervisors.
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 education programs.
Is subject to injury from falls, burns from equipment, odors, etc., throughout the workday, as well as to reactions from dust, plastics, synthetics, disinfectants, tobacco smoke, and other potential contaminants.
Is subject to exposure to infectious waste, disease, and conditions including TB, 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 resident’s needs.

S t a f f D e v e l o p m e n t F u n c t i o n s
Direct the Nurse Educator in the planning, conducting, and scheduling of timely in-service training classes to ensure a well-educated nursing services department. Training would include OSHA, CDC, TB management and blood borne pathogens as well as other in-service training required by state/federal regulations.
Direct the development of and maintain an effective orientation program that promotes the retention of associates.
Assist in providing leadership training for Nurse Supervisors/Charge Nurses.
Encourage the professional development of supervisory staff and schedule times as appropriate.
Assist in developing and revising the nursing assistant training curriculum used by the facility, as appropriate.
JOB REQUIREMENTS: E d u c a t i o n
Must possess, as a minimum, a Nursing Degree (RN) from an accredited college, university or nursing school.
E x p e r i e n c e
Must have, as a minimum, three to five (3-5) years of experience as Director of Nursing in along-term care facility.
Must have, as a minimum, 6 months experience in geriatric nursingpractices.S p e c i f i c R e q u i r e m e n t s
Must possess a current, unencumbered, active license to practice as a Registered Nurse in the state in which they are working.
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 agency 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 long-term care.
Must possess leadership and supervisory ability and the willingness to work harmoniously with and supervise others.
Must have 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 resident’s condition.
Must not pose a threat to the health or safety of other individuals in the facility.
P h y s i c a l a n d S e n s o r y R e q u i r e m e n t s ( wi t h o r wi t h o u t t h e a i d o f m e c h a n i c a l d e v i c e s )
Must be able to move continuously throughout the workday.
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, families, personnel, and support agencies.
Must meet the general health requirements set forth by the policies of this facility, which may 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 10pounds to a minimum height of 5 feet and be able to push, pull, move, and/or carry such weight a minimum distance of 5 feet.
May be necessary to assist in the evacuation of residents during emergency situations.
Sitting: 1-2 hour per 8-hour shift. Alternates frequently to standing and walking.
Standing: 4-5 hours per 8-hour shift. Alternates frequently to walking and occasionally to sitting.
Walking: 2-3 hours per 8 hour shift. Alternates frequently to standing and occasionally to sitting.
Lifting:1-10 lbs.Continuously11-20 lbs.Occasionally21-35 lbs.Rarely36-50 lbs.Rarely51-75 lbs.Rarely> 75 lbs.Rarely
Carrying:1-10 lbs.Continuously11-20 lbs.Rarely21-35 lbs.Rarely
Fine Manipulation:Continuously(Frequency: Never=0%; Rarely=1-10%; Occasionally=11=33%; Frequently = 34-66%; Continuously = 67%+)

Equal Employment Opportunity/Affirmative Action Employer and do not discriminate on the basis of race, color, age, sex, religion, veteran’s status, national origin, disability, marital status, or any other characteristic protected by law.

Company Info

Company Name
Aspire of Gowrie

Contact Name
Tara Behrendsen




1808 Main Street
Gowrie, IA 50543