Director of Nursing

POSITION TITLE:     Director of Nursing (DON)/Registered Nurse (RN)  

HOURS:     40 hours/week and on-call  

REPORTS TO:     Executive Director 

Schedule: Monday- Friday (Weekend as needed)

JOB SUMMARY: 

The role of the RN is to ensure that the health and safety of all clients are met through assessments and reassessments of the clients, development and implementation of appropriate service plans and plans of care, monitoring of clients’ services, supervision of home care staff and on-going training of home care staff and determining they are competent prior to delegating tasks to them.  The RN will ensure that staff is trained in nursing procedures and policies which are current and up to date. The RN will also ensure that the home care services are in compliance with current regulations and standards.  Must be able to relate professionally with clients, staff and family members, display a positive work attitude and be able to work as a team with other staff members.   

EMPLOYMENT RELATIONSHIP:   

This position is an “at will” position and the employee and employer are free to sever the relationship at any time with or without cause. A minimum of 30-days notice of the intent to resign is requested for this position.  

POSITION SPECIFICATIONS: 

• Graduate of an accredited school of nursing.  Must be registered and licensed with the State of Minnesota as a RN, and must maintain current unencumbered license with the Board of Nursing. Bachelor’s degree preferred.  

• At least 2 year(s) experience in home care or home health care, assisted living and/or long term care setting.  

• Working knowledge of the state requirements for the Comprehensive Home Care license and Housing with Services settings. 

• Excellent judgment and decision-making abilities and problem-solving skills and the ability to work independently. 

• Flexibility in dealing with changing situations. 

• Ability to use computers and electronic records.  

• Ability to effectively communicate in English both verbally and in writing. 

• The ability to deal tactfully and use good communication and customer service skills with clients and their families.  

OTHER REQUIREMENTS: 

• Must receive a “not disqualified” criminal background result from Department of Human Services and may not be on the OIG exclusions list. 

• Must be screened for TB. 

• Must have reliable transportation as this position requires some travel. 

• Must be able to use company-issued cell phone for calls, text and web-based applications.  

RESPONSIBILITIES: 

• Completes initial, face to face comprehensive assessment of prospective/new clients and develop a proposed service plan. The assessment must be completed within five days of initiation of our services, and prior to the initiation of any delegated nursing tasks.  

• Monitors and reassess clients no more than 14 days after initiation of services. Thereafter, monitors and reassesses client as needed based on changes in the clients’ needs, with the monitoring and reassessment not to exceed 90 days from the date of the previous monitoring/reassessment.  

• Develops, reviews and implements service plans with all new clients.  Reviews and revises service plan as needed due to changes in clients’ needs and a minimum of once every 12 months. The RN will review any needed changes to the service plan with the client and/or the client’s representative. 

• Assures clients have up-to-date care plans that address their needs and preferences, including interventions to address any areas of vulnerability and individualized medication management or treatment or therapy management plans.  Reassesses the client and modifies the service plan if necessary whenever the client has a fall or other incident, whenever there is a significant change in the client’s condition or if the client or the client’s representative requests a change in services.   

• Responsible for educating clients and clients’ representatives about advance directives, medications, safety of side rails or assistive devices, potential hazards in the home and other relevant information. 

• Monitors and maintains client’s clinical chart and clinical progress notes. 

• Communicates with physicians and other personnel (e.g., case manager or care coordinator) regarding changes in client’s needs or conditions. 

• Facilitates coordination of client’s home care services with other service providers, such as hospice, and transitions to the hospital or nursing home. 

• For any client receiving assistance with medications, the RN is responsible for medication management services identified in the individualized plan, such as setting up or ordering medications and as well as any necessary follow-up with physicians regarding medications and/or medical conditions. 

• Assures all physicians orders are signed and implemented on a timely basis consistent with the client’s needs and condition.  

• Assures that proper systems, policies and procedures are developed and implemented correctly by licensed and unlicensed staff regarding the storage, set up, administration and disposal of medications, including systems to control controlled medications. 

• Assures that clients’ medication records are up to date, that medication administration procedures are followed properly, investigates any errors and issues with staff, and implements corrective action plans as needed.  

• Reviews each client’s medication record regularly for consistency with medication orders and with agency documentation policies. 

• Communicates in client’s record any information that staff needs to know and reviews staff communications (written, voice mail or other) on a timely basis each work day. 

• Documents disposal of medication per our agency procedure and the client’s individualized medication management plan. 

• Provides direct supervision of new licensed and unlicensed staff within 30 days of date the staff person begins work and thereafter provides direct supervision on a schedule consistent with the staff person’s experience and performance to assure that procedures are followed accurately and that the client’s needs are being met.   

• Directly supervises LPNs’ and unlicensed staff’s performance of delegated nursing services.   Conducts evaluation of staff performance of delegated nursing services in coordination with the home care director through appropriate documentation and consistent with agency personnel policies for performance reviews.  

• Re-train or discipline staff as needed for non-compliance with job performance or agency policies and procedures. 

• Works as a team player with all members of the client’s care team. 

• Is responsible for implementing the agency’s infection control plan, universal precautions, and TB prevention plan, and for implementing and documenting TB screening of home care staff and other vaccinations. 

• Works with other management staff to orient new staff members to the organization’s policies and procedures.   

• Provides all new unlicensed home care staff with training required in the home care law and training on all delegated nursing tasks that the staff will perform. Determines the staff’s competency to provide all delegated tasks according to the procedures for the client. Develops and assures that all staff has at least 8 hours of in-service training on required topics for every 12 months of work.  

• Develops and maintains a system to track the training and competencies of all unlicensed staff, including all delegated tasks to be performed and provides continuing education for all staff and documents such training to assure compliance with state, federal and local regulations.   

• Assures that each home care staff person is oriented to the individual needs of each client the person will serve and that staff clearly understands and follows all client care procedures. Assures that changes to the plan of care are communicated and understood by staff.  

• Addresses client and family concerns or complaints to the extent possible and follows up with appropriate staff to resolve the issue. Document complaints and report complaints to the Home Care Director.  

• Complete and close client charts upon discharge or death.  

• Creates the service schedule and assignments for licensed and unlicensed staff and assists other staff with daily responsibilities as needed.  

• Completes all required paperwork in a timely and legible manner.  

• Is flexible and willing to adapt to changes in our program as they occur to respond to the market 

• Promotes a positive, team approach and a healthy work environment. 

• Is available for on-call medical questions and/or emergencies via phone as assigned. On-call duty may require the RN to come to the facility to handle a medical emergency.  The 24/7 on-call duties are shared by LPN.  

• Assures compliance with regulations and is available for state licensure surveys. 

• Communicates with clients and the client’s representatives regarding changes in the clients’ needs and identifies as early as possible when client’s needs are likely to exceed the services that our home care agency can safely provide; communicates these concerns to the client and the client’s representative both verbally and in writing, and provides assistance to the client in obtaining other needed services.  

• Uses appropriate communication techniques, such as validation or diversion activities, when working with clients with dementia.   

SUPERVISORY RESPONSIBILITIES: 

• Develop, maintain and update as necessary written policies and procedures that govern the daily functions of the agency, consistent with current nursing standards and evidence-based practice. Provide clinical leadership to licensed staff.  

• Establish the agency’s policies regarding the types of services we will provide, the geographical area where our services will be available, the types of reimbursement our agency can accept and other policies regarding the scope of our services.  

• Develop, implement and oversee our agency’s quality management and quality improvement program, analyze resulting data and make changes necessary to improve client outcomes and agency operations.  

• Develop relationships with other service providers, such as physicians, health plans, pharmacies, clinics, hospice providers, therapy services and establish protocols for coordinating their services for clients receiving our home care service and to ensure smooth transitions for clients who may need hospitalization or a move to a nursing home or another setting.  

• Periodically audit client records and supervise staff to assure that staff are following agency procedures, are providing quality services and are maintaining client records according to agency policy and state home care requirements.  

• Provides direct supervision of new RNs and LPNs within 30 days of date the staff person begins work and thereafter provides direct supervision on a schedule consistent with the RN’s/LPN’s experience. Completes the RN’s annual performance review. The RN/Home Care Director will coordinate with the RN regarding supervision and performance reviews of the LPNs.  

• Is responsible for overseeing the implementation of the agency’s infection control plan and TB prevention plan. 

• Orients new RNs and LPNs, and other Home Care staff to the organization’s policies and procedures.   

• Promotes a positive, team approach and a healthy work environment. 

• Is available for on-call medical questions and/or emergencies via phone and to fill in for the LPN/RN due to illness or vacation. 

• Assures compliance with regulations and is available for state licensure surveys. 

• Responsible for ensuring that any issues identified in a licensure survey are appropriately addressed, either though changes in policies, procedures, training, etc. Responsible for contacting MDH regarding any requests for reconsideration or appeals of survey findings that appear to be undeserved or inappropriate. 

• Responsible for compliance with the reporting requirements of the Vulnerable Adult Act and the Board of Nursing, including the investigation and immediate reporting of incidents of suspected client maltreatment to the Common Entry Point and the documentation and reporting of the findings of such investigations.  

• Responsible for investigating complaints about our services submitted by clients, clients’ representatives or others and identifying steps to address the complaint and communication with the clients and the clients’ representatives about our agency’s actions to resolve the issue.  

• Wears appropriate professional apparel and name tag at all times and maintain good personal hygiene and grooming.  

WORKING CONDITIONS: 

• Primary responsibilities will be conducted in client homes and in housing-with-services establishments in clean, well-lit, climate-controlled areas such as client homes, hallways, work rooms, client dining area and meeting rooms. 

• Exposure to body fluids, infection, odors and behavior of clients that may be aggressive, combative or demanding. 

• The noise is usually moderate. 

• Exposure to chemical and respiratory hazards is possible. 

• Travel to clients’ homes, nursing homes, other assisted living facilities and some travel to meetings and seminars/training may be required. 

PHYSICAL DEMANDS: 

• Must be able to move throughout the work day. 

• Must have adequate vision and hearing to meet the requirements of this position and to perform administrative requirements. 

• While performing duties of this job, employee is regularly required to use hands and fingers to examine clients, handle or feel objects, tools, or controls. In addition, the job requires walking, bending, stooping, pushing, pulling, kneeling, reaching overhead and lifting up to 50 pounds . 

• Must be able to cope with the mental and emotional stress of the position.