Director of Nursing

POSITION SUMMARY

The Director of Nursing (DON) is the senior clinical leader responsible for the overall quality, safety, compliance, staffing, and performance of nursing services within the skilled nursing facility. The DON establishes clinical standards, directs nursing operations, maintains continuous survey readiness, and ensures residents receive person‑centered care consistent with federal and state requirements, professional standards, physician orders, facility policies, and the organization’s mission.

The DON is expected to maintain a visible leadership presence, promptly address clinical and regulatory risk, and build a culture of accountability, service excellence, and continuous improvement.

• Direct, organize, and evaluate all nursing services; establish clear clinical expectations and ensure consistent leadership coverage across all shifts, weekends, holidays, and emergencies.
• Conduct regular clinical and environmental rounds to evaluate resident conditions, staff performance, infection‑control practices, documentation, care‑plan implementation, and resident safety.
• Ensure changes in condition, adverse events, and significant clinical findings are promptly assessed, treated, documented, communicated, and escalated to physicians, responsible parties, and organizational leadership as required.
• Ensure residents receive care consistent with their assessments, diagnoses, preferences, physician orders, and comprehensive plans of care, while protecting dignity, choice, privacy, autonomy, and quality of life.
• Monitor and improve high‑risk clinical areas, including falls, pressure injuries, wounds, weight loss, dehydration, infection, pain, medication management, behavioral health, psychotropic medication use, restraints, elopement, incontinence, restorative nursing, hospital transfers, and readmissions.
• Ensure incidents, accidents, medication errors, injuries, allegations, and adverse outcomes receive immediate clinical response, complete investigation, root‑cause analysis, required reporting, corrective action, and follow‑up monitoring.
• Maintain continuous compliance with CMS, state licensing, professional practice, mandatory reporting, resident‑rights, abuse‑prevention, and other applicable requirements; remain prepared for surveys, complaint investigations, and audits at all times.
• Lead or support survey response, plans of correction, directed plans, and regulatory follow‑up; ensure corrective actions are implemented, sustained, audited, and incorporated into the Quality Assurance and Performance Improvement program.
• Provide executive clinical oversight of infection prevention and control, including surveillance, isolation practices, hand hygiene, personal protective equipment, outbreak response, immunization, antibiotic stewardship, and required public‑health reporting.
• Oversee the accuracy, completeness, timeliness, and consistency of nursing documentation, including assessments, physician orders, medication and treatment records, nursing notes, care plans, and change‑of‑condition documentation.
• Collaborate with the MDS Coordinator and interdisciplinary team to support accurate assessments, care planning, reimbursement documentation, skilled coverage, medical necessity, quality measures, and Patient‑Driven Payment Model performance.
• Support a responsive short‑term rehabilitation and post‑acute model by coordinating with admissions, rehabilitation, social services, physicians, case managers, and payers on clinical acceptance, timely treatment, length of stay, discharge planning, readmission reduction, and safe transitions of care.
• Ensure adequate numbers of qualified nursing personnel are scheduled based on census, acuity, competencies, resident needs, and regulatory requirements; review call‑offs, overtime, registry use, productivity, skill mix, and staffing patterns.
• Partner with Human Resources and nursing education leadership on recruitment, orientation, competency validation, retention, succession planning, performance evaluation, attendance, corrective action, and employee development.
• Ensure nursing personnel maintain current licenses, certifications,…