Director of Nursing

POSITION:

The Director of Nursing assumes full time administrative authority, responsibility and accountability for the delivery of nursing services in the facility. Manages facility employees in the provision of care and services according to professional standards of nursing practice, consistent with facility philosophy of care and county, state and federal laws and regulations. Develops and implements policy and procedures consistent with current law and best nursing practices. In collaboration with the Administrator, allocates department resources in an efficient and economic manner to enable each resident to attain or maintain the highest practicable physical, mental, and psycho-social well-being. Collaborates with other departments, professionals, consultants, and organizations, including government agencies and advocacy groups, to develop support and coordination of resident care, related administrative functions and to represent the interests of the facility.

QUALIFICATIONS/REQUIREMENTS

* Graduate of an accredited school of nursing
* Current, active license as a Registered Nurse
* 3 years professional nursing experience in long term care setting
* 1 year administrative experience in nursing service administration or comparable management experience

ESSENTIAL JOB FUNCTIONS:

* Assist in the development and maintain nursing policies and procedures that reflect current standards of nursing practice and facility philosophy of care consistent with county, state and federal laws and regulations, as applicable. Communicate and interpret policies and procedures to nursing staff. Monitor practice for effective implementation
* Review 24 hour report from every unit daily to ensure timely, effective responses to significant changes in condition, transfers, discharges, or use of physical or chemical restraints, unexplained injuries, potential abuse or neglect, medication errors, loss of resident property, any evidence or resident or family dissatisfaction. Gather and analyze facts, assess situations, develop and implement appropriate actions to investigate, to notify appropriate parties, to resolve issues and to record facts properly. Keep Administrator informed of findings and results
* Communicate directly with residents, families, medical staff, nursing staff, interdisciplinary team members and Department Heads to coordinate care and services, improve organization and implementation of plans of care, to maintain quality of care, quality of life and a homelike environment for all residents
* Establish and implements infection control program designed to provide a safe, sanitary and comfortable environment and to prevent the development and transmission of disease and infection. Review infection control surveillance reports to identify trends and to develop effective actions to control and prevent infections in the facility. Include infection control information and statistics in Quality Assessment and Assurance Committee report
* Monitor the provision of care and services to residents on all shifts and evaluates regulatory compliance efforts through daily rounds to observe care on units, to review records and to interview staff members, residents, families and other interested parties. Evaluate the findings of compliance rounds conducted by designated facility staff on a daily basis. Design, implement and evaluate actions to continuously improve quality
* Participate in monthly Medicare Triple Check to ensure Medicare Part A and Part B are billed accurately with charges captured in a timely manner for all allowable costs and that the facility has acquired the clinical documentation to support charges for services to Medicare be in compliance under the Medicare program and in accordance with the Medicare Triple Check Compliance Monitoring Policy, Procedure and Guidelines.
* Conduct quality assessment and assurance activities, including regulatory compliance rounds, in all departments to monitor performance and to continuously improve quality. Develop program to gather and analyze data for trends and to institute actions to resolve problems promptly
* Evaluate effectiveness of actions. Participate as member of Quality Assessment and Assurance Committee with the Medical Director and at least three other facility staff members. Report and make recommendations to Quality Assessment and Assurance Committee
* Supervise development of in-service education programs designed to equip nursing staff with sufficient knowledge and skills to provide nursing and nursing related services to each resident to attain or maintain the highest practicable physical, mental and psycho social well-being and to perform the essential functions of their jobs satisfactorily
* Assist Administrator in preparation for long term care survey. Actively participate in long term care survey process by instructing staff in matters of conduct and disclosure, maintaining a presence at all times surveyors are on-site and directing the timely collection of information required by the survey team. Demonstrate concern for identified problems and undertake corrective action while survey is in progress if appropriate. Gather and present supplemental documentation to avoid potential deficiencies. Collaborate with Administrator to develop responses to survey report as needed
* Collaborate with physicians, consultants, facility agencies and institutions to improve quality of services and to resolve identified problems
* Consult with Administrator daily about resident status, census, budget, and personnel and other relevant issues
* Participate in the development of the nursing department budget. Provide relevant financial information to Administrator regarding department financial needs and status
* Over all responsibility for the Admission process: Review and approve admissions, be aware of acuity needs of current residents and impact of admissions, monitor staffing needs/abilities in relationship to admissions
* Develop and maintain a good working relationship with hospital discharge planners to facilitate admissions and maintain census
* Over all responsibility for the Medicare/PPS program: Determine eligibility for coverage, monitor and approve admissions, case management (utilization review), timely response to requests for billing related information from Fiscal Intermediary and Service Center A/R department, maintain close working relationship with Rehab Department personnel, monitor daily documentation, monitor the MDS assessment process in relationship to A/R process, establish guidelines for management of acuity (staffing needs), and provide resident and family education regarding benefits (as needed) of the Medicare/PPS program to maintain the integrity of the Medicare Program
* Develop staffing plans that assure sufficient numbers of qualified, competent nursing staff to meet direct care needs, conduct assessments as required, develop plans of care, evaluate residents' responses to interventions and document clinical records effectively in compliance with county, state and federal laws and regulations, as applicable. Recommend number and type of nursing personnel necessary to provide care and to maintain compliance with facility mission and regulations
* Hire and retain qualified competent nursing staff to provide nursing and nursing related services to attain or maintain the highest practicable physical, mental and psycho social well-being of each resident. Conduct interviews, provide regular performance reviews, take appropriate job actions, review job actions taken by subordinates to assure that staff meet qualification and performance standards and can perform all essential functions of the job
* Ensure 24 hour availability as nursing administration resource by providing on-call and telephone access or designating an alternative, qualified nursing staff member to do so
* Maintain current skills and knowledge through continuing education. Apply information to job responsibilities